tag:blogger.com,1999:blog-26666124.post8220695069354659895..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: My Shrink Rap Life vs. My Real Psychiatry LifeUnknownnoreply@blogger.comBlogger48125tag:blogger.com,1999:blog-26666124.post-23558429805615174162013-05-19T13:27:57.986-04:002013-05-19T13:27:57.986-04:00Hey Dinah,
visiting after a couple of years away ...Hey Dinah, <br />visiting after a couple of years away from all blogging- related activities ....<br /><br />The first thing that has struck me, reading through the Shrink Rap archives, is that "wow! There are some amazingly rude people out there!", and I have to question why they insist on hanging around if they hate you and everything you stand for so much.<br /><br />As far as this post goes, I guess I fall into the same group of people that you generally see in your practice. That is, I choose to see a psychiatrist, and I can choose which one I see. My issues are the kind that impact on me, not on society in general, so I'm not in line for the involuntary kind of stuff. Which means my relationships with psychiatrists might be skewed positively - I want help with the whole bipolar depression bit, and I believe that a psychiatrist is on my side in that. From many of the comments on this post, as well as others from the last couple of years, it seems that many other patients (or at least the ones online) view psychiatrists as the enemy. And I have to question whether that attitude isn't a big part of the problems that those people might have. If you view a psychiatrist as someone who is there primarily to force bad drugs on you, to engage in power struggles, and to otherwise infringe on your "rights", I'd think that you are going to influence your treatment negatively. Kind of a self-fulfilling prophesy....if you act like an asshole, you should expect to be treated like one....jcathttps://www.blogger.com/profile/03736961961261409218noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-46460154170034519612013-04-22T20:36:37.760-04:002013-04-22T20:36:37.760-04:00Actually, Maggie, what you wrote about jumping too...Actually, Maggie, what you wrote about jumping too quickly to diagnoses is exactly the point Dr. Allen Frances was making a few posts ago. Neurosis does deserve to make a comeback, too, but psychiatry has moved away from trying to understand inner conflict, which is a real loss. What often happens is that an excellent explanation is used to eplain increasingly more of everything, until a backlash sets in.<br /><br />And again, welcome back to Shrink Rap.jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-24404559619541562032013-04-22T13:47:16.182-04:002013-04-22T13:47:16.182-04:00I'm sorry Jesse, re-reading my last comment it...I'm sorry Jesse, re-reading my last comment it does look like I was saying that I thought that neurosis and psychosis were the same thing, but I was trying to say the opposite. <br />My personal experience has been with difficult-to-pin-down neurotic disorders. I find it extremely unlikely that I actually have a half-dozen separate neurotic disorders rather than some more cohesive explanation. <br /> <br />There seem to be many people who have similar diagnostic problems with psychotic disorders. There are pretty rampant stories of schizophrenia being diagnosed in any psychotic episode, even without enough information, or with inaccurate information. <br /> <br />I think that the neurosis vs. psychosis dichotomy should have been retained for initial diagnosis, and more specific diagnosis should wait for a broader picture, rather than being rushed into an immediate classification. <br /><br /><br />Dinah, I see your point about the difference between your "real" life and your Shrink Rap life. However, while I've got some pretty significant bones to pick with psychiatry in general, if you asked my psychiatrist, I doubt that's something that would even come to mind. Besides medication, the biggest thing I need is a quiet, predictable environment in which I can remain engrossed in finicky details of my latest sewing or 3D modeling project. I've had to reassure her several times that when I describe my current state as "boring," I really do mean that as a good thing. <br />Having found a psychiatrist I'm happy with, my problems with psychiatry are now limited to more generic issues (and terror at the idea that I may someday move out of the area and have to go through the same hell of finding a decent psychiatrist all over again.)Maggiehttps://www.blogger.com/profile/13276587338037331781noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-13800533816239548532013-04-20T18:53:48.352-04:002013-04-20T18:53:48.352-04:00Dinah and the other Shrink Rappers,
