Thank Goodness for Psychiatry!

PSYCHIATRIC VIEWS ON THE DAILY NEWS

The Thanksgiving holiday is usually devoted to giving gratitude to loved ones. But why not add on our workplace and field of psychiatry? This focus might be a bit of a necessary counter to the ongoing intermittent criticism of our field, from the early days of warehousing patients in large institutions to modern antipsychiatry, and more.

Perhaps some of the genesis of the criticisms, much stronger than the rest of medicine, lies in the nature of psychiatry. Our precious brains have been so well protected that research on it is more difficult. Then, what about the mind and even soul? Those aspects that are more ethereal and depend more on faith, at least for now. Then there is the challenge of accepting one’s own mental disorder as that challenges one’s own identity, and that individuals with severe disorders have been stigmatized and labelled as “crazy.” Our patient care outcomes have also been questioned and difficult to document.

Our scope of practice is not clearcut. Although individual patient care is our primary ethical responsibility, what about our ethical responsibility to improve the mental health of our communities? Another obstacle here is the so-called Goldwater Rule which, which advises against using our knowledge in discussing public figures.

And yet, we persist. We try to do our best with often inadequate resources, especially for the poor. We overcome stigma against our patients and ourselves. We are vulnerable to secondary trauma when we care for significant numbers of traumatized patients. The obstacles of these challenges and the primary business goal of profits result in an epidemic rate of burnout and a growing prevalence of moral injuries.

Like Thanksgiving, though, family conflicts and disagreements can reduce the enjoyment of the holiday. Similarly, when psychiatrist colleagues are overly critical or dismissive of other colleagues, say in regard to the conflict in Gaza, psychiatry can crack from within.

There is a Japanese practice of repairing broken pottery by using gold or platinum to paste broken pieces together. It is called kintsugi. Often, the vessels become more attractive and stronger than it was before. Let such kintsugi be the case with psychiatry as we move ahead.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.