Comments on: Context and Care vs. Isolate and Control: An Interview on the Dilemmas of Global Mental Health with Arthur Kleinman https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/ Science, Psychiatry & Social Justice Wed, 15 May 2024 20:03:45 +0000 hourly 1 https://wordpress.org/?v=6.5.3 By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-280950 Wed, 15 May 2024 20:03:45 +0000 https://www.madinamerica.com/?p=255900#comment-280950 In reply to Birdsong.

CLARIFICATION: …seeing an MD should be the LAST THING on anyone’s list when feeling EMOTIONALLY DISTRESSED —

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-280242 Mon, 06 May 2024 08:14:47 +0000 https://www.madinamerica.com/?p=255900#comment-280242 In reply to Birdsong.

Saying that half the people suffering from depression need “medical intervention” is an unreasonably high number. But I bet it’s one that’ll keep the folks in Big Pharma happy!

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-280198 Sun, 05 May 2024 23:11:53 +0000 https://www.madinamerica.com/?p=255900#comment-280198 In reply to Birdsong.

Question: So why are half the people with “depression” getting medical intervention THEY DON’T NEED???

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-280195 Sun, 05 May 2024 22:05:20 +0000 https://www.madinamerica.com/?p=255900#comment-280195 In reply to Birdsong.

“It’s the other half that don’t get better who need the medical intervention.”

That’s a disturbingly even-handed statement.

A word to the wise: Politics has no place in medicine.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-280097 Sun, 05 May 2024 04:46:12 +0000 https://www.madinamerica.com/?p=255900#comment-280097 Psychiatrists are trained in a medical school.
Psychiatrists write the DSM.
MD’s write prescriptions for psychiatric drugs.

But since (most) emotional problems aren’t caused by physiological problems, why seek help from a physician???

Wrong context leads to wrong care.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-280069 Sat, 04 May 2024 22:01:30 +0000 https://www.madinamerica.com/?p=255900#comment-280069 “Vikram Patel and Paul Farmer have shown that you can train local people who have limited education to deliver psychotherapy, and their outcomes can be indistinguishable from those of psychologists or psychiatrists. That is the future of mental health: that psychotherapy works as effectively as medication. That’s number one. Two, it does not have to be delivered by a psychiatrist or psychologist.”

This doesn’t surprise me. In my experience, the higher the degree, the less likely it is for someone to be able to relate to people having a hard time, and (strangely enough) this applies more often in my personal experience to people with degrees in ‘mental health’!

Common sense says: Seek out people who’ve not only been there, but people whose egos aren’t too big to admit it.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-280061 Sat, 04 May 2024 20:38:11 +0000 https://www.madinamerica.com/?p=255900#comment-280061 In reply to Birdsong.

CLARIFICATION: It was easy to see the guy was fixated on CONVENTIONAL forms of accomplishment, that he viewed conventional forms of accomplishment (a college degree, a full-time job, a serious relationship) as ‘signs’ of someone’s ‘mental health’. He seemed to have almost no imagination or psychological flexibility, that he had trouble understanding a creative personality.

And get this: one day the asshole went so far as to say my “track record wasn’t that good” which proved to me he was an even bigger son of a bitch than I’d suspected from the beginning.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-280053 Sat, 04 May 2024 19:10:30 +0000 https://www.madinamerica.com/?p=255900#comment-280053 “We want PhD psychologists and MD psychiatrists to focus on patients who are recalcitrant to ordinary treatment.”

Using words like ‘recalcitrant’ sounds like a veiled reference to the thorny subject of FORCED TREATMENT.

But whitewashing doesn’t change the nature of an inherently abusive practice with a long and continuing history of racism, sexism, and the usually unspoken REALITY of classism.

“These patients require sophistication in the use of medications, psychotherapies, etc.”

Psychiatric prescribing is guesswork; there’s nothing ‘