I’m aware that an argument broke out in the comments that stepped outside the little box above the comments section – went interpersonal. It has happened before, which why that box says what it says. The first time, the circumstances were unusual. It was someone in town who discovered I had a blog and inserted himself into the comments as if it were a hot-line to my home. I shut down the blog [off the air…]. When I returned, I held and moderated all the comments. My models were Danny Carlat and Soulful Sepulcher who had done that for years for the same reason. Ultimately they left the public stage. After a time, the assault was over and I stopped. I didn’t like doing it. I don’t live at the computer and often compose with a primitive device, so it meant a lot of "checking in."
Time passed, and there came a period with multiple commenters who preached." I wrote them, asking them to stop, and they either did or moved on – all except one who escalated. It wasn’t that his views were the main problem, it was that he was dominating the space and insisting on agreement. I said that, even gave my alternative views and he escalated. I finally bannned him [a limit… last paragraph]. He found my home email address and made his closing argument. When I occasionally comment elsewhere, he often chimes in with another version of the story. I lost a lot in that episode. A number of very thoughtful commenters who didn’t feel safe and moved on. I hear from them from time to time, but it’s not the same as when they were adding input and perspective frequently.
In my life, I ran a number of therapy groups and groups of other kinds. The solidest line of thinking I ever read was written by Winfred Bion, a British Kleinian Psychoanalyst who was, as is common in that set, a lunatic who spoke in very peculiar ways. But his theories on the behavior of unstructured groups is as solid a piece of evidence-based-medicine to me as Vitamin C cures Scurvy. He says that people in groups are all frightened at some level, and that fear mobilizes aggression [in all of us]. At some point in a group’s history, the aggression will rise to the surface. Actually, it is in part because people feel safe enough to let it. One common solution is for the group to find a shared enemy, and the group organizes around opposition to that shared enemy. Think Klan. Think Nazi. Think tree-hugger. Think political party. Think Cult. We’ve all been in such groups. Group members are safe with each other guaranteed by the presence of a common enemy. Such a group can never change.
Another possibility is that the aggression can be mobilized inside the group, among members. A group leader can’t keep that from happening. It’s human nature. And people begin to take sides. There’s often a scapegoat, a person who is seen as the problem, and the group points towards that person. They have to shape up or ship out. It may be a weak link. But it may also be a strong link. Here, the group leader needs to do a difficult thing – keep the group from disintegrating or from killing [extruding] the scapegoat [whether they deserve it or not]. Success in that endeavor leads to the leader becoming the target. The leader is in charge, so fix it! The double bind is that the leader is only human and knows he/she can’t resort to murder – having just prevented several. He/she can’t change people, so he/she becomes the target. Weak. Playing favorites. No real leader at all. Safety was only an illusion. I once watched a perfectly competent Full Professor who ran a Resident’s Group be fired by the Group itself, and later censured by the University – which he left. His error? He thought he could fix it. He originally had given me the Bion book, but I don’t think he’d read it, at least not the last chapter. There’s only one outcome that ever works. 
The leader is no longer the leader, but survives and becomes just another vulnerable member. The safety of the group becomes the valued property and responsibility of the group itself. And safety without a shared enemy is the only viable principle for groups to remain healthy, creative, and endure. You saw the movie already. The Wizard of Oz. And that outcome is never guaranteed.
I haven’t really thought of the regular commenters as a group, but now that I think about it, you are. Steve said it best. I went back and reread all the comments for several months and this isn’t the first tit-for-tat. When it happens, I wince. Sometimes I turn off the comments. But mostly I wince. I’m not going to play wizard, spank anybody. Fire anybody. In a couple of emails, it was suggested that I’m protecting a "pal" – Dr. Carroll. We are pals, but he doesn’t need me to protect him. There was also a hint of the League of Arrogant Male Psychiatrists idea in there. I hate those people too. This bruhaha makes me aware of how much I value the input from everybody currently commenting. You have shaped and occasionally changed my own opinion. I don’t mean to be drippy, but I’m genuinely honored you chose this space to think out loud in. Here’s my contribution to the theme of safety. I just explained a psychoanalytic principle of Group Psychology out loud on this blog. After 34 years of being ridiculed for even thinking about such things, I just don’t do that – ever – except with safe colleagues. While I don’t plan to continue doing that here, I must feel at least safe enough to reveal the part of being a psychiatrist that has most preoccupied and mattered to me throughout my career.