Congratulatio...Dinah and the other Shrink Rappers,<br /><br />Congratulations on the blog reaching its 7th birthday! It's certainly an interesting challenge, blogging on the Internet and being exposed to all sorts of points of view. I've written a bit about this on a blog that I'm starting, and I'd be interested in your thoughts.<br /><br />- <a href="http://psycritic.blogspot.com/2013/04/challenges-of-psychiatry-blogging_20.html" rel="nofollow">Psycritic</a>Psycritichttps://www.blogger.com/profile/05279225254350525266noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-28421098791168703222013-04-18T20:57:03.382-04:002013-04-18T20:57:03.382-04:00Hi Maggie, welcome back to Shrink Rap! Here is a p...Hi Maggie, welcome back to Shrink Rap! Here is a part of Wiki's article on neurosis:<br /><br />"As an illness, neurosis represents a variety of mental disorders in which emotional distress or unconscious conflict is expressed through various physical, physiological, and mental disturbances, which may include physical symptoms (e.g., hysteria). The definitive symptom is anxieties. Neurotic tendencies are common and may manifest themselves as depression, acute or chronic anxiety, obsessive–compulsive tendencies, specific phobias, such as social phobia, arachnophobia or any number of other phobias, and some personality disorders: paranoid, schizotypal, borderline, histrionic, avoidant, dependent and obsessive–compulsive. It has perhaps been most simply defined as a "poor ability to adapt to one's environment, an inability to change one's life patterns, and the inability to develop a richer, more complex, more satisfying personality."[7] Neurosis should not be mistaken for psychosis, which refers to loss of touch with reality, or neuroticism, a fundamental personality trait according to psychological theory.<br /><br />"According to psychoanalytic theory, neuroses may be rooted in ego defense mechanisms, but the two concepts are not synonymous. Defense mechanisms are a normal way of developing and maintaining a consistent sense of self (i.e., an ego), while only those thoughts and behavior patterns that produce difficulties in living should be termed "neuroses"."<br /><br />jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-47254982513621795412013-04-18T20:33:57.206-04:002013-04-18T20:33:57.206-04:00Personally, I think that "neurotic" need...Personally, I think that "neurotic" needs to come back. I dislike the quick jumps to specific diagnosis; it seems to me that it would be more accurate to use "neurotic disorder NOS" or "psychotic disorder NOS" as a starting point. The need to quickly arrive at a specific diagnosis seems like it usually ends up rushing the process and making conclusions without enough information. I think it ends up clinging too tightly to the original conclusion-- arrive at a diagnosis, and then interpret future information based on that diagnosis, rather than taking in the new information. (Obviously that's not universal, but once you've come to a conclusion, it's too easy to use it as a frame or reference, even if you know you didn't have enough time or information initially.)<br />Yes, I'm neurotic. Going beyond that, you end up with a laundry list that adds up to something that ends up sounding nonsensical. I feel like the attempts to name everything that seems like it might be descriptive ends up just making a blurry mess. "Neurotic" is technically less descriptive, but I still think it's more accurate.Maggiehttps://www.blogger.com/profile/13276587338037331781noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-71141262477150047682013-04-06T19:45:46.595-04:002013-04-06T19:45:46.595-04:00Dinah, the biggest problem with you is that you do...Dinah, the biggest problem with you is that you don't listen and you deligitimize readers. You assume , or at least act/write as if, your opinion is more valid then those of us who have experienced these things. And then you don't listen when we tell you about that. To my mind, that is the single worst characterstistic a shrink could ever have. Clink and Roy don't do this, so you don't see these sorts of posts on their posts. It's that simple.Lnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-26347169780011281222013-04-05T22:05:32.654-04:002013-04-05T22:05:32.654-04:00Dr. H.
