I was gone all day Saturday. I’m the BAR-B-Qist for our community, and it was a beautiful day for it. When I got up Sunday, there was an email from a Statistician with a ton of work for me to do. And then I read the comments and the emails about the comments, and my mood sunk. So I turned them off, because I had other important things to attend to. There was nothing wrong with the things people said, but it was the tone. It got contentious again. Let me be clear, I, 1boringoldman, don’t like that. One can make a point without doing it. I’m not going to moderate comments. The reason is simple. I don’t want to. If one of those obviously crazy comments shows up, I’ll deep-six it. But for regular commenters, I’ve got plenty on my plate as it is, and comment-cop just isn’t on my top ten list of fun things to do. So I turned the comments back on and am leaving it up to those of you who comment to make it safe. It’s your space – not mine. If you’ve got something to say to me in private, use 1boringoldman@gmail.com.
Sigh, it makes me sad how this happens.
Maybe stop letting the polarized extremists control the debate? Those telling us there are no harms from meds are just as ridiculous as those who tell us all meds cause harm.
Besides, where are the alternatives in criticisms? ??
Now that is beautiful parental monitoring. I don’t really need that from you anymore because you taught me the rule so very well: “Never accept an invitation to go crazy.” And for the most part, I don’t. Watch and learn, not-Mickey’s Daughters!
One may refute an argument, even passionately, without resorting to character assassination.
“All drugs are dangerous, some are also useful.”
in my opinion, Dr Nardol, you have become a pawn for those who just want to use you as example of professing this false message that psychiatric care is only harmful. Every doorway of every healthcare providers’ office should say this above it, ” the road to hell is paved with good intentions.”
I find it fascinating and also pathetic at the same time, how those who are most critical of medical care are so far removed from the responsibilities of it. It’s always so easy to criticize and condemn those who do the best to provide care that is not always going to be infallible. But, we live in a culture that expects everything, but yet no sacrifice on the patient’s part, and expect perfection and complete resolution of problems. It is the poster child of American culture. And so many buy it and so many sell it and so many falsely claim it as their “Savior”. So we’ll just continue this pathetic dance of how the idiots who run Psychiatry sell this false message of biology trumps every other intervention, and their counterparts say that there is no such thing as mental health care.
And the majority of the population continues to twist in the wind.
Frankly there are times where I come to blogs like this and really wonder if people really see the truth.
Spell correct on phones are annoying, sorry, Dr Nardo.
Earth to commentators! It is not the CONTENT but the TONE of the exchanges which is problematic. We should be able to correct that.
First of all, by definition, a disagreement on the content posted by someone hiding behind an alias cannot be personal since we have no idea who that person is or what their qualifications are.
Secondly, it is hypocritical to hold pharma and KOLs to rigorous disclosure standards while hiding behind an alias.
So one quick fix: no more aliases.
Dr. O’Brien, as an FYI, I could use a “real name” and you would have no way of knowing whether it was valid or not. Anyway, two of the three people I felt were treated disrespectfully on this blog were using their real names so I am not sure what your point is. It is simply a matter of not treating commentators like court cases as Dr. Apraia has wonderfully alluded to.
AA
I totally agree with Dr O’Brien, and I will go a step further, or lower per the perspectives of readers here, I think aliases are BS until proven otherwise, as if you claim to have an expertise or valid experience in treatment interventions, documenting who you are is part of the validation process.
Plus, after nearly 5 years of participating at mental health care blog sites, I can say with fair accuracy a good portion of the alias commenters are characterologically dysfunctional, their comments say it outright consistently, and, for blog authors to allow it makes loud statements to what is the agenda of the blog sites.
Having run my own blog for over 2 & 1/2 years now, my agenda is to inform and opine, not gain notoriety, money, or internet glorification. My advice to those who come to sites, which does not apply here to Dr Nardo’s site by the way, watch for the advertising and links to other sites at such blogs. When money or attention is overtly being sought, you have to wonder what is the mission statement to the blog at the end of the day.
Really does separate who is on the Net to support and assist mental health care, and who is just out to benefit personally. Again, I don’t see this applicable here, but since the general issue is aliases and thread decompensation, my two cents.