Thanks. That was really good.
You just described Obama’s problem. 🙂
The analogy of psychiatry as Rome, which is now burning, does bring out a multitude of reactions. There are some who want to just flee, others who want to grab the buckets and try to control the fire, some who just want to sit and be consumed, and, then there are some who want to watch the flames destroy everything, with a perverse smile on their faces.
I see myself as a bucket guy for now. Except I worry I am being given a bucket that may have something else besides water in it. Perhaps I am ignoring the smell of gasoline as I pull back to toss it forwards, but, it is not intentional of me to add fuel to the fire. But, what about those who are oblivious to the bucket contents, or in fact know what they are throwing will not quell the burn. Maybe passive watching the conflagration is not enough for some in our profession, eh?
http://www.ncbi.nlm.nih.gov/pubmed/15257832
Cyberpsychol Behav. 2004 Jun;7(3):321-6.
The online disinhibition effect.
Suler J.
Abstract
While online, some people self-disclose or act out more frequently or intensely than they would in person. This article explores six factors that interact with each other in creating this online disinhibition effect: dissociative anonymity, invisibility, asynchronicity, solipsistic introjection, dissociative imagination, and minimization of authority. Personality variables also will influence the extent of this disinhibition. Rather than thinking of disinhibition as the revealing of an underlying “true self,” we can conceptualize it as a shift to a constellation within self-structure, involving clusters of affect and cognition that differ from the in-person constellation.
PDF at http://www.samblackman.org/Articles/Suler.pdf
My personal observation, after 20 years participating in online groups, is that outbursts of verbal abuse reveal more about the commenter than he or she is aware. It has been interesting to see the effect of online disinhibition on psychiatrists.
Dr. Nardo, I would have preferred reading your thoughts on this under different circumstances, but, either way, I found them helpful.
I hope you reconsider about not writing on the subject of groups going forward. What you wrote here makes sense in its context, but it doesn’t quite explain what I learned in basic training or something awful like The Lord of the Flies. I’m more intrigued now than ever.
Well, I hope you write more about it someday then; I just read your most recent post.
As Lucy Van Pelt said, or as near as I can remember it, “Have fun in school today. Learn things.”
Learning from your blog, dr Nardo, and the many wise and varied commenters, is at times even more enlightening than I’ve come to expect, and lots of fun, as Arby and Lucy said. I’m grateful. To try and get the intended meaning, I often search for translation into my mother tongue. I had to do that to correctly (I hope) understand your reaction when you wrote that you “wince” at tit-for-tat among commenters. I did not get it at first, even when my English dictonary said “shrink, flinch”. I had to have it spoonfed in Norwegian to feel that I’d understood what you were saying, and to recognize my own usorted, uncomfortable feelings of fear, anger, competition, assertiveness… when there is shooting from the hip and censure instead of openminded curiosity, and civility about different ways of seeing things and differing ways of expressing oneself. The Grand Inquisitors are alive and kicking, trying to extinguish us heretics. Their clinging to power is hampering thinking, discovery, diversity and development. It’s a good thing, I think, to recognize them, endure fear and transient pain and not be silenced by these trolls. I’m learning more than I knew I was in for. Thank you!
The Trolls are always with us and within us. When we chop off a head, three new ones appear, according to my understanding of traditional folk tales, Henrik Ibsen, Winfred Bion, dr Nardo, dr Steingard, the war aginst terrorism and the Big Business Pill against illness, suffering and humanity.
Moderation of comments has been a universal problem since the very beginning of the Internet.
http://www.wan-ifra.org/reports/2013/10/04/online-comment-moderation-emerging-best-practices
Online comment moderation: emerging best practices
World Association of Newspapers and News Publishers
“….It is impossible to limit commenting to those who do have something constructive to say and discussions frequently descend into torrents of insults that are utterly irrelevant to the original article. Maybe it’s the fact that anonymity and distance often allow consequence-free behaviour and a chance to defy social norms, or maybe it’s a factor of the structure of online conversations, but comment threads on websites can frequently shock due to abusive, uninformed, not to mention badly written contributions….”