Just curious...perceptual distortions, brai...Dr. H.<br />Just curious...perceptual distortions, brains zaps, Crashing depression as ssri side effects. Horrific or annoying? Guess we needed a middle category bc it's not renal failure, but it's pretty darn serious. I agree, weight gain, forgetting words, weird taste...annoying but usually benefit outweighs. Baz-Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-21010372621460733622013-04-05T21:20:52.056-04:002013-04-05T21:20:52.056-04:00@Anon above and AA, I agree with much of what Dr. ...@Anon above and AA, I agree with much of what Dr. Hassman wrote. Bipolar is diagnosed a lot, and in addition it is the favorite lay diagnosis, especially of kids ("He is SO bipolar..."). Curiously, when I was in training, the popular diagnosis was neurotic. "He's SO neurotic." You don't hear that anymore and almost no one even knows what it means.<br /><br />My own practice is completely voluntary. If a patient wants to go off his medications, or not follow my recommendations, that is his choice. I have never stopped working with a patient who wanted to continue to see me, and certainly would not make taking my medication suggestions as reason for terminating treatment.<br /><br />I always try to suggest what I think is in my patients' best interests. I often suggest consultation with others.<br /><br />I very much agree with what Dr. Hassman picked up and responded to in regard to "horrific" side effects. Often there are side effects, but going crazy and doing very destructive things to one's self or others also has consequences, frequently vastly worse than the side effects that led to it.<br /><br />For instance, it is not uncommon for a student to go off his medication and set off a depression/mania that has him out of school for a year or more. And this occurs when in fact there were no side effects.<br /><br />One "medication" that it is often hard to get a patient to give up is alcohol. The terrible effects of alcoholic drinking combined with mood disorders is well known.<br /><br />I hope this answers your questions. I think most of the psychiatrists I know would say the same thing.<br /><br />jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-84509271051141662982013-04-05T11:30:44.215-04:002013-04-05T11:30:44.215-04:00As part of the problem with some examples in treat...As part of the problem with some examples in treatment noncompliance, I have never been a fan of conditional care demands, that meaning court ordered care. Which seems to involve more often schizophrenia or bipolar as diagnoses. Treatment has to be framed as voluntary as outpatient services go, even if the patient is not 100% invested, at least a core 50% is hoped.<br /><br />Outpatient care is more convoluted these days per the role of courts, employer mandates, and even family somewhat coercive with demanding people be in care. Unfortunately, insight and judgment can't be medicated into place, and people sometimes just don't want to admit to a problem/disorder.<br /><br />Also unfortunately there are more side effect profile issues with antipsychotics and antimanics (note I don't call them mood stabilizers because as far as I am concerned, there is no drug that stabilizes bipolar disorder, just either mania or depression). So, with the history of the older established drugs like Lithium, Tegretol, Depakote, and the antipsychotics like Haldol, thorazine, Mellaril, Navane et al, I was trained to be cautious prescribing because of the added risks. Why colleagues mistakenly just assumed new meds in the same class of drugs would be easier and need less monitoring was at least foolish to assume, if not reckless.<br /><br />And, I still believe to this day that antipsychotics prescribed for NON psychotic illnesses should NOT be assumed needed for indefinite periods of time. At least not at the higher dosages first prescribed when the patient presented with acute symptoms. I cringe to hear colleagues tell patients "you need to be on this the rest of your life" and never try to lower dosages when patients are stable and making non pharmacological efforts to maintain stability while being compliant with med use.<br /><br />Also, Bipolar Disorder is overdiagnosed to this day. I again cringe to see what DSM 5 has the audacity to claim are further presentations to label Bipolar.<br /><br />Unfortunately, there are not medications for immaturity, low frustration tolerance, and just poor interpersonal skills. But, docs don't get reimbursed for diagnoses that aren't simple 296 codes, true, colleagues?<br /><br />So, hope the comment is of value to AA/anonymous. My final comment to offer in this thread is this to patients: do you also come to your PCP/somatic providers and demand full negotiation with care interventions for non psychiatric treatment? Not saying you can't in some instances, but, I get the sense that some who write here think that patients call all the shots in care interventions, but, as a collaborative, it is finding middle ground if there is disagreement in the treatment process.<br /><br />just my opinion. Have a nice weekend.Joel Hassman, MDhttp://cantmedicatelife.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-58069934059147923222013-04-05T09:47:52.342-04:002013-04-05T09:47:52.342-04:00Dr. Hassman, thank you for your response. I great...Dr. Hassman, thank you for your response. I greatly appreciate the fact that you understand the issues in keeping people on meds when they find the side effects intolerable.