Understanding the Haters

If you went to APA this year, or any year, you know there are people who don’t like psychiatrists. Traditionally, we’ve referred to them as being part of the “Anti-Psychiatry” movement, but I’ve come to realize, through years of writing a psychiatry blog, that there are shades of grey here (though not necessarily 50). I’ve stopped lumping everyone who is critical of our work together in one category as “anti-psychiatry” because our critics differ as to just how "anti" they are. Instead, I’ve come to loosely refer to them as “The Haters.” It’s probably an awful term because adults cringe at the word “hate,” but I borrowed it from my teenage children who seem to use it freely, and if you look in UrbanDictionary.com, you’ll find that there are seven definitions for the term “hater.” For my purposes, I like #6 the best:

A label applied to people who are more negative than positive when discussing another person. It most commonly refers to individuals whose negativity is so extreme that it is all-consuming. However, there are various levels and forms of being a hater, ranging from completely dismissing any positive traits or actions, to merely painting a less than flattering picture by using words with negative connotations. Hating is often attributed to jealousy, but just as often, it seems to stem from some other source.

For my own personal use, psychiatry “haters,” used facetiously, include all of those people who are outspoken against our work. It seems too easy to lump our critics together in a single category of radical anti-psychiatry proponents: those who march with signs saying “Psychiatry Kills,” or who show up at APA with jumbotrons or who chant in unison, “Stop drugging and shocking our children!” It’s easy to dismiss the concerns of those who belong to the anti-psychiatry movement; they don’t understand what we do, they are over-the-top; and they aren’t interested in a having a discussion with us. But they do have power and they do influence how others (including legislators), see our field.

While many haters are angry, many have valid messages--ones we should consider, engage with them about, and use to look more closely at our field. I’ve broken the haters down into a few categories. Please note, these are my own observations. These are not validated classifications and the is no peer-reviewed research available on psychiatry haters. Perhaps there should be.

So “haters” exist along a spectrum:

• There are those that believe that psychiatry as a field should be abolished. Psychiatry inflicts harm, and if you feel it’s been helpful to you, you’re wrong. Those aren’t symptoms you’re having: your problems are the result of the medications, which cause perfectly normal people to become crazy. Mental illness isn’t real, it was created to benefit psychiatrists. Psychotropic medications should be illegal, and no one should be prescribed them. These haters are the traditional anti-psychiatry movement members.

• There are haters who are angry for individual reasons. Perhaps they had a bad reaction to medication, or are angry about events pertaining to hospitalization. They may openly discuss their distress in books, on blogs, or on listservs, but they don’t believe that psychiatry should be abolished or that no one else should be permitted to take medications. It is important to listen to these stories, to validate distressing experience, and to ask if there are different ways of approaching problems— certainly for the individual in question, and perhaps as such issues pertain to other patients as well.

• There are haters who specifically feel that the pharmaceutical companies have deceived the public and medical professionals, and have tainted psychiatric care toward a bias of overusing, or inappropriately using, medications. They may be right (or am I a hater?).

• There are haters who focus on psychiatry as an instrument of control, and they talk about authority imbalances, the wrongness of forced care for those who are dangerous, and philosophical issues of power. Sometimes, it is difficult to navigate these discussions.

• There are haters who have had bad experiences with a single doctor and who generalize this to all of psychiatry. Perhaps their bad experiences were the result of poor interpersonal chemistry, an elevated degree of sensitivity to human interactions, overly high expectations, or perhaps they simply had a bad experience with a bad psychiatrist. Sometimes a subsequent, more positive, experience helps the individual become less of a hater.

• There are haters who are angry because they lack insight into their illness and view their behavior or emotions as being normal when others do not. They may feel they were forced, or unduly cajoled, into getting psychiatric care, and if they played a role in creating a difficult situation, they may not see it. These are really difficult situations for everyone involved.

I’ve probably missed a few “hater” subsets. As a field, I believe we’ve gotten better about considering the concerns of those who criticize us. As we work to find better treatments for our patients, we need to remain open to hearing out those who feel they have been wronged by psychiatrists and psychiatric treatments. There are certainly moments when we can learn from the haters and when they can learn from us. Education and open communication go a long way toward letting those who need help actually get it in a way that comforts, rather than antagonizes, the patient.

Other articles:

From Shrink Rap: Top Ten Things That Annoy Me About Psychiatry Haters from Psychiatric Times, May 24, 2012, “Moving Beyond Hatred of Psychiatry: A Brave Voice Speaks Out,” by Ronald Pies, M.D. (May require subscription to Psychiatric Times)

--- by Dinah Miller, M.D. 

DR. MILLER is the co-author of Shrink Rap: Three Psychiatrists Explain Their Work, published by Johns Hopkins University Press.