I think group psychology and ethics change when you are talking about the macro where the primary purpose is not social or therapeutic, but fact-finding. In a debate, courtroom, or deposition, people are confronted about erroneous or dubious statements that would one would politely ignore at a cocktail party or in group therapy. On a website where pharma and KOLs are frequently attacked for dubious self promotion and lack of transparency, often rightly so, I don’t quite comprehend the idea that commenters shouldn’t be held to the same standard.
As far as ad-hominem, pointing out someone’s errors in thinking or factual misrepresentations really is attacking an idea, not the person.
I’m in forensic psychiatry and I’m used to depositions in which I have to back up everything I say with evidence. Maybe this is why I find confrontation less problematic.
By the way, I don’t really see any “trolls” on this board that I would call pharma shills. Most would fall into the category of antipsychiatry zealots with agendas.
Pharma is not going away and we need them. Our relationship to them is one of dependency, like it or not, and this is especially true as antibiotics become more resistant. I don’t want hangings, I want the system to work and I want better drugs coming out faster. No one who posts here including me is going to discover the next penicillin, so let’s get real. No one who posts here has saved millions of lives of HIV+ patients. Pharma does some sleazy things, but they also do great things. Hostile dependency doesn’t mean you get to stab your step-parents.
In any setting, invective is unnecessary in contesting erroneous or dubious statements.
If what you want is rational, informative discussion, invective aimed at other commenters is a self-indulgence with a corrosive effect on the quality of discourse, as it instigates retorts, recrimination, retaliation, vendettas, and factionalization.
This has been demonstrated over and over in Internet discussion groups since they began in 1980 and has given rise to an extensive literature on moderation of such groups.
Quoting James O’Brien, “As far as ad-hominem, pointing out someone’s errors in thinking or factual misrepresentations really is attacking an idea, not the person.” That reflects my position, and I see no need to walk back anything I said above. Dr. Mickey does a huge service to a large but mostly silent readership through his research on this site. It would be nice if the commenters actually helped him move the ball down the field. Confusing the issues with poorly expressed and vague material, often delivered in a tone of righteousness, doesn’t do that, nor does tedious repetition of antipsychiatry zealot agendas, quoting James O’Brien again. Sometimes silence is golden.
I don’t see what has happened here reflecting what I have seen other boards devolve into.
What I see is the different communication styles between men and women. I make no value judgment here as they seem to work within each gender; I merely bring it up as my observation.
Forgot to add:
And, apparently a difference in communication styles between males in Britain and males in the U.S.
http://philosophy.lander.edu/logic/person.html
Informal Structure of ad Hominem
Person L says argument A.
Person L’s circumstance or character is not satisfactory.
Argument A is not a good argument.
Dr. Carroll’s original point was to clarify a historical argument about Kraeplin, and to correct some ideas, not to attack the poster. If these kind of things cannot be discussed on a blog without people’s feelings getting hurt, then there’s really no point in public discussion forums at all.
One cannot claim to be the victim of ad hominem while hiding behind an alias. In fact, since the alias blinds the critic to the actual person whose arguments he is attacking, personhood has been completely taken out of the equation. Only an identified person can be the victim of an ad hominem.
My new policy is to not respond directly to people using aliases, and I don’t mean to imply that everyone using one here is up to something. But the point of the blog is transparency and accountability and to me it’s just to0 hypocritical and unfair that people do throw stones publicly while somehow demanding internet privacy. For all we know these aliases could be interns from a certain church that does not care for psychiatry.
http://philosophy.lander.edu/logic/person.html
Informal Structure of ad Hominem
Person L says argument A.
Person L’s circumstance or character is not satisfactory. (Imputed to be a Scientologist, despite a complete lack of evidence.)
Argument A is not a good argument.
I’m glad this isn’t Dr. O’Brien’s blog.
I would suggest an ignore button and prohibition of aliases who want full transparency for everyone but themselves would solve a lot of the problems.
I do not join in Alto’s approach of splitting hairs about the Scientologists. There is no doubt this blog was invaded in the past by a self-declared member of the antipsychiatry movement. He used an alias and he expressed solidarity with the Scientology organization known as CCRH (Citizen’s Commission on Human Rights). Dr. Mickey finally kicked him out. If it can happen once then it can happen again, and Dr. O’Brien is right to signal the need for caution about motives when aliased commenters turn disputatious and tedious. That just derails what might be more productive conversations and it surely does not move the ball down the field for Dr. Mickey.
berit bryn jensen,
I really appreciate you working so hard to understand our language here. Unfortunately I am not adept intellectually, so I use whatever tools I have available. This often means I use references to popular American culture including Lucy Van Pelt. Explanations for most can be found on the internet, but if it causes you difficulty, I apologize, and will try to be more cognizant of it.