<br /><br />Sorry I wasn't clear in my previous post but I am also interested in how you and your colleagues would do if one of your patients with schizophrenia or bipolar disorder wanted to go off of their meds. Here is the reason I am asking this question.<br /><br />I understand what Dinah is saying about making sure her goals are the patients' goals. But in my opinion, the story changes when it comes to patients who have schizophrenia and bipolar disorder. By the way, I am stating that in general terms as this not directed anyone specifically. Again, if you chose not to answer, that is fine.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-20319622748212026752013-04-05T03:24:42.758-04:002013-04-05T03:24:42.758-04:00As an informed patient, the only ways in which psy...As an informed patient, the only ways in which psychiatry may affect me personally are forced medication and forced hospitalisation. I won't rehash these topics here now. <br /><br />As a thinker, I'm more alarmed by the philosophical frivolity of current psychiatry. Psychiatrists wish to replace priests as exorcists, but their ways are neither more nor less effective, comforting, or scientific than those of the healers of the past ages. On the contrary, since we live in the age of scientists, scientists have tested the alleged effectiveness of particular established treatments, and found them seriously lacking, so that certain modern treatments could be said to be obviously unscientific in a way that past treatments were not known to be until recently. <br /><br />Also, in a distinctly unscientific fashion, psychiatry makes grand ontological claims about issues its practitioners know very little about. It depends, for its validity, on vague concepts that can be expanded to accommodate any data — its ethos, its Core Theory, can't be falsified even in principle. <br /><br />For instance, I can't say that if the intrusive voice in my head told me something I couldn't possibly know or guess then that would disprove the idea it is somehow part of me. A properly trained psychiatrist would simply respond that if I seemed to experience such an impossible thing, this would just be further evidence I'm suffering from delusions. Similarly, if I perceive that my emotions are being controlled, that means I'm suffering from delusions of control. If I said I've experienced my body being controlled like a puppet, that's just a delusion as well, never mind that I was the person who experienced it, not my psychiatrist, so I'm supposed to be the one who knows what he is talking about on that issue. But no, in psychiatry, experience becomes meaningless and theoretical notions whose limits no one understands reign supreme. <br /><br />Or if the psychiatrist doesn't expand the vague concept of delusion to accommodate that sort of thing, he will expand the vague concept of the unconscious mind to accommodate it instead: so it was just my unconscious mind that made me walk around like a rag doll, never mind this sort of thing is supposed to be impossible.<br /><br />At no point, would I have the opportunity to object with "wait, did your theory of the unconscious mind predict (i.e. allow for) that sort of thing, and on what basis other than circular reasoning?" or "hey, wait a second, if anything can be delusion or hallucination, then what priviliges the conventional worldview above all others?"<br /><br />The three concepts, delusion, the unconscious mind, hallucination, can, in the wrong hands, be used to account for absolutely everything that can be imagined to happen or that will happen even if no one can imagine it. It doesn't matter what really happens in the real world. Regardless of actual facts, those three concepts can be expanded to explain away anything at all. <br /><br />Nasty people call that sort of thing pseudo-science, because any hypothesis which is unfalsifiable in principle cannot be scientific. Modern psychiatry is no different from Dark Age Christianity, with its ad hoc "God did it" explanation for every strange phenomenon. Both have their holy trinity which explains all conceivable phenomena in this world inasmuch as it falls beyond the confines of traditional science. If you object, you are either possessed by a demon or "lack insight".mctpshttp://mctps.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-80051858161527345662013-04-04T15:22:58.704-04:002013-04-04T15:22:58.704-04:00I can only speak for myself, but if a patient is h...I can only speak for myself, but if a patient is having a side effect that causes disruption or impairment in function that rivals the symptoms that got the patient on the medication in the first place, then the patient has to speak up and consider other options.<br /><br />Different medication, begin therapy if not already in it, take stock in lifestyle and choices and then reframe and change, and be invested in care.<br /><br />It is a multifactorial process to illness and treatment. Any doctor who would not consider a change if the medication was causing problems, well, there better be a good reason that trumps patient comfort and continued compliance.<br /><br />I hope that gives some perspective to one physician's opinion.