Joel H
I have to admit that I am a little stunned that there are people working in the mental health field who do not understand that there are many reasons why anonymity is often necessary for people. Although I do not really want to start listing all the reasons, if you asked around to your patients, their families, colleagues etc, I imagine you would hear a lot of the reasons, as long as they felt safe to tell you. Shutting off the people who do not feel safe to post publicly for many different reasons, would frequently prevent the many sides of an issues from being presented.
I totally understand why people would want to remain anonymous. However, they have to understand that when they start demanding full disclosure from other parties, they are not going to be taken seriously. You can’t have it both ways. If one is going to demand a KOL or a drug company stop spiking studies and disclose conflicts, you can’t do that from the safety of the peanut gallery. You have to be identifiable in the arena.
Not caring for aliases is a poor excuse for abusive behavior. You know for a fact there is a real person behind the aliases.
There are doctors posting here under aliases for their own reasons as well.
I think Sally’s point is well taken. I will also add that for those of us in confidential occupations, or who work with high-risk populations, it may be prudent to be very careful about disclosing personal information online.
My policy on this board has always been to identify myself at intervals, usually about six months apart, though never in my user ID– not quite so easy to hack, though my colleagues can track me down here if they are so inclined, and I stand behind what I say. Since the issues of experience and responsibility have been raised, I will provide more detail.
My name is Matthew Jansky, MFT Intern #66278. I do not hold any medical degrees, and I have not published any articles. I have completed the required 3,000 hours of clinical experience required for licensure with the Board of Behavioral Sciences in California, and passed my first of two examinations. I have four years of supervised clinical experience in an inner city mental health clinic, one (simultaneous) academic year of supervised experience counseling high school students and one (simultaneous) academic year supervised counseling K-8 students. Most of my experience was providing 1:1 individual therapy, but I co-facilitated a DV group for two years and an Anger Management group for one year. By the end of my internship, my weekly caseload was approximately 25 clients in various combinations of group, crisis, individual, and school-based counseling. I have stopped practicing while I am in the examination process, and hope to resume sometime later this year or early next.
I use my real and only name. My agenda, to the extent I can identify it, is to parse through the multitude of data – much of which many of us believe is tainted – in order to be able to engage in true shared decision making with the people who consult with me. Perhaps I may not be the best at analyzing data and I appreciate reading various views even – sometimes especially – those that challenge mine. But I find it difficult to engage in this comment section. If any of you want to correspond and learn of my own views on this topic, by all means contact me.I left my e-mail in the “persistence” post. Most of all, I apologize to all, and certainly to Dr. Nardo, if I have (inadvertently) contributed to the improper tone of this comment section.
There is a venue for catharsis in front of others in the absence of accountability. It’s called group therapy. Please let me know if this is group therapy and not a critical psychiatry forum. I guess I had the wrong impression. In a scientific forum, accountability is important.
By the way, even in group therapy, sometimes things get messy.
If this was a political blog, I would get the need for anonymity, as the retaliation aspect in politics, well, you see it every day by both sides of the polluted aisle that are the Republocrats.
But, this is mental health, this blog alone is not about retaliation, at least by the clinicians who comment here when the narrative and rhetoric is not polarized and rigid. We don’t care who you are, unless you are a current or former patient of a commenting clinician and want to make issues personal at a general thread. Otherwise, noting your honest first name at least is not going to have consequences. And, it makes it more personal and direct.
But, I still feel the issues by at least some are not about honest debate and consideration. No, it is about abolishment, about termination, about vindication. And aliases enhance the narrative.
Unfortunately, complete generalizations there are no good clinicians, there are no good interventions, and there are no honest effective outcomes, well, what do you want invested and caring clinicians to say to this, honestly?
“Thank you for the insults and inappropriate assumptions”? “Your polarized and rigid appraisals really deserve consideration?” “Demanding we give up 12 or more years of training to find another career just because some idiot and clueless colleague was inappropriate and/or irresponsible in providing you care?”
Nah, these threads are not a treatment arena, this is not solely an empathetic forum, this is about commenting about the rights and wrongs in mental health care, more specifically psychiatry, and those of us who do it the best we can as trained aren’t going to be sympathetic and supportive to those who just want psychiatry shelved.
And, we have patients who appreciate our time and efforts, and have impacted on their lives positively and effectively for the better. So, yeah, meds aren’t the only answer, but, they are part of the equation for some.
Deal. With. It.
And, yes, some of the points of view by dissenters have legitimacy and validation. I leave all with this: isn’t it at least a bit incongruent for psychiatrists to be members of the APA these past 10 or more years and claim passionately they care about patient care if they support the alleged advocacy actively claimed by that organization??