I find you communicate in English, wonderfully. Better than I as a native speaker sometimes.
Dr. O’Brien, I hope you do start a blog someday.
I don’t agree with everything you say or how you say things sometimes, yet I haven’t ever taken our go-rounds personally, and I continue to learn things from you.
But, possibly the biggest reason I’d like you to have one is that when you’re at the top of your game, you have an extraordinary, razor-sharp wit. Strikingly so.
Of course, I’ll just be a lurker there; no comments. I rather enjoy my self-imposed non-personhood, and since part of my job involves the internet, my anonymity helps keep me employed.
No reply expected.
https://www.youtube.com/watch?v=ulg-V-mgtHU&index=15&list=PLNFEPts1WucSqaZ79b4gKe6qs_vEn41WF
I enjoyed the Dutch psychiatrist, professor Marius Rommes take on schizophrenia, which he – and many more – considers an invalid diagnoses, a scientificsounding construct made by Kraepelin and Bleuler a hundred years ago in order to advance the scientific standing of their profession. The hoplessness it still conveys has harmed patients and blocked productive thinking and progress to more helpful assistence and treatments
Arby. Thank you for kind words, which I appreciate, but when I see how many mistakes I’m able to make in just a few hasty sentences, as above, I blush a little. Your Lucy may be the one in Peanuts, I think, pestering Charlie Brown and anyone around, advertising her “psychiatric advice” at discount rates… I seldom see the comic strip these days, as they have been “disappeared” from most print media here. But I remember Charlie Brown’s miserable figure, face towards the ground, saying “”My favorite depressive posture.” I do enjoy your comments, Arby, and do try to learn what I can from this most excellent of blogs, in style, content, honesty, wit and variety, thanks also to variety and differences among the commenters.
Dr. Carroll, I have to respectfully disagree with your position. Alto make an excellent point about how calling someone anti psychiatrist constiutes an ad hominen attack just like if you had made argument A and I said you weren’t be taken serious because you are a psychiatrist. It works both way.
As far as anonymity, I have chosen this route so that when future employers do searches of me on the Internet, they won’t be turned of by what I have written, And sure I could switch to a fake real name which many people do but what purpose does that serve?
One thing that a commenator named Nate used to suggest on various boards was that people list their biases and background so that everyone knows whom they are dealing with, If everyone else agrees, I definitely would be willing to do that.
Dr Carroll. I also respectfully beg to differ with you, and most certainly on your statement that you have nothing to walk back on. A word I had to look up and translate, is “carping”. It sounded harsh to me, and I found that it is, according to the translation. Your use of “carping about” did not clarify anything to me, but came accross as irritated disrespect, feelings anyone is entitled to entertain, but reflects badly on possible attitudes of intoleration of which one may be blind, when at the same time arguing for robust arguments, of which I am also strongly in favour . Incivility and disrespect muddies the issue discussed. I’ll continue to read your comments with critical interest. Respectfully yours, Berit BJ
From my favorite psychologist, Paul Meehl, in 1973:
“The tradition of exaggerated tenderness in psychiatry and psychology reflects our “therapeutic attitude” and contrasts with that of scholars in fields like philosophy or law, where a dumb argument is called a dumb argument, and he who makes a dumb argument can expect to be slapped down by his peers. Nobody ever gives anybody negative reinforcement in a psychiatric case conference. (Try it once–you will be heard with horror and disbelief.) The most inane remark is received with joy and open arms as part of the groupthink process. Consequently the educational function, for either staff or students, is prevented from getting off the ground. Any psychologist should know that part of the process of training or educating is to administer differential reinforcement for good versus bad, effective versus ineffective, correct versus incorrect behaviors. If all behavior rewarded by friendly attention and nobody is ever nonreinforced (let alone punished!) for talking foolishly, it is unlikely that significant educational growth will take place.
This is really at the core of many problems in psychiatry and psychiatric research, and it is vitally important that critical psychiatry not fall into the same trap. I do believe that if researchers and academics had followed Meehl’s sage advice and not been such buddy-buddy careerists, blogs like this would not be necessary. The blogs at Psychiatric Times are carefully monitored for offending someone’s feelings. To their credit, they’ve allowed me to be somewhat critical of giddy overoptimists lately.
