A Psychiatrist Airs His Professional Doubts

Highlights from this essay

Did you ever stop to wonder or ask yourself 'what am I doing?' I did and in many ways I wish I had not. As a Psychiatrist, I still do not know what our profession is trying to do. It seems we have a series of solutions and now we are trying to find the problems that they can solve. My observations are either anecdotal or part of research that I have done as a Psychiatric Auditor and are based on my 38 years experience in the field of Psychiatry.

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It has been shown that after 10 years of illness a psychotic not taking medications is four times more likely to be symptom free than one that is taking medications. Read that again. You would expect the complete opposite. In spite of the hype, the quality of life in patients using the older medications are better than the new. So we are paying more, endangering more and getting less. Not very impressive is it?

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For some reason these emotional disturbances are treated as if they are mild forms of mental illness. They are not. Very often we are seeing stress caused by poor coping styles or skills. They are treated as if they have, or about to have depression, anxiety, or panic. The vast majority are offered medication. They should be offered alternative drug-free modalities such as Cognitive Behavioral Therapy or Psychotherapy.

Of those referred to psychotherapy much less than half will get past three visits. The major explanation of 'file closure' in these cases is drop-out. 'Completion of therapy' ranks as one of the least given reasons.

And we have to wonder about the effectiveness of some of the alternatives and solutions he does discuss.