I wandered into that discussion when I came across a link to it in a blog search on "schizophrenia". A thread had been initiated there by an individual who goes by the user name of chaos.
Chaos is a diagnosed "schizophrenic" who is training to become a psychologist; he/she had posted a question to the group at large -- namely, should a diagnosed schizophrenic disclose their condition to their peers and advisors?
I happen to have a certain degree of fondness for individuals who have been diagnosed with schizophrenia and I especially like them to know that there is never cause to give up hope -- many people have recovered and some, like chaos, have gone on to become professionals within the mental health field where they often serve as a beacon of hope to others, i.e., Dr. Daniel Fisher.
Within that community, there just so happened to be another thread devoted to the subject of "Psychologists With Mental Disorders". I participated in that thread as well and thought it was very fruitful, very informative. I was thanked for my participation by at least one other participant and the moderator who banned me (psisci) also took part in that discussion, addressing me directly and engaging me in the discussion. Naturally, these behaviors did nothing to indicate to me that I was in violation of any community guidelines. Apparently however, I did violate something, perhaps when moderator psisci -- a licensed psychologist -- said this:
Schizophrenia is a very debilitating disease that is not curable, but is treatable.
Any reader of this blog would know that not only do I not agree with that statement but that numerous clinicians in the fields of psychology, psychiatry and neurology also do not agree with it. Rather than argue that point with psisci, I chose to highlight some quotes from this blog that demonstrate that statement is not a valid one -- many people have recovered from schizophrenia.
What happened next?
The thread was closed.
This comment was offered as an explanation:
psisci: I understand your points, however this board is for student doctors not patients. A forum affiliated with SDN would be perfect for your topic www.psychcentral.com.
MOD
Because I was not able to respond in that thread I initiated a new one, explaining that it had not been my intent to contravene any community standards but that nothing in my experience of that community thus far had indicated to me that I was in violation of any community norms. I pointed out that the registering software not only allows non-student-doctors to register and post, it also allows them to identify themselves as non-student doctors! Apparently, those who set up the standards for potential registrants felt that participation by those who were not doctors-in-training was quite acceptable.
I stated that it was distressing when topics were closed down as based on undisclosed expectations and then thanked the moderator for the suggestion that I investigate www.psychcentral.com. At this point, my post was deleted and I was banned from the community with no explanation.
As noted, psisci had engaged in direct dialogue with me, even after I had explicitly noted that I was not a doctor or a student-doctor. This behavior has left me puzzled as to why that moderator would feel it was necessary to silence me and remove me from the community.
This blog currently receives 600 - 1000 page views per week [Note: Actual page views this week were 1,267.] so I'm going to leave it to my readers to determine for themselves exactly what happened and what I said that was so offensive that psisci felt it was necessary to take the actions he did. Those who wish to do so can read that thread here: Psychologists With Mental Disorders. [For the record, I would advise the moderator(s) to not remove that thread. It's already been read by more than 450 people and according to my site stats, a number of them are also reading here.]
Everything is a learning opportunity, is it not? There is a lesson here in this experience of mine -- for people like chaos, for people like psisci, for those of you who read this blog on a regular basis, and for those of you who go into the mental health field as motivated by a sincere desire to help others overcome the debilitating effects of severe mental illnesses, including the bias and stigma that surrounds those who currently or ever have suffered from them.
I have just received this message in my web-based mailbox...
We are happy to have you here, but you posted as a patient who has recovered from schizophrenia, and challenged the treatment of this disease in a medical fourm. Posting with personal experiences, asking for medical feedback is a violation of the TOS for SDN.
MOD
***************
Again, please do not reply to this email. You must go to the following page to reply to this private message:
http://forums.studentdoctor.net/private.php
All the best,
SDN Volunteer Team
Readers are welcome to read that thread and identify where I "asked for medical feedback". They are also welcome to review the Terms of Service of the studentdoctor.net forums.
Naturally, when I attempted to respond to that message I recieved yet another notification that I had been banned from the community. Apparently, silence is greatly preferred to dialogue by those who are licensed psychologists and moderators of the studentdoctor forums.
A few moments ago I discovered that my access had been restored. I further discovered a duplicate of the above message in my private mailbox at that site. I let the sender (psisci) know that I appreciated their kindness in restoring my access but I also let him know that I had made the decision to move on.
These words come to mind in this moment; they were offered to me by the father of a schizophrenic son and given to that father, by his son...
Those are wise words.
Reflections on the above:
I was thinking on this situation through the day and what I found disturbing about it. That conversation opened with a question regarding the legalities of people with "severe mental illness" practicing as clinicians.
