Critical Psychiatry

We should all criticise psychiatry, all the time. We criticise many other things in life, and see it as a positive, which it is. We criticise art, literature and music; we criticise science; we criticise each other; and without this criticism we would never learn or grow. Our lives would not be interesting. 

I like to question and criticise; I like to change my mind. But what I see now in critical psychiatry is more akin to playground squabbles than anything else. I don’t doubt that there’s valuable science and thought behind it all, but it comes across as ‘he said, she said’. I didn’t always find the playground a happy place, and I don’t like being reminded of it. Some would retort that I should keep off social media, but I have made many happy contacts there as well as the others. 

This feels more about morals and beliefs, and we have many millennia of these. People have killed and tormented other people for them, and I start to wonder if this is our natural human condition. With religion now less powerful, let’s use other forces – politics, the environment….psychiatry? I have an instinctive fear of people who say they ‘believe’ things, as it implies a leap of faith. Why would that be required? 

I am in an extraordinary position, being a conservative psychiatrist and a patient who asks questions. I want to take advice, I respect those from whom I ask it, yet I am bombarded by the opinions of critical psychiatrists amongst others. I would be crazy if I didn’t consider what they say, and ask questions. And I feel tortured by it. Sometimes I think I should join their ranks – I know people would listen to me, probably quite a lot of people. I would be seen as an authority, and I might persuade people of things that were uncertain, but would gather power from me. This is why I don’t do it. I don’t want to be a leader, someone who is charismatic – and possibly wrong. I don’t want people to believe in me. 

I have a conservative, or traditional illness, that I often doubt. This might not matter, were I not having a controversial treatment, ECT (electroconvulsive therapy). I don’t agree lightly to this; however the last few years haven’t been great at all. I am someone who wants to work and write, and the only way I seem to stay well enough to do so is by having maintenance ECT. I can’t prove that this treatment works, but on balance the evidence and my response is enough for me just now. There are distressing side effects, which I acknowledge. Surely I can both have, and question, my treatment? 

Many years later, there may be little difference between our views – both ‘sides’, and many in between, may be seen as ignorant and wrong, or not. I wonder how we choose our opinions – science, belief, the need to be a leader, or what? I suspect that many with broader views, who consider both sides, are often ignored and forgotten, but they too will add to the knowledge of the future. Realistically, perhaps, we need the ‘believers’ so we can hear them and question them; without them we might be complacent. But it doesn’t mean that they’re right, we have to consider all options. 

But, what we do need is compassion. It’s all very well having new ideas, and proposing new theories, but not if you ignore those who suffer, often the patients. Maybe ‘being right’ matters more to some, but how can you be sure that you are actually right? Change is often necessary, but do ask others first. Personally, I’d rather learn cautiously and try not to cause suffering.