<br /><br />By the by, perhaps unrelated to the post and thread, but the issue with patients not being treated at outpatient sites with chemotherapy for cancer, well, once the partisan rhetoric and shill special interest media reporting has subsided, if the truth is that sequester cuts are a primary cause, you all better think again if you think that Abomination Care, ie PPACA, is good for America.<br /><br />Because if the politicians can get away with chipping away with the elderly who are terminally ill, you really think mental health care populations are safe?<br /><br />Again, not cynical, but hardened reality and ugly history as guide!Joel Hassman, MDhttp://cantmedicatelife.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-12306917534321804022013-04-04T15:00:37.710-04:002013-04-04T15:00:37.710-04:00Dr Hassman, this is in response to this exert from...Dr Hassman, this is in response to this exert from your post, "Weight gain, fatigue, headaches, sedation, troubles with cognition, are all unpleasant and need addressed, but are not horrific side effects as usually presented."<br /><br />Well, I think it all depends on perspective. True, something like acute liver failure sounds worse than trouble with cognition. But as someone who was already cognitively compromised before starting psych meds for various reasons, experiencing that side effect made life h-ll for me.<br /><br />I guess since I feel it is the patient who should decided what is horrific for them, maybe I should restate my point to ask, what would you do if that person wanted to get off of meds? Maybe he/she isn't experiencing any side effects but is simply concerned about being on them long term. Or they are experiencing problems you don't think are a big deal but they have a different perspective.<br /><br />By the way, thank you for being willing to discuss this issue.<br /><br />AAAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-666661540918153362013-04-04T12:54:10.260-04:002013-04-04T12:54:10.260-04:00There are several dynamics that have forced psychi...There are several dynamics that have forced psychiatry into the inappropriate role it has morphed into now, but the one I see as the largest and most pervasive really can be summed up as "hear the lie enough and it becomes the truth".<br /><br />It is concerning, disruptive, and annoying when patients come in and basically demand meds as intervention number 1, and too often not interested in interventions 2 or more, but, when you hear providers/clinicians just echo this false notion of meds only, meds first, more meds, and "oh, you have a biochemical imbalance", what has done this to providers? The lie. And when few if none in our profession refuse to speak out to argue otherwise, well, you know the adage about silence too.<br /><br />As an aside, anonymous above writes about "horrific side effects", that is too general for me to comment on. Horrific to me means dystonias, acute liver or renal failure, Neuroleptic Malignant syndrome, entrenched GI upset or emesis, pancreatitis, exacerbated polycystic ovarian syndrome, acute withdrawal with high dose benzos.<br /><br />Weight gain, fatigue, headaches, sedation, troubles with cognition, are all unpleasant and need addressed, but are not horrific side effects as usually presented.<br /><br />If you are interested in my perspective, please give examples of what is "horrific".Joel Hassman, MDhttp://cantmedicatelife.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-72923206657192975792013-04-04T05:18:07.338-04:002013-04-04T05:18:07.338-04:00Jesse,
I too wanted to thank you and Dinah for en...Jesse,<br /><br />I too wanted to thank you and Dinah for engaging with commentators. Totally agree with everything that Nathan said.<br /><br />Your post about there not being any surprise regarding notes made me recall a situation with my psychiatrist in which the issue of a med side effect came up. He stated that I had said a few things that absolutely stunned me as I recalled saying something completely different. Of course, no one is perfect but for various reasons that are too long to get into, i found this very troubling.<br /><br />And speaking of communicating about treatment, near the end of my sessions, I did express some negative comments. I did try very hard to be respectful but all that resulted was the guy starting to ask about my mood which of course, completely stopped me from saying anything else and made me very careful in anything else I said.<br /><br />I felt this was a perfect example of many of your colleagues using complaints by patients as evidence that they had a disorder when there was nothing of the kind. Nathan's situation in which he got additional diagnosis' is a perfect example of this.<br /><br />On a different note, after watching the Dr. Oz show on the dangers of antidepressants yesterday, I am beginning to think there should be anti primary care doctor movement. Of course, I am being facetious but I am just as outraged they are over prescribing these drugs as I feel psychiatry is. And in some ways, I feel it is more outrageous because I am greatly concerned that many physical diagnosis' may be misdiagnosed as psych issues just because the doctor can't take the time to figure out what is wrong. And I am sorry, blaming the insurance companies is a cop out reason.<br /><br />Finally, I am curious as how you, Dinah, and other psychiatrists who post on this blog would deal with a situation where someone who has schizophrenia or bipolar disorder wanted to go off their meds due to experiencing horrific side effects. Perhaps this could be a future blog entry if you didn't want to currently address the question.