The responses to that question were particularly insightful because the conversation unfolded primarily between students who are training to become psychologists -- issues of discrimination, fear, ethics, and the potential harm of categorizing and limiting the potential of others were raised. For a conversation, it had some good meat on its bones! At the point I entered the dialogue, I did so to challenge the premise that a mental illness -- any mental illness -- is of necessity, a permanent condition. What I found most disturbing was the way the conversation was shut down, closed, locked, when the conversation turned to cure.
I have encountered this sort of behavior before. Readers familiar with this blog will know that it was begun after encountering two psychiatrists in the online environment who insisted that schizophrenia is an incurable condition -- they further considered that telling their "patients" as much was an act of compassion. One psychiatrist went so far as to say this: "On behalf of my profession, I do say that psychiatrists are the most gifted of physicians. In no other branch of medicine is the chief complaint so cryptic such that the physician has to start completely from scratch. Often, when a patient is unable to state their chief complaint and there is no one to state it for him, the patient is passed off as crazy, and sent along to psychiatry to figure him out, or he dies."
Can you feel the love?
Meantime, I'm thinking that perhaps what offended psisci most was a comment I made in my post that was deleted -- I stated that I was not a patient; a therapeutic relationship with a psychiatrist or psychologist was not a factor in my recovery. I was not hospitalized, nor have I received any form of psychiatric medication. Maybe I was banned for not adopting the subservient role that is expected by some doctors of those they profess to serve. Maybe I was banned for challenging psisci's declaration of expertise. Regardless of the motive, the end result was the same: I was silenced, excluded, pushed out -- not even allowed the opportunity to speak on my own behalf. When I attempted to do so, that post was deleted and I was banned.
The first few times I saw this kind of behavior in professionals, it shocked me. I'm not shocked anymore. Those who can speak of recovery are those who have recovered; there are some within the medical community who would prefer that they not speak.
What I also find disturbing is that psisci was once a student-doctor, just like all the rest of the student-doctors in that community. Someone, somewhere told him that schizophrenia was incurable and that statement became sanctified as higher knowledge to the extent that speaking against it is akin to blasphemy. Meantime that statement will get passed on to the next group of student-doctors, many of whom will probably go on to silence those who can speak knowledgeably of recovery.
See also: Vincent
A clinical psychologist writes...
This is a wonderful spot. I read through your experience [at the above medical forum]. For the most part you encountered lazy jibberish.
The 'Synopsis of Psychiatry' is about the most widely used psychiatric texts by psychiatric residents in training. You can't get more mainstream or 'medical model. That said, here are excerpts from the 9th edition page 497 under 'prognosis' for schizophrenia: 'Reported remission rates range from 10-60% ....reasonable estimates that ....30% of schizophrenic patients are able to live somewhat normal lives. Another ....30% go on to experience moderate symptoms ....and 40% ....remain significantly impaired ....their entire lives.'
This simply doesn't jive with the jibberish you were hearing.
There are a fair number of luminaries in psychology and psychiatry who 'carry diagnoses' of schizophrenia and bipolar illness....more bipolar. If we looked at the lifetime prevalence of diagnosable mental disorders in the careers of mental health professionals, we will see a majority of clinicians 'qualify' ....some for GAD, Panic, OCD, Major Depression, Dysthymia, Bipolar II, and so on. Most psychologists I know are dysthymic as their baseline, with intermittent episodes of more serious depression.
We have a responsibility to manage any medical problem or cluster of serious psychosocial stressors like we would if we had diabetes, heart disease, hypertension, hypothyroidism, etc. I believe you were dealing with a very young, naive, and 'frightening' group of people in that forum. I am a clinical psychologist, age 47, and felt you were the most intelligent, well read, and sensible one of the bunch.
You have lots of people who know the intimate details of your journey. Don't pay much attention to the uptight frightened --'us-them' mental health types....
Great work you are doing.
Several months ago I had a similar discussion with Dr. Richard Petty in regard to the “schizophrenia is incurable" statement during which he also noted:
This is not true: but rather than being an indictment of psychiatry, it’s an indictment of bad psychiatry. We have a great deal of evidence that the brain is a highly plastic organ, and that many of the typical changes seen even in unmedicated people with the illness can return toward a normal pattern. This shouldn’t be a surprise: it has been known for many years that at least a third of people who carried a diagnosis of schizophrenia recover completely. To say that the recovery indicates that the original diagnosis was wrong is an extraordinary piece of circular reasoning.
Let the above serve as an example that there are good clinicians out there. If you or someone you love should end up with one of those who -- like psisci -- tells you that schizophrenia is incurable, take that as an indication that they are not up-to-date with the current research (or even the not-current research!) and that you should look elsewhere for skilled assistance.
Further reflections...