The best analogy for me is one claiming to be supportive of equal rights for all in society and be a member of the Klu Klux Klan. Too harsh there?!
There is nothing inherently immoral or unethical about posting on the InterWeb under a pseudonym.
Mickey, who posts under the handle of 1boringoldman, has asked in every possible way for commenters to maintain a civil tone. We are guests here on his blog. He can block people he doesn’t want to participate.
I do not understand any rationale for ignoring the requests of our host for civility. Why can’t his wishes be respected?
Guess what else is civil? Not confabulating.
Not claiming to be a “world’s expert” without any qualifications.
Not making stories about your conversations with the UCSF faculty.
Not making up unsubstantiated theories about epilepsy.
Not pretending to be an academic when one has no qualifications.
Even your own audience is bored with your tedium. Watch your YouTube video again.
Oh, I forgot, now watch the seamless transition from “world expert” (who has never been named nor deposed nor even credentialed) who talks down to psychiatrists who have allegedly never heard of SSRI withdrawal syndrome to “victim-patient” who is being bullied and picked on.
I finish my comments at this thread with this from the Alinsky Tactics (From Wikipedia for Saul Alinsky):
3.“Whenever possible, go outside the expertise of the enemy.” Look for ways to increase insecurity, anxiety and uncertainty.
4.“Make the enemy live up to its own book of rules.” If the rule is that every letter gets a reply, send 30,000 letters. You can kill them with this because no one can possibly obey all of their own rules.
#4 especially, we as doctors have to be always polite and respectful, and be always sympathetic to others, irregardless of how the others approach us.
Be the mensch always, bah, I like my cheeks on my face to not always be stinging!!!
These tactics are the typical behaviors of those who don’t want to engage in responsible and effective debate, but just to win, at all costs.
Readers here who are objective and unbiased, you don’t see these tactics in the antipsychiatry crowd more often than not?
And I am done here…
I’m not sure why the ethics of BBS medical boards should be any different than grand rounds or any kind of medical meeting at a teaching hospital.
What would happen at Mass General case conference if someone came in off the street with no qualifications, refused to identify himself, pretended to be the foremost expert on the subject, tried to take over and kept changing the subject to their axe to grind? The answer is obvious: call security.
Calling out pharma and organized psych (which I am clearly not a fan of) for lack of transparency while hiding behind an alias and misrepresenting expertise a pretty obvious hypocrisy. There are only a few explanations why someone might not understand that and none of them are flattering.
Dr. O’Brian, you say
“If one is going to demand a KOL or a drug company stop spiking studies and disclose conflicts, you can’t do that from the safety of the peanut gallery. You have to be identifiable in the arena”
Dr. O’Brian I was not going to respond to this comment as I assumed you had got caught up in the moment and did not really mean what you said. However, you have now said a variation on this theme multiple times so I am responding.
Of course one can not change things as efficiently from the peanut gallery as one can when one is fully and completely welcomed into the arena.
But certainly as a doctor, you can not really mean that the people in the peanut gallery do not deserve or should not ask for or expect the kind of good health care that results from things like full disclosure from pharma? Thankfully many others do not feel this way, and they do listen to the problems of those who are not able to show a public face,
It’s all right by me if commenters are anonymous; they’re not responsible for anyone’s well-being. If someone feels routinely abused here, and in life, it’s sign they’re barking up the wrong tree. They might be right, but they’re doing it wrong.
I use a fake name here for many reasons. I do have a doctorate in psychology, though I didn’t study pathology or treatment. (I’m ashamed of it, too, given what’s become of my sub-disclipline.)
I was anti-psychiatry, but now I’m anti-dogma. Watching what happens here has helped me mend my ways. I agree that it’s futile to demand disclosures from pharma while hiding one’s name. There’s no credibility there. I’d be wary of taking medical advice from an anonymous provider, too, but that’s more to do with accountability. What if something goes wrong? No recourse without a fair bit of sleuthing.
While I certainly support full disclosure regarding clinical trials, and I deeply appreciate Mickey’s posts and activities on this subject, I personally have never campaigned on this issue, other than signing the AllTrials petition (with my real name),
Not directed at you. I’m not informed of your feelings or actions regarding data transparency. If you do give online advice, though, are you accountable? Seems like a legal minefield.