Language does matter

Language matters (as, nauseatingly, we’re reminded daily). It matters also when psychiatrists and psychologists write about their fields. The shrinks are trying to rebrand psychiatry, psychologists want more money. Here are a few comments on their attempts.

I must admit that the article “Shrink rethink” has raised my eyebrows. Yes, psychiatry is negatively perceived, yes, sometimes it’s unfair, but, really, this escape forward is just, I’m struggling to find the right word, oh I don’t know. Think of a polite word negative enough to suggest that I would not have published it.

This is because when a shrink says:

Think about and prepare answers for question on our rich and controversial heritage: Bedlam, lobotomies, electroconvulsive therapy, LSD …, anti-psychiatry etc.…. Be able to explain that the psychiatrist’s role as a pioneer who searches out new ways to alleviate the suffering of those they serve was not, and still is not, without risk.

I think: Really?!?! I mean, is it, like, REALLY, what you want to say? All you want to tell those people with an ice pick driven through their skull, is: “Tough shit”? (I do apologise – I very rarely use expletives in my posts, but I feel, it’s warranted here). Because this is what you’re saying, aren’t you? Oh well, you know, shit happens, but we just cannot help but ride into the psychiatric sunset, the all-successful Clint Eastwoods of medicine.

I assume that psychiatry’s involvement in politics (Soviet stuff is just the beginning) is also part of your rich heritage when you tried alleviate the suffering….Just like with aversion therapy for which your president recently apologised. I assume she simply didn’t realise that it was part of your ‘rich and controversial’ stuff.

That was my rant. What I really want to focus on is the appendix. This is the bottom line of psychiatry.  And I would like to warn my readers, it’s not for the faint-hearted. Let’s start with the creative idea:

Changing minds.

to which I would like to ask: What on earth gives psychiatrists the right to change my mind, for pity’s sake? How bloody presumptuous of you to think is that you simply can change my mind about anything. I dread to think how you do it, to be honest. Will you just drug me out my mind or will you just manipulate me? Neither? So, how about if you let me change my mind, should I choose to, while you, I ask you kindly, keep your distance.

Now, when I was reading how shrinks are described, I was wondering about the strategy. For the first thing that came to my mind was that psychiatry is constructed as this bizarre, off-the-wall discipline which has nothing to do with ‘real’ medicine. The second sentence is:

We heal mind, body and soul

You do?! The soul too? With your crystal ball?  Somehow I don’t understand the reference to the soul. For me the sentence quite dangerously moves psychiatrists from being doctors to being healers  that venture into spirituality and Tarot cards (compulsory to carry them on you at all times!). But, further, what if I happen to think that I haven’t got any soul? Do I still come and see you? Because while I might just about resign myself to you messing with my mind, I really don’t want to invest in a soul, so you can heal it.  In fact, I don’t even know where one gets a soul.

But that’s no all. Apparently psychiatrists are

unashamedly eccentric, quirky, unique, deeply empathetic

and have ‘creative flair’, too. To be completely honest, I would just save the ink and say: bizarre. All this eccentricity and quirkiness, for me, just about confirms the worst stereotypes I have of psychiatrists. Strange people who deal with strange things, and it’s probably best keep a distance. But let me put it in a different way. You’re depressed, you find it difficult to get out of bed, but, hey ho, you can meet our eccentric psychiatrist Bob, whose quirkiness and intellectual curiosity will deprive you of the will to live after two questions. This whole bloody text suggests that, in fact, psychiatry has nothing to do empathy. Strange people who pry!

But, at least, now you know that psychiatry treats the whole person. Angina, you see the shrink, sprain an ankle, the shrink is a phone call away, rash – don’t worry, the shrink will make it disappear while healing your soul. Bloody hell, this is psychiatric diarrhoea not empathy.

Now, let me offer a suggestion. My own, personal. If I were to see a shrink tomorrow, I would like to know two things. First, that s/he is normal. A normal person and a normal doctor. Second, I would like to know that I am quite normal, and not a freak. So, if you must rebrand psychiatry, which I think is, on the whole, a bad idea, how about saying it’s OK to see a shrink. It’s normal to see a shrink. How’s that?

Now, this was supposed to be the end of this post. Unfortunately, there is one more text that has been bothering me for some time. I haven’t written about, because it’s probably not for a large post, also, some of my recent posts have attracted some, perhaps, irritation (?) and I guess, I didn’t want more. But as I get to rant against psychiatry, in the interest of balance, let me offer a psychology rant. At least I’d get pummelled in one go.

Here is a recent position statement on suicide. I read it with interest, I agree with some, I don’t agree with other things. But what struck me were the modal verbs (yes, I know, it’s sad) in the recommendations statement at the end of the document. There are 11 recommendations, 10 of which start with a sentence which contains a modal verb – either ‘must’ or ‘should’. And I find their distribution quite fascinating. This is because, ‘must’ occurs only this recommendation:

The government must ensure investment in research into public mental health interventions and research into innovative brief psychosocial interventions (employing a range of delivery methods and modalities) to reduce suicidal ideation, suicidal behaviours and deaths by suicide.

The rest – from 3 to 11 – contain ‘should’. And I find it quite self-serving. Is the text really meant to say that the only area which ‘must’ happen is where researchers benefit (in)directly? And there is no such urgency in, say, mandatory GP training. For the authors say:

The Royal College of General Practitioners should consider the development and introduction of mandatory GP training on identifying signs and symptoms of suicide ideation/behaviour;

If language matters, and this mantra is repeated so many times, you think nothing else matters (oh yeah!), it matters also when you write position statements.

I want to be very clear. I analyse text. I do not wish to speak to the intentions or mind states of the authors. I don’t even know whether the six great scholars actually wrote the final version of the statement. And I don’t care, as I only want to speak about the text. And the text, in my view, sucks. There is a false note, discord introduced by the urgency and high obligation constructed for research funding and absence of such urgency when it comes to all the other recommendations.  You know, language matters.






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