If you went to APA this year, or any year, you know there are people who don’t like psychiatrists. Traditionally, we’ve referred to them as being part of the “Anti-Psychiatry” movement, but I’ve come to realize, through years of writing a psychiatry blog, that there are shades of grey here (though not necessarily 50). I’ve stopped lumping everyone who is critical of our work together in one category as “anti-psychiatry” because our critics differ as to just how "anti" they are. Instead, I’ve come to loosely refer to them as “The Haters.” It’s probably an awful term because adults cringe at the word “hate,” but I borrowed it from my teenage children who seem to use it freely, and if you look in UrbanDictionary.com, you’ll find that there are seven definitions for the term “hater.” For my purposes, I like #6 the best:

A label applied to people who are more negative than positive when discussing another person. It most commonly refers to individuals whose negativity is so extreme that it is all-consuming. However, there are various levels and forms of being a hater, ranging from completely dismissing any positive traits or actions, to merely painting a less than flattering picture by using words with negative connotations. Hating is often attributed to jealousy, but just as often, it seems to stem from some other source.

For my own personal use, psychiatry “haters,” used facetiously, include all of those people who are outspoken against our work. It seems too easy to lump our critics together in a single category of radical anti-psychiatry proponents: those who march with signs saying “Psychiatry Kills,” or who show up at APA with jumbotrons or who chant in unison, “Stop drugging and shocking our children!” It’s easy to dismiss the concerns of those who belong to the anti-psychiatry movement; they don’t understand what we do, they are over-the-top; and they aren’t interested in a having a discussion with us. But they do have power and they do influence how others (including legislators), see our field.

While many haters are angry, many have valid messages--ones we should consider, engage with them about, and use to look more closely at our field. I’ve broken the haters down into a few categories. Please note, these are my own observations. These are not validated classifications and the is no peer-reviewed research available on psychiatry haters. Perhaps there should be.

So “haters” exist along a spectrum:

• There are those that believe that psychiatry as a field should be abolished. Psychiatry inflicts harm, and if you feel it’s been helpful to you, you’re wrong. Those aren’t symptoms you’re having: your problems are the result of the medications, which cause perfectly normal people to become crazy. Mental illness isn’t real, it was created to benefit psychiatrists. Psychotropic medications should be illegal, and no one should be prescribed them. These haters are the traditional anti-psychiatry movement members.

• There are haters who are angry for individual reasons. Perhaps they had a bad reaction to medication, or are angry about events pertaining to hospitalization. They may openly discuss their distress in books, on blogs, or on listservs, but they don’t believe that psychiatry should be abolished or that no one else should be permitted to take medications. It is important to listen to these stories, to validate distressing experience, and to ask if there are different ways of approaching problems— certainly for the individual in question, and perhaps as such issues pertain to other patients as well.

• There are haters who specifically feel that the pharmaceutical companies have deceived the public and medical professionals, and have tainted psychiatric care toward a bias of overusing, or inappropriately using, medications. They may be right (or am I a hater?).

• There are haters who focus on psychiatry as an instrument of control, and they talk about authority imbalances, the wrongness of forced care for those who are dangerous, and philosophical issues of power. Sometimes, it is difficult to navigate these discussions.

• There are haters who have had bad experiences with a single doctor and who generalize this to all of psychiatry. Perhaps their bad experiences were the result of poor interpersonal chemistry, an elevated degree of sensitivity to human interactions, overly high expectations, or perhaps they simply had a bad experience with a bad psychiatrist. Sometimes a subsequent, more positive, experience helps the individual become less of a hater.

• There are haters who are angry because they lack insight into their illness and view their behavior or emotions as being normal when others do not. They may feel they were forced, or unduly cajoled, into getting psychiatric care, and if they played a role in creating a difficult situation, they may not see it. These are really difficult situations for everyone involved.

I’ve probably missed a few “hater” subsets. As a field, I believe we’ve gotten better about considering the concerns of those who criticize us. As we work to find better treatments for our patients, we need to remain open to hearing out those who feel they have been wronged by psychiatrists and psychiatric treatments. There are certainly moments when we can learn from the haters and when they can learn from us. Education and open communication go a long way toward letting those who need help actually get it in a way that comforts, rather than antagonizes, the patient.

Other articles:

From Shrink Rap: Top Ten Things That Annoy Me About Psychiatry Haters from Psychiatric Times, May 24, 2012, “Moving Beyond Hatred of Psychiatry: A Brave Voice Speaks Out,” by Ronald Pies, M.D. (May require subscription to Psychiatric Times)

--- by Dinah Miller, M.D. 

DR. MILLER is the co-author of Shrink Rap: Three Psychiatrists Explain Their Work, published by Johns Hopkins University Press.