P.S. Thank you for the kind words.
As I’m sure Mickey is aware; some of the topics and post shared here are not considered sweet music to some very large industrial interest. These large interest do employ company’s to monitor these kinds of critical blogs, and are not beyond sending in plants to cause diversion, disruption, and harassment.
I’m not saying that this is evidenced fact in this particular instance; but it’s always wise to never under estimate the lengths some interest will go to when many billions of dollars are at stake.
Personally, I seldom comment here or on other blogs anymore. Everyone has pretty claimed their cemented positions, and are not making any substantive movement toward effective solutions or reasonable compromise.
As it’s been said; Great efforts made in futility, lead to little more than folly
There is only one way to say this: it’s not about us, it’s about our helping to promote awareness of the research Dr. Mickey does here. We can do that through posting well written and well informed comments that clarify or expand upon or give a useful gloss on what Dr. Mickey has written. But our agenda should be Dr. Mickey’s agenda, not some peeve of our own making. The last 2 comments from Dr. O’Brien and from ‘much ado about’ are the sort of comments that can add perspective to Dr. Mickey’s words. A great many people do follow this blog silently with both benevolent and malevolent intent, and it would be a plus for Dr. Mickey’s sake if the commenters stayed on topic, avoided tedious repetition of stale material, and generally refrained from derailing productive threads with personal issues. Sometimes silence is golden.
Mickey — I appreciate your application of group dynamics to this situation, but I think you have to factor in how online communication differs from face-to-face communication.
Unlike a face-to-face group, a commenter population has no internal cohesion. They owe no allegiance to keeping the group going. Individuals may come and go at will.
Three decades of Internet precedent have demonstrated that insult in the name of “fact-finding” corrodes the quality of discourse. Those who think life is too short for the usual Web nonsense will simply stop visiting the “group,” leaving it to the blowhards and bullies.
Every blog owner has the same difficulties with comments.
Unmoderated Internet forums do not organically establish norms supporting civil discussion — most people don’t have the stomach for the endless sniping and meta-discussions. (I run a moderated forum site myself.)
I’m sorry to see this evolution, but it’s also an Internet truth that unmoderated discussion forums tend to implode after a while.
I apologize to the psychiatrists and therapists to whom I’ve recommended this blog. Although our physician culture certainly has its problems, the presumptuousness and abusiveness in the comments is *not* the way we like to do things in the US. It reflects only the predilections of a few.
Having been called “hyper ethical” in the past in a private practice by a colleague who was just tired and sold out, I think if the above comment about “righteousness” was at least somewhat directed to me, I’ll be glad to add it to my list of adjectives describing who and what I am not only here on the Net, but in real life as well.
And, isn’t that somewhat true for some here, there is the “life” some lead on the internet, and then what they do in their lives outside cyberspace? Me, I am what I am whether in front of this keyboard, out on the street, or in an office. I do think I practice more respect and consideration with patients, as they are not the problem by in large, but, why should I be pleasant and respectful to those who are crude, rude, and socially unacceptable.
As I have written over and over, (ironic there), OVERtolerance is as detrimental as intolerance. Hey, just my opinion.
Righteousness has its place, better than “wrongfulness”, eh?
Berit – yes, I was referring to the Peanuts character, but the quote was from Lucy as big sister, not as faux psychiatrist. It’s what she yelled to her younger brother as he was on his way to school. On the face of it, she was wishing him some fun, but telling him to do his job at school (learn), even though she was ignorant of what he would be learning. However, since the author of Peanuts, Charles Schultz, shared profound thoughts at times, I imagine he intended something more.
I only vaguely the recall the wording of the first sentence, but it acknowledges that learning can be fun, and that there are places you can go to learn. However, the second sentence “Learn things.” I remember distinctly because of how powerful two simple words can be. “Learn” implies a responsibility to learn, but also, that if you take it seriously the result will be that you have learned. “Things” is exceptional in that it doesn’t define what is learned. The expectation is that you will learn what you set out to, but it also alludes to learning what you didn’t plan for or could never have imagined. It reminds me of what J.R.R. Tolkien wrote in The Hobbit “It’s a dangerous business, Frodo, going out your door. You step onto the road, and if you don’t keep your feet, there’s no knowing where you might be swept off to.”
