[D66] Paternalism and psychiatry

[René Oudeweg]

madintheuk.com
Paternalism and psychiatry - Mad in the UK
Cathy Wield
9–11 minutes

It seems to me that many doctors who self-select to do postgraduate 
training in psychiatry are attracted to the profession largely in a 
quest for self-realisation. Once trained, they pride themselves as 
doctors who are compassionate listeners, unlike most of their colleagues 
in the medical profession who are doers and fixers. Psychiatrists like 
to get to the bottom of things, to see people as they really are. They 
believe they are best placed to interpret the words, actions and 
behaviours of their patients. Without any confirmatory tests, it will be 
the psychiatrist’s conclusions that will be the foundation on which a 
diagnosis is made. Psychiatrists see themselves as unique in possessing 
the wisdom needed to make such judgements and have become the experts on 
whom the world trusts, able to differentiate and define, motive and 
intention in complicated lives. Their opinion is so widely respected 
that the lay public becomes nervous, fearing that a psychiatrist can 
‘read their mind’.

Psychiatrists also have powers which other doctors do not have. They can 
force their patients to have treatment and to be incarcerated, and 
detained under lock and key. Such patients have little recourse to 
advocacy or to lawyers. Once sectioned (detained), they have no 
entitlement to vote.

Many psychiatric patients have been in the system for years. Those who 
have survived the plethora of psychotropic drugs and treatment will have 
been or are still being harmed. Yet when these very same individuals 
attempt to make any retrospective claims, they have no way of proving 
that they have been hurt. Their medical record will always be written 
from the psychiatrist’s point of view. Psychiatrists will always have 
the safety net that their patients’ accounts cannot be validated due to 
the diagnosed mental condition they were ‘suffering from at that time’. 
Their doctors express their beneficence with a knowing shrug of the 
shoulders and shaking of the head. They can dissolve any argument 
without question by the psychobabble which predominates throughout their 
patient’s psychiatric record. All in all, psychiatrists have a golden 
ticket to sanctioned paternalism.

Take Jean. She has been drugged to the eyeballs over many years. Once 
she was slim, suffering from a problem which was first termed 
‘anorexia’. But as is the psychiatrists’ wont, this morphed into 
depression and then ‘psychosis’. They gave her more and more drugs, and 
then deemed her incurable, spat her out of the system labelled her as 
having a ‘personality disorder’.  Like many she was thought of as a 
‘hopeless case’, and in common with others when she self-harmed, the 
psychiatrists claimed it proved their point. In the defence of such 
diagnoses, psychiatrists never fail to mention how their patients 
exhibit outrageous behaviour such as self-harm or acts of aggression. 
Psychiatric patients have been forced into lives of boredom and 
dependency and such ‘behaviours’ are commonplace within a system where 
they are not listened to. For many patients, it is the only way that 
they can get any attention at all.  It is psychiatry that has made them 
dependent on the system and then they are punished for their dependence. 
After years of hospital treatment, years of medication, Jean is 
overweight. She has metabolic disorders caused by her medication and 
long-term sleep disturbance. She has no means of earning a living and 
like many who are discharged from care as a psychiatric success story, 
she is living as best she can out in the community and claiming 
benefits.  She cannot suddenly change her life. She has no chance of 
getting the last 30 years back.

When patients such as Jean who have spent the better part of their adult 
lives being ‘treated’ by psychiatric services are then informed that the 
drugs they took in the hope of recovery, were exactly what robbed them 
of the chance to lead their best life, their pain and loss becomes 
unbearable. It is Catch-22. Those patients whose lives have been 
destroyed have no way of answering back and so the wheel keeps turning.

Why is it that society is not rising to their defence? I suggest that 
ignorance is bliss and it is only in governments’ interest to care for 
citizens who they see as either productive or likely to win them votes. 
They will take notice of certain vulnerable sectors of society like 
babies and young children because they are the future. They will take 
notice of the elderly because they themselves may live to become old. 
They will care for the disabled only if there are those to champion 
their cause. But there are few willing to advocate for those who have 
survived the excesses of psychiatry. Psychiatric patients, though 
vulnerable are not useful; they are victims who are seen as wasters. 
Many survivors have acquired long lists of psychiatric diagnoses. These 
labels stick like glue and along with drunks, addicts or the homeless, 
their lives are considered low value and easy to dispense with. This is 
humanity at the bottom of the barrel, forgotten.

The ‘mentally ill’ were euthanised even before the Jewish population in 
the horrendous mass extermination of the Nazi Holocaust. It is 
convenient to forget this fact, as much as it is convenient for 
Holocaust deniers to diminish the suffering of the Jewish nation, or for 
the empire to forget how she contributed to the vast destruction of 
indigenous communities and peoples across the globe.

We might say the right things, such as ‘a nation should be judged by how 
it treats its most vulnerable’, and of course, it is right to look at 
those within its population who are discriminated against, whose 
well-being must be preserved. Yet perhaps nations should be judged by 
how they treat those members of their society who are most despised 
within it. Even so, today’s Western societies like to think of 
themselves as more advanced, and less capable of committing the 
atrocities of the past. But our recent history says otherwise. Extreme 
opinions are commonplace, fake news is rampant and yet freedom of speech 
is curtailed. There are attempts to silence debate and stop the 
criticism of current healthcare practice including the prescription of 
medications that are thought to be causing, or have the potential to 
cause, catastrophic harm in the lives of individuals. Doctors can’t even 
talk about these things openly for fear of bringing the wrath of their 
regulatory bodies down on their backs. Not long ago a doctor whose 
opinion on the Covid-19 vaccinations was not in line with the official 
messages from the government was disciplined for voicing his opinions 
publically. Following this, the media publicised the fact that one of 
the vaccines was found to cause death in certain vulnerable individuals. 
Why silence the canary in the coal mine?

This is a pivotal time as big pharma has spread the net wide, hoping to 
increase their profit throughout the world. There are psychiatrists who 
are prepared to sacrifice themselves and their reputation rather than 
continue with the status quo. They seek to debunk the myths of chemical 
imbalance and overturn the diabolical lies when the pharmaceutical 
industry claim their drugs are safe as well as effective. We honour 
their efforts and their agreement to partner with patients. But it is 
critical that many advocates arise from amongst us, whether survivors, 
friends or family of loved ones.

There are still psychiatrists who are in denial when the harms their 
discipline has caused to patients and their families, is brought to 
their attention.  Thankfully it is not everyone and there are 
psychiatrists who are listening to the thousands of patients who are 
giving testimony about the suffering that has resulted from their 
psychiatric treatment. But can we allow psychiatrists to reform their 
own profession from within when they have been given enough time and 
have failed to put their house in order? It is serious when they are 
blinded by the mythology surrounding EBM (evidence-based medicine) and 
RCTs (randomised controlled trials.) They are not objective – perhaps it 
is not possible while they have vested interests in their own careers. 
Undoubtedly it’s a no-brainer that those who profit from the sale of 
their products are the last people to go to for independent evaluation.

Unfortunately, the psychiatrists who refuse to be open about their 
recent history, hold the prizes for arrogance and paternalism within 
their anachronistic profession. They sit under the umbrella of 
respectability, and even if they do not directly put financial gain or 
the nebulous concept of the ‘greater good’ above the safety of 
individual patients, they enable those who do. They are the wolves in 
sheep’s clothing, and while they present themselves as benign, 
truth-seeking, compassionate individuals, they are dangerous beyond 
belief. They have lost their way and lost their most valuable talents. 
They are no longer able to treat every patient as an individual with the 
time and care that they would want for the most loved member of their 
family.

I believe we cannot afford to wait any longer – it is time for us to 
stand up and fight for our rights and to prevent more irreparable damage 
to be forced on us by those who are old school, patriarchal, 
institutional, and self-seeking and whose primary goal is to preserve 
their notional expert status.

Editor’s Note: These posts are designed to serve as a public forum for a 
discussion about the mental health system and related interventions, 
critiques and alternatives. The opinions expressed are the writers’ own.