<br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-77158088971888310572013-04-03T23:11:09.843-04:002013-04-03T23:11:09.843-04:00@Nathan, what you describe is exactly what Jessa t...@Nathan, what you describe is exactly what Jessa talked about in her paper. Good treatment is an honest dialogue. If any of my patients ever saw my notes they would not be surprised by anything I wrote, or, if they were, it would be that the notes were much softer than anything I had said. There should be no surprises in notes, as the patient is in the room with the doctor and both have heard the same thing. <br /><br />It is very appropriate to write to a doctor to comment on treatment.jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-55898176384549029162013-04-03T22:51:20.397-04:002013-04-03T22:51:20.397-04:00Jesse,
Thanks for the info. I wish I never set my...Jesse,<br /><br />Thanks for the info. I wish I never set my letter, as it made an already bad situation much more entrenched. My goal was to with more clarity than I could when in treatment detail why I found treatment unhelpful. I did this primarily for myself, as verbalizing it in treatment was difficult and I failed to effectively do so before I left. Taking the time to think it through was helpful to bring clarity to me, and I wanted for my sake to express myself with more clarity and freedom than I felt in treatment. My letter also included gratitude and appreciation for components that were helpful. While the letter I got in response was kind, when I accessed my health record later, it told a very different story. I won't get into it here, but I will say it only exasperated feelings of mistrust. So whether or not sending a letter is a boundary violation, I will say that at least one provider considered it a part of treatment and took it as evidence for new diagnoses that were never shared with me directly (only in my notes).<br /><br />I do want to thank you and Dinah for engaging commentators. I know you work hard to understand your patients and the people you engage with online. While I am often critical of your perspectives, that you publish them and actively are thoughtful about responses to them is admirable. Nathannoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-90896817312396834262013-04-03T22:30:11.928-04:002013-04-03T22:30:11.928-04:00@Nathan and Catlover, writing to former psychiatri...@Nathan and Catlover, writing to former psychiatrists about treatment , positive or negative, is not a boundary violation. If you do it it may be useful to the doctor and the feedback may also be useful to you. Both you and they would hopefully learn something.<br /><br />And Catlover, I hope you decide to stick with Shrink Rap.jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-23494679300590350522013-04-03T13:19:22.368-04:002013-04-03T13:19:22.368-04:00catlover:
You are always welcome. You express you...catlover:<br />You are always welcome. You express yourself in a way that is effective, and I have tremendous admiration for the fact that you don't just complain on blogs, you actually go out an enact having your concerns heard by the people who can make changes.<br /><br />The delivery is crucial. Relentless delivery of the same message is tiresome and does nothing to further any effort. <br /><br />We have heard that there are people out there who feel wronged by psychiatry. We right our stuff to express ourselves, to enjoy reasonable dialogue, to learn and educate. There is not any question that we believe that people have been treated disrespectfully, wronged, given medicines that make them worse. I'm just not sure what that does in the big picture of things. I think we're all on the same side, we want patients to be treated respectfully and to get better.<br /><br />"I didn't like what happened to me." is fine. All psychiatrists are evil is not. We help many people, and telling people that medicines are bad as a blanket statement and that diagnoses are bad diminishes those who feel helped by them, or those who felt comforted by having an explanation for their problems. It also diminishes a free society to suggest that no one should take medicines because some people don't like them: we believe people with psychiatric disorders should have the choice of taking medications that may help them or seeking treatment with those who offer help.<br /><br />There's a difference between saying "I had this bad experience with a psychiatrist/medicine/institution and I'm not going that route again" and saying "psychiatry is evil and you shouldn't try it." <br /><br />I do think that part of the reason that those who are helped by psychiatry don't hang out on blogs posting relentlessly is because they've gotten better and they are busy with work/friends/projects/family and those who feel injured hang on to it.<br /><br />So Catlover, I like having you here, do come visit, but if you have better things to do than write about life as a mental patient, go in peace, visit when you feel so inspired, and keep on being a positive force in the world!