Interesting that two great thinkers of our time chose to share their wisdom for adults in works written for children.
Dr. Nardo – regardless of the original intent of Charles Schultz, which I will never know, when I write “Learn things.” you have my sentiment as described above.
And, now, I’m golden [slang: all set; good to go].
To follow up on Dr. Carroll’s point, there’s nothing that would stop that former CCHR alias from using another alias under a different IP and coming back to post.
It’s not hard to ascertain that there are a few commenting here that are not in the critical psychiatry camp but that are firmly in the antipsychiatry camp.
No one is asking for less rules, in fact I’m asking for more, and specifically more transparency and accountability. The same thing we are all asking from KOLs and pharma. Even Facebook is moving to ban aliases. I’d like to think that would be the minimum standard on a board like this that is so much more intellectually advanced.
Dr. O’Brien, I’ve explained who I am to you. I’ve participated here for years. Mickey has posted references to what I do.
If Scientology is the bogey under your bed, you need to get out more.
Our UK friends must be more mystified than ever about this obsession of some US psychiatrists.
I suggest you sit with your anxiety and learn from it. There are many more reasons for a non-doctor to be critical of psychiatry than following Scientology. Or do you think patients are so stupid they cannot develop their own thoughts about your specialty?
Experience gives wisdom, not expertise. I think some commenters blur the terms. I respect a patient’s experience, but it does not make them an equal.
As long as silence or vague support gives the illusion those terms are synonymous, well, the threads just become frayed.
Anyone can comment here, but no one trumps the author of the blog. Can some of you here really accept that premise?
ive just checked the blog here through the words of a fellow blogger who has also gone dark. Past are the ‘olden’ days where the stories flew, and the pharma companies attempted to rule the roost and implant their many minions in a twisted way to find a seat on our opinion-based panel! I certainly did have to moderate comments and I most certainly did have to silently ban commenters as did other well-read blog authors. We were, as YOU are today—are the ones asking the precise questions that the industry did not want asked; nor did they want to hear the anecdotal stories of the destroyed lives that were endless and still continue to this day. The lives ruined and destroyed… yes! do I know that scenario well. At this late stage— just let it roll off of your back and do not engage– just decide who gets to post a comment here and leave it at that.
Stall tall Mickey!! Please keep on writing, because the reaction you are getting means you are on to something, and shedding light where they do not want it.
soulful sepulcher
It’s both ad hominem and proselytizing to discount thoughtful critics and those with valuable first hand experience, by referencing them as cultist (Scientology).
In my humble opinion, I have most often found that when you follow the money trail long enough and dig deep enough: it eventually leads us to the power brokers and puppet masters. Everyone else just ends up as either attached by strings, or are used as props in this grandiose theater.
There are those that have long suspected that “Scientology” is merely a created demon used to distract attention away from irrefutable evidenced based criticism of the industrial/profit based psychiatric mass consumption/modality of our recent and current times.
It may be wise to refrain from using broad brush stroke negative depictions, if one wishes to maintain any air of professional credibility or may wish to toot the horn of civility.
In the past I have personally baited psychiatrist into the nasty gutter with the rest of us mere undecorated laymen to make a valuable point. I found they are no different than anyone else once that MD is tarnished by the unavoidable reality of their mere fallible humanity.
Interesting post Dr. Hassman. What about doctors who don’t do the fundamental things that they should according to their expertise and end up worsening the patients’ health? Correct me if I am wrong but haven’t you mentioned quite often about your understandable frustrations in dealing with patients sent to you on various meds that didn’t seem to make any sense? Is that doctor still an equal in your eyes?
I guess my point is I can understand you saying a patient isn’t an equal because they didn’t go to med school. But at the same time, many patients would say that just because a doctor went to med school doesn’t mean they are an expert, especially if the treatment is horsebleep. So I am just curious about your thought process regarding those issues.
Agree with your point that no one trumps Dr. Mickey. It is his site and we have to follow the rules whether we agree with him or not. It is that simple.
Sure, there are unfortunately too many physicians who practice beyond their scope of expertise, exhibit A being PCPs writing for psychotropics like pez and then dumping their debris on us psych docs who have the expertise.
Just like I DO NOT treat somatic illnesses in my office, as I cannot keep up with the trends for medical disorders, but, I have the expertise to acknowledge there are medical issues and need medical follow up ASAP, especially if the somatic problems impact on the psychological struggles in front of me.
