Things Psychiatrists and Therapists Do to Help You Stay the Way You Are


1) Call your troubling emotions an “illness.” An illness is something that happens to you independent of your control. While certain behaviors under your control (smoking, for example) may bring on illness, once an illness develops it runs its course outside of your control, and only medical intervention (also external) can stop it. Emotions, on the other hand, come from your ideas and beliefs. Your ideas and beliefs are not always conscious, but they can always be made conscious — by you — and challenged, corrected, and acted on … or not. While there might be a known biological illness affecting your emotions and beliefs (such as dementia), the mere fact of troubling emotions is not, in itself, proof of illness.

2) Label your failure or refusal to achieve what you want as “depression.” Depression has become the all-purpose term, so overused and now so completely and utterly devoid of any meaning whatsoever, that it’s perfect for ensuring that you stay the way you are. While it might seem cruel or harsh to blame yourself for your failure to accomplish what you want, it’s actually the only way to face the truth and possibly make course corrections while there’s still time. To conclude, “Oh, I’m depressed. That’s why I haven’t done what I wanted,” is to state the obvious, and to ignore mistaken beliefs or actions that are the real cause of why you haven’t yet accomplished what you want. To me, it’s kinder to be accurate to yourself while it’s cruel to delude yourself. I consider psychiatrists and therapists who encourage you to believe depression is the cause of all your ills to be cruel.

3) Define “functioning in society” as the standard of mental health. If you take the time to read the American Psychiatric Association definition of mental health, you’ll find that functioning in society is a key part of the definition. Imagine if you lived in a society dominated by Nazis, or terrorists, or nutty religious fanatics. Is fitting in with them the definition of mental health in those societies? If not, then why is fitting in the definition in one place, and not another? I assume you could say that fitting in to a rational society is mentally healthy, while fitting in to an irrational one is not. OK, but is any society completely rational? Is majority opinion necessarily the most rational? Consider our own. Is American society completely rational? Look at the news — and I’m referring here to the behaviors of our most educated and powerful people, in particular. Are most of them acting like rational people? Are most of them saying completely rational things all the time? Unless you think so, then you surely cannot assume that fitting in is the definition of mental health, even in America as opposed to Nazi Germany or totalitarian Iran.

4) Imply that your obnoxious or otherwise self-defeating behaviors are due to external factors. For example, “I suffer from procrastination.” Or, “I suffer from anxiety.” Or, “I suffer from OCD.” Whether these are accurate facts or not, how does it help you to change to say you “suffer” from your own odd behaviors? Are you the victim of your own behaviors? How can you be the victim of yourself? Normally we think of a victim as someone held at gunpoint. When held at gunpoint, or otherwise physically coerced, it’s accurate to call someone a victim. But if you’re doing stupid or self-defeating things — things which you can change and you know you ought to change, things nobody is forcing you to do — then you’re not a victim of anything. You’re doing things that for some reason you find easier to keep doing than putting the effort into changing. Admit it. The truth will set you free and you’ll possibly change. Or, you can keep saying that you “suffer” from these maladies of behavior and find well-paid mental health professionals to help you delude yourself into believing that you’re the helpless victims of your own nutty beliefs and behaviors. The choice is yours.

5) Pretend that psychiatry is an exact science when it’s barely a science at all. It’s true that medications are very real substances that do very real things to your brain, at least if taken in high enough a dose. However, a science is more than a pill. For something to be a science, it implies that the people administering the substance have some idea about what that substance will do in all or most cases. For example, a physician who gives you an antibiotic is reasonably certain that it will kill, or at least arrest the strength of, the infection detected in your body via an objective medical test (blood, urine, whatever). A psychiatrist is nothing whatsoever like this. Psychiatrists diagnose by inference, or even subjective feeling, not by objective tests or observation. In the field, you’ll find different psychiatrists who play guess work — not always random guess work, but still guess work — based on prescribing the medications they personally like best. If one doesn’t work, they try another. Conveniently, the psychiatrist spends about 5 to 10 minutes a month with you (if you’re fortunate) to assess how well the medication is working. In practice, this means that you get little or no time to explain how you’re really doing. Yes, you can go to a therapist weekly or even more often, spend an hour each time with that therapist, and give that therapist a good idea of how you’re really doing. But no psychiatrist I have ever encountered (and I have been a therapist since 1988) has ever paid much attention to the perspectives or opinions of any therapist. Psychiatrists are trained to conclude that medication is THE answer, and that anything else a person tries to do to improve his life (therapy included) is silly and unnecessary. And psychiatrists spend so little quality time with their patients that they’re in no position to ever find out otherwise. End result: Patients usually stay the same, concluding, “I guess it’s working — how could a doctor be wrong?” — and that’s the state of psychiatric care as we know it today.