
Is Psychiatry Now a “House Divided”?
Hired guns.” “Whores.” “Greedy, insensitive bastards.“ These are some of the more printable epithets used to describe psychiatric physicians who (allegedly) have “sold out to Big Pharma.”
"Hired guns.” “Whores.” “Greedy, insensitive bastards.“ These are some of the more printable epithets used to describe psychiatric physicians who (allegedly) have “sold out to Big Pharma”-for example, by failing to disclose conflicts of interest, or to report large sums of money earned through their work with pharmaceutical companies. It may surprise some-but perhaps not many-that these terms of abuse were hurled not by members of some anti-psychiatry group, but by psychiatrists, writing on a well-known “watchdog” blog site.
To be clear: I have no wish to excuse or rationalize the actions of some in our field who indeed have abused the public trust by engaging in any of the actions described. Anger-even outrage-is appropriate and healthy, with respect to their behavior. But must we also demonize these individuals, some of whom (notwithstanding their transgressions) have made important contributions to clinical care and scientific research?
The late Dr Albert Ellis-the psychologist who originated
We often tell our patients they should not condemn the totality of their being on the basis of a selfish or hurtful act they have committed-yet some of us seem all too ready to condemn a colleague in the most sweeping and dehumanizing terms, because he or she is guilty (or is believed guilty) of one or more ethical lapses. By all means, let us condemn the transgressions! But let’s also retain a scintilla of human sympathy and understanding for the flawed human beings who committed them.
The problem of “demonizing rhetoric” is obviously not confined to the field of psychiatry, where it seems to be the effluvium of a few particularly bilious individuals. The language of demonization is all too prevalent in the narratives of many political and religious groups, who attack their opponents as infidels, heretics, traitors, or even worse. Carried to an extreme, we find terms like “vermin” applied to ethnic or religious groups who are the objects of hatred or persecution-the Nazis were infamous in their use of this term. Yes, I know-there is a difference between calling someone a “drug company whore” and reducing the person to the status of vermin. But the distance between the terms is not as wide as some would persuade themselves. And when one moves from the psychiatry blog sites to the rabid anti-psychiatry websites (eg,
The divisions within psychiatry extend far beyond concerns over “conflicts of interest” and “Big Pharma”-where there are, at least, valid ethical issues to be raised. Unfortunately, the profession continues to be mired in the same fruitless arguments over “biology” versus “psychology” that anthropologist Tanya Luhrmann documented in her classic investigation,
This sterile debate persists, despite the heroic efforts of “pluralistic unifiers”, such as my colleagues
"Every kingdom divided against itself is brought to desolation; and every city or house divided against itself shall not stand."--
“Judge the whole of the person charitably.”-Talmud (Pirke Avot, 1:6)
Newsletter
Receive trusted psychiatric news, expert analysis, and clinical insights — subscribe today to support your practice and your patients.