What People Want vs What Psychiatrists Can Offer: The Fantasy and the Reality

The psychiatric fantasy

• To eliminate unwanted feelings-with a pill-but the pill must be “natural,” contain no chemicals, and produce no adverse effects

• To be thoroughly understood and have all emotional demons exorcised-in 15 minutes

• To stop people from behaving immorally or dangerously

• To give powerful, life-enhancing advice, like experts do on the talk shows (the more charismatic and commanding, the better)

• To pen and consult the Book of the World, whose pages all converge toward a single agreement and unifying theory of human nature; the BOW describes human behavior with an accuracy surpassing basic physics

The psychiatric reality

• First-do no harm

• Make genuine, sincere efforts to relieve suffering

• Make earnest endeavors to serve patients’ best interests

• Offer empathic listening and honest communication

• Provide full disclosure of the following:

(a) No one can read minds or predict complex human behaviors

(b) There are limits to what doctors and medicine can accomplish

(c) Some illnesses can be intractable

(d) Ultimately, all lasting change in psychiatric illness requires an inward effort on the part of the sufferer

• Offer invitations to:

(a) View as much reality as possible without fear

(b) Accept uncertainty

(c) Relinquish, to the extent possible, rigid or dogmatic thinking

(d) Distinguish needs from wants

(e) Relinquish harmful patterns

• Do all of the above-to the best of our ability

[Editor's Note: This serves as a sidebar to Dr Knoll's article, "A Synapse Darkly."]