<br /><br />In friendship,<br />DinahDinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-9790633122509946922013-04-03T12:58:08.953-04:002013-04-03T12:58:08.953-04:00I'm going to clarify that I have no interest i...I'm going to clarify that I have no interest in writing former doctors as a therapeutic exercise. My reason for doing so is to help other people not go thru what I did. I'm going to take Nathan's experience under advisement. I'll see what my current doc and therapist think. My therapist will probably say it would be therapeutic, LOL, isn't that what therapists say? Ha ha, I can imagine the conversation already.<br /><br />I won't post here anymore. I have no interest in stressing someone out. My main purpose was to have doctors think carefully when patients are getting worse in treatment. I've given that message, and because of various topics that came up, I also communicated about the trauma of forced treatment, and what I did in my local area to improve that a little bit. I wrote about rural life, and how guns are an intrinsic part of that, and that I would drop out of treatment rather than be put on a government list. I think I was heard. Time to move on. I'm rapidly losing interest in a lot of this stuff anyway now that I am getting my "normal" life back again. Now I can do stuff, instead of just write about my life as a mental patient. <br /><br />It's a great blog, and I've loved the rubber duckies.<br /><br />catlovernoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-9622390874086727102013-04-03T10:35:52.840-04:002013-04-03T10:35:52.840-04:00Dinah, I do not have a high-profile blog like your...Dinah, I do not have a high-profile blog like yours, so I can't relate to the "shrink rap life," but I definitely relate to your real psychiatry life. Our profession is one of helping, listening, trying things out, and working with people, not against them. I know that some psychiatrists are real wolves - but isn't that true in every profession? I sympathize greatly with people who have experienced bad psychiatry. But I'm often surprised to read the comments on your blog as well referencing coercive therapists who ruined their lives. I would never ever think to coerce a client. Thank you for sharing your insights here. Minneapolis psychiatristhttp://www.allisonholtmd.com/noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-23718629517290855462013-04-03T10:02:54.100-04:002013-04-03T10:02:54.100-04:00I wanted to caution people to not lump everyone wh...I wanted to caution people to not lump everyone who speaks out against psychiatry as crazy anti psychiatry zealots just like we are cautioned not to label psychiatry as totally evil.<br /><br />I personally have experienced psychiatry as adversarial even though it was subtle. When I tapered off of psych meds, I felt like my psychiatrist was waiting for me to fail and did not feel supported by him. As a result, I learned pretty quickly to be careful as to what I said and eventually reduced my visits to practically nothing near the end of my taper. <br /><br />Still, I don't hate psychiatry as there are some very thoughtful ones such as Sandra Steingard, who blog on the Mad In America website.<br /><br />I am also not anti medication as recently, due to horrific insomnia, I tried ambien which unfortunately, was a bleeping disaster. It didn't help that the doctor who prescribed it rushed me through a 15 minute appointment and just threw it at me without any thought. So yes, Dr. Hassman, a perfect example of non psychiatrists doing a horrible job of prescribing meds.<br /><br />My concern is that many people who take meds have not been given fully informed disclosure and that is criminal. But as long as that is occurring, then that is fine.<br /><br />Jessa, I read your paper and it is excellent. You nailed the crux of the issues and maybe if folks who railed against "crazy anti psychiatry" nuts read your paper before they wrote their post, they might have a different perspective. <br /><br />I so related to the section in which you wrote about people being forced to socialize no matter what. It made me think about people with autism who had been hospitalized who felt brutally assaulted when they had to deal with those conditions. <br /><br />For those of you not familiar with autism, many of the folks with the condition (not all) get overloaded very easily sensory wise. That is why being forced to socialize all day would feel like an assault.<br /><br />By the way Jesse, kudos to you for reading the paper and being willing to look at the issues that Jessa raises.<br /><br />AAAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-23349011412710910152013-04-02T22:47:00.017-04:002013-04-02T22:47:00.017-04:00Jesse is a good egg.Jesse is a good egg.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-53907911604287347332013-04-02T21:53:36.819-04:002013-04-02T21:53:36.819-04:00Jessa told us she has a blog so I visited it and r...Jessa told us she has a blog so I visited it and read her college paper which is intriguingly titled "The Parallel Universes of Mental Health Care Professionals and Patients." There is a lot in it and it reminded me of papers on the difficulties in doing psychotherapy and how therapists can unwittingly harm patients.<br /><br />One of many points she makes is to draw attention to how professionals can hurt patients by not answering honestly and by not validating, or even worse denying, correct observations from the patients.<br /><br />This might be an excellent subject for future blogs on Shrink Rap.<br /><br />jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.com