Regarding the note from the clinical psychologist who responded above...
I did very much appreciate finding that note in my mailbox. I appreciate the support and I think it's important that when one psychologist stands up to speak for their "field" that if others in the field disagree, they should stand up and voice their disagreement. If the individual above hadn't taken the time to respond, readers of this post might walk away with the impression that all psychologists were as misinformed as psisci and that would be an injustice to those in the field who are not that way at all.
The more I think about it, the more I think my "offense" was to state that I was not a patient. Earlier in that thread, psisci had already noted his discomfort with that perspective and likely did not appreciate my affirmation of his fears.
psisci: Not to hijack this thread at all, but WE are doctors, they are patients, we are not lawyers, used car salesmen or real estate agents, and they are not clients whether they pay out of pocket or not..........sigh
Aside from that, I do think the conversation was going along swimmingly; I saw a lot of intelligent responses from others that I found encouraging. The poster who goes by the name of Toby Jones for example, was clearly willing to examine and challenge the boundaries of the issue. Meanwhile, another poster there who goes by the name of Amy203 has had me chuckling all morning with her response to psisci in yet another thread titled: What is Psychology?
I would hope that any reader walks away from this post, not with the feeling that all psychiatrists or psychologists share the arrogance displayed by some, but rather, that it's vitally important to apply the tool of discernment. There are some very good clinicians out there, there are also a certain percentage who should not be permitted within ten feet of wounded human beings.
Remember the golden rule: Choose your caregivers wisely.
Interesting. Apparently, some more discussion has arisen out of the thread that was closed: Ethics Code Info: re personal problems
For those who are interested, the code of ethics of the American Psychiatry Association can be found here. The code of ethics for psychologists appear to be far more substansive, at least on first glance. They can be found here.
Elsewhere in the blogosphere...
Here's Spiritual Recoveries on being booted from a mental health bulletin board for her thoughts on schizophrenia. Glad to see that tomorrow's doctors are learning today how to kick patients out of conversations.
Regards and thanks to Furious Seasons for the plug.
Who is "John Grohol" and what does he have to do with this entry? For those not in the know, John Grohol is a clinical psychologist and also the founder of psychcentral.com. I was curious to know a bit more about him because psychcentral co-hosts the studentdoctor.forums. So I decided to check out the link psisci had recommended to me.
According to this link...
Psych Central is the oldest peer-reviewed psychology and mental health directory on the Internet. Started in 1992 as an index to mental health and support newsgroups it now indexes over 3,500 resources. It also offers hundreds of informative articles on mental health symptoms and treatments, psychology and relationship topics, as well as interactive online quizzes, and a vibrant online self-help support community.
I thought I'd take a gander at the community. What I found was a nice little forum, with an abundance of topics related to mental health issues and well-defined expectations of the participants. The emphasis appears to be on peer support although I am told that a number of students and doctors are members. John Grohol seems to take a reasonably active role in the community as well; he serves as a moderator and even hosts a Tuesday night chat with community members during which they get to ask him all kinds of questions and he does his best to provide some answers. That piqued my interest. I've heard of professionals who blog and professionals who run online communities, but I've never heard of one who chats. It just so happened that a Tuesday night chat was scheduled to begin in less than an hour...
When I logged into the chatroom, several others were already there in anticipation of the evening's event. Through the course of the scheduled one-hour chat session, a number of others popped in and out -- some to ask "Doc John" a question, others to offer up a round of "hellos" to their online friends. The entire chat had a warm free-for-all quality. Several conversations were going on at any one time, but the primary focus seems to be an informal question and answer session between the community and its founder. It was clear to me that the community members liked and respected "Doc John". It was equally clear that he liked and respected them back. As the hour wound to a close I decided to take a turn at the cyber mike...
"I have a question..."
"Sure spiritual," Doc John replied.
"If I'm here," I said, "I'm here to speak about recovery from schizophrenia. Do you anticipate any difficulties with that?"
The conversation drifted in four different directions and I had to redirect him back to my question at one point. Nonetheless, he did respond...
"No," he said. "I don't anticipate any difficulties with you speaking of your recovery ...."
And that was that.
When I logged out of chat I noticed a link down at the bottom of the forum index that linked the psychcentral community directly to the studentdoctor community along with a notation that those looking for discussions with students in psychology should try the Student Doctor Network. None of which provides me with any clearer indication as to why psisci saw fit to delete my post and ban me, but it does let me know that "Doc John" does not seem to operate from the same mindset.
Schizophrenia, Psychosis, Recovery, psychcentral.com, studentdoctor.net, Bias, Stigma,Psychology, Psychologists, Psychiatrists, Psychiatry, Professional Ethics