If you went to APA this year, or any year, you know there are people who don’t like psychiatrists. Traditionally, we’ve referred to them as being part of the “Anti-Psychiatry” movement, but I’ve come to realize, through years of writing a psychiatry blog, that there are shades of grey here (though not necessarily 50). I’ve stopped lumping everyone who is critical of our work together in one category as “anti-psychiatry” because our critics differ as to just how "anti" they are. Instead, I’ve come to loosely refer to them as “The Haters.” It’s probably an awful term because adults cringe at the word “hate,” but I borrowed it from my teenage children who seem to use it freely, and if you look in UrbanDictionary.com, you’ll find that there are seven definitions for the term “hater.” For my purposes, I like #6 the best:

A label applied to people who are more negative than positive when discussing another person. It most commonly refers to individuals whose negativity is so extreme that it is all-consuming. However, there are various levels and forms of being a hater, ranging from completely dismissing any positive traits or actions, to merely painting a less than flattering picture by using words with negative connotations. Hating is often attributed to jealousy, but just as often, it seems to stem from some other source.

For my own personal use, psychiatry “haters,” used facetiously, include all of those people who are outspoken against our work. It seems too easy to lump our critics together in a single category of radical anti-psychiatry proponents: those who march with signs saying “Psychiatry Kills,” or who show up at APA with jumbotrons or who chant in unison, “Stop drugging and shocking our children!” It’s easy to dismiss the concerns of those who belong to the anti-psychiatry movement; they don’t understand what we do, they are over-the-top; and they aren’t interested in a having a discussion with us. But they do have power and they do influence how others (including legislators), see our field.

While many haters are angry, many have valid messages--ones we should consider, engage with them about, and use to look more closely at our field. I’ve broken the haters down into a few categories. Please note, these are my own observations. These are not validated classifications and the is no peer-reviewed research available on psychiatry haters. Perhaps there should be.

So “haters” exist along a spectrum:

• There are those that believe that psychiatry as a field should be abolished. Psychiatry inflicts harm, and if you feel it’s been helpful to you, you’re wrong. Those aren’t symptoms you’re having: your problems are the result of the medications, which cause perfectly normal people to become crazy. Mental illness isn’t real, it was created to benefit psychiatrists. Psychotropic medications should be illegal, and no one should be prescribed them. These haters are the traditional anti-psychiatry movement members.

• There are haters who are angry for individual reasons. Perhaps they had a bad reaction to medication, or are angry about events pertaining to hospitalization. They may openly discuss their distress in books, on blogs, or on listservs, but they don’t believe that psychiatry should be abolished or that no one else should be permitted to take medications. It is important to listen to these stories, to validate distressing experience, and to ask if there are different ways of approaching problems— certainly for the individual in question, and perhaps as such issues pertain to other patients as well.

• There are haters who specifically feel that the pharmaceutical companies have deceived the public and medical professionals, and have tainted psychiatric care toward a bias of overusing, or inappropriately using, medications. They may be right (or am I a hater?).

• There are haters who focus on psychiatry as an instrument of control, and they talk about authority imbalances, the wrongness of forced care for those who are dangerous, and philosophical issues of power. Sometimes, it is difficult to navigate these discussions.

• There are haters who have had bad experiences with a single doctor and who generalize this to all of psychiatry. Perhaps their bad experiences were the result of poor interpersonal chemistry, an elevated degree of sensitivity to human interactions, overly high expectations, or perhaps they simply had a bad experience with a bad psychiatrist. Sometimes a subsequent, more positive, experience helps the individual become less of a hater.

• There are haters who are angry because they lack insight into their illness and view their behavior or emotions as being normal when others do not. They may feel they were forced, or unduly cajoled, into getting psychiatric care, and if they played a role in creating a difficult situation, they may not see it. These are really difficult situations for everyone involved.

I’ve probably missed a few “hater” subsets. As a field, I believe we’ve gotten better about considering the concerns of those who criticize us. As we work to find better treatments for our patients, we need to remain open to hearing out those who feel they have been wronged by psychiatrists and psychiatric treatments. There are certainly moments when we can learn from the haters and when they can learn from us. Education and open communication go a long way toward letting those who need help actually get it in a way that comforts, rather than antagonizes, the patient.

Other articles:

From Shrink Rap: Top Ten Things That Annoy Me About Psychiatry Haters from Psychiatric Times, May 24, 2012, “Moving Beyond Hatred of Psychiatry: A Brave Voice Speaks Out,” by Ronald Pies, M.D. (May require subscription to Psychiatric Times)

--- by Dinah Miller, M.D. 

DR. MILLER is the co-author of Shrink Rap: Three Psychiatrists Explain Their Work, published by Johns Hopkins University Press.