Incompetence and malfeasance is not just about sleeping with patients, or using drugs. No, those terms should also include irresponsible meddling with treatment needs one is not trained to treat repeatedly or endlessly. But, the practice of medicine still has a “fraternity” mentality, and most in the profession feel “you do not rat on a brother or sister”. Which only gives more ammunition to the public who are legitimately outraged when doctors do the stupid crap that gets exposed at times, which is the tip of the iceberg of incompetence and malfeasance at the end of the day.
As Dr Carlat noted in his blog before he disappeared from view, if CMEs are run by Pharma and other special interests by in large, then getting responsible and appropriate CME is not going to improve care overall. I personally look for CMEs that are not tied into pharma small print.
As an aside, I am about to begin another Locum opp that will have me do 15 min med checks for a CMHC. We’ll see how much this program really stresses therapy as they claim in the interview phone call, and how much is just about med visits. My experiences the past 4 plus years, put your money on the latter, better living thru chemistry rules throughout the mental health field! I just cannot fathom how these administrators lie without any hesitation nor conscience. Oh yeah, incongruent terms, administrator and conscience…
Some people here have a reading comprehension problem here. I never specifically accused any poster of being CCHR. My argument was originally hypothetical, and Dr. Carroll pointed out that it actually happened, and this proved by idea correct. But I have no doubt that there are some antipsychiatry people here not seeking solutions, and I have proof (their own videos), but posting it might be considered “ad hominem” because I guess that means any words that can hurt someone’s feelings.
BTW explaining who one is and what they are about would include a name and actual qualifications.
I’m reading past posts and see that ‘therapy first’ aka Dr Hassman was supposedly banned from commenting here due to a comment section candid rant. I do recall MANY times that happening at Furious Seasons– nothing changes!
Now it certainly DOES show how commenters in certain blogging arenas are the same ones, so often we know each other’s writing styles, aliases, thought, beliefs on med use and more. Same conversation just months and years gone by. One thing is guaranteed… that pharma has pushed new and remodeled meds forward and the treatment remains milk toast without much help for those suffering.
Talk on, that’s all we got.
Found this reading as well http://www.madinamerica.com/2014/06/blame-clients/ over at Mad In America…Philip Hickey, PhD wrote an article with this: “..June 16, 2014
On June 6, I wrote a post titled Psychiatry DID Promote the Chemical Imbalance Theory. The post generated a number of comments, five of which were from TherapyFirst, who in his first comment identified himself as Joel Hassman, MD, a practicing psychiatrist. …”
Continue reading there… then wonder why many of us moved on…same old dribble, over and over again across how many blogs? nothing changes.
Take care!
Some people just carry that torch, eh S.S.? Once again someone comes here and tries to dictate the discussion, “I’m reading past posts and see that ‘therapy first’ aka Dr Hassman was supposedly banned from commenting here due to a comment section candid rant.” What are you going to do next, advise Dr Nardo what criteria deserves censor??
And give up the Therapyfirst argument, I haven’t used that as a pure alias in a long time now, catch up to the present, please. (MIA inferred I had to use one in signing up to comment; a bit of projection here with your “Soulful Sepulcher” nom de plume?)
Then you turn for alleged validating example to that real bastion of moderation and fairness over at Mad in America, well, you certainly have revealed your colors accurately, SS. Oh, and I don’t waste my time at MIA after that side show back in June, because their blog authors reinforce the bashing agenda that is alternatively being politely debated here (until now) with some interest and ability to dialogue, not just shriek and howl abolitionist banter endlessly at MIA.
I think my blog has consistently noted my opinion of the abolitionist agenda, and feel free to go there and add your vitriol at appropriate posts, I most likely will print it, as it will deter my point?
For whatever it is worth to you, do some real soul searching before you try to villainize others just because you do not like our perspective. ‘Cause that is how you come across. Oh, and to the other readers, I take on the abolitionists at other sites because they depend on doctors to be forced to act as mensches and maintain polite decorum while the attackers live by Alinsky techniques when there is a crowd watching. Again, why am I being nice to those who are rude, crude, and socially unacceptable?
Sense the thread is about to close now…
It does feel a bit like old home week, doesn’t it? Hi to both of you, but I think the thread has kind of run its course. Thanks for noticing…