Friday, May 21, 2010

Psychiatric double standards

Here is a comment that I posted today to Family Dysfunction and Mental Health: Dr. Allen, like so many psychiatrists, sees schizophrenia as a special case, a "true brain disease," that is generally unresponsive to anything but medications.

Dr. Allen: When I began writing this blog, I expected to be attacked by those folks who think that child abuse and dysfunctional family interactions are a figment of the imagination of a bunch of whining liars, and that the problem with modern psychiatry is that we are just not prescribing near enough drugs. I was waiting with baited breath to hear the phrase, "Parent Bashing."

My response:
Hang on, hang on, here. To quote you "This blog covers mental health, drugs and psychotherapy with an emphasis on the role of family dysfunction in behavioral problems." A lot of what you call negative comments come from people who take issue with your opinion that schizophrenia and bipolar are "true" brain diseases. The commenters I have seen who take issue with your opinion of bipolar and SZ are people who actually believe (including me) that these conditions arise from Family Dysfunction. Many people diagnosed as bipolar and schizophrenic believe that it is family dysfunction that made them what they are and you are telling them that they are wrong? Oh, no, you have a true brain disease, you say. Take this pill and go away.

How many ways do you want to have this, Dr. Allen? To replay one of your answers to an earlier comment of mine, you wrote "I certainly do not want the mothers of psychotic patients to blame themselves for their child's illness, as such guilt generally is toxic to everyone in the family." Hello? Your blog is about linking Family Dysfunction to Mental Health. I am linking Family Dysfunction to Schizophrenia. Your professional view of schizophrenia is a bit schizophrenic, IMO. It is weird, quite frankly, that you see schizophrenia and bipolar as a brain disease and not a mental health problem.

I can't help but notice that you are getting most comments from people with a bipolar or schizophrenia background. Something about your blog twigs with them, but not with other people, judging from the lack of comments. But you are dismissing them as being negative and insisting that THEY'VE got it wrong. You are getting almost no comments from anybody else, I've noticed. Where are the personality disorder people that you treat? Can't they come up with a comment or two? What about fellow psychiatrists. Where are they in the comments? I would appreciate it if you would look at the people who actually are caring enough to respond to you and think about perhaps opening your mind just a smidgen to the possibility that mental health and family dysfunction includes schizophrenia and bipolar.


  1. Brilliant comment! "Your professional view of schizophrenia is a bit schizophrenic, IMO." Haha! Exactly!

    Reading Dr. Allen's post, I almost choked on my coffee: "I am always amazed at how people, even professionals who should know better, can take extreme positions and then argue vehemently for them (usually with a healthy dose of debate tricks and logical fallacies)." I am always amazed at how easily some people manage to escape painful self-insight by simply projecting their own dysfunctionality into others.

  2. I am hoping Dr. Allen is enjoying this verbal repartee as much as we are. I keep yanking his chain, but it's getting lonely.

  3. I'd keep you company over there, but I decided not to comment on his blog anymore.

    BTW: I couldn't agree more with your comment on family dysfunction going back more than one or maybe two generations. Actually, I think it goes back all the way to Adam and Eve. It gets passed on from generation to generation, and as it gets passed on it also gets accumulated. And at some point there will always be someone in a family for whom it becomes too painful to ignore (= repress/deny - "sz" usually is about denial more than about repression).

    What I don't agree to is that "looking for family dysfunction in the immediate family misses the bigger picture in schizophrenia". If you know what to look for, you can't miss it, and if you can't see it, you're probably suffering from the same dysfunctionality without being aware of it.

    The tricky thing with much of dysfunctionality is that it looks completely like normality. In as far as Dr. Allen (and most of his colleagues) is a victim of this normality himself, he will never recognize its dysfunctionality.

    (And, yes, Ken Loach makes use of a number of clichés in Family Life. But I think he needed to, and that still most people don't really get it. Aren't these parents just trying to help their daughter the best they can? Where exactly is the dysfunction if there is any at all, elsewhere than in Janice's head - or her brain chemistry? - Or, and this is what Dr. Allen supposedly would do, watching this film, you recognize some of the dysfunctionality, the noisy part, but conclude that "sz" would be a misdiagnosis, and that Janice probably is suffering from "borderline"... )


I am no longer approving comments. All I ask is that you be respectful of others and refrain from using profanity.