Thursday, September 22, 2011

Transference to the Blog, Revisited

Early on in Shrink Rap life, I wrote a post called Transference to the Blog.  A bit tongue-in-cheek but it was inspired by the idea that readers seemed to have their own feelings and internal relationships with Shrink Rap,  just as we had with them --so Counter-transference emanating from the blog was also addressed.   As was transference to the duck.

Over the years, the feelings and tone in the comment section of Shrink Rap has varied quite a bit.  At times it's warm and fuzzy with people writing in to tell their own stories-- good and bad-- and readers offering one and other support.  At other times, it's been rather hostile with reader writing in to express their venom toward psychiatry and to criticize other commenters who say they have benefited from treatment.  From my perspective, I thought things had calmed down, at least a bit, but we've gotten several communications from readers complaining they feel attacked if they make comments.  I worry that our continued commenter-constituent base of those who criticize the field has served to silence those who might like to have a voice.  Even my co-bloggers seem to have lost interest in engaging in these conversations.

Some of the commenters have asked why people return to make the same points over and over.  What interest is there in this drum beat of reiteration after reiteration of why psychiatry is bad.  I've wondered the same thing, and wondered why they don't form their own blog!  If you're a Republican, don't you frequent Republican blogs?  Why hang out and hound the Democrats?  Do Jewish people standout side Catholic Churches to make the point that the Catholics are wrong in their beliefs?   Which brings me to the subject of Transference to the Blog.  Obviously, I can't speak to the motivations of people I don't know, but I am allowed to speculate in my head, and I can't help but assume that those who visit with a repeated agenda that opposes the spirit of by-psychiatrists-for-psychiatrists (and anyone else who might enjoy the ride), do so because they've had a bad experience and Shrink Rap might serve the purpose of being a flame to the metaphorical moth.  It feels like a compulsion to revisit the site of a trauma in the hopes of mastering it.  Sorry if this is too shrinky for you, but oh, hey, I'm a psychiatrist and we do sometimes think this way.

When people make the same adversarial comments over and over,  it gets old and it stifles new ideas and new discussions.

If you believe that psychiatrists wrong patients by inflicting diagnoses on them, that it's wrong to take medications for psychiatric problems or psychic distress, that psychiatrists have evil motives, that psychiatric disorders do not exist, that psychiatric hospitals inflict damage, that involuntary hospitalization is never, ever, warranted no matter how sick or how dangerous someone is, or that psychiatry is about inflicting punishment/being coercive & controlling,  and not about healing or treatment, then please know we have heard you.  You're welcome to your views, but the writers of Shrink Rap don't agree that these are over-riding themes in psychiatry as a whole, and expressing the same opinion and rationale for the 27th time is not going to change this.  On the other hand, it does appear to offend many people who might like the opportunity to comment, express themselves without a barrage of insults, and garner either support or similar stories in a welcoming environment.

This may be read as Don't Criticize Psychiatry.  Read it as you wish.  I don't think we've ever steered readers away from an honest look at the issues, or that we defend every aspect of our work as done by all of our colleagues.  Our book is about psychiatry with the good and the bad, and we mostly discuss it in positive terms with the hope that this will set the standard :  Hey, none of the docs in Shrink Rap are prescribing medications after 10 minute evaluations, they all listen to their patients and have thoughtful discussions--  maybe that's what I should expect.  

If you've made your point, it's been made.  If you have a new point and it critiques psychiatry in a new way, please say it in a manner that is respectful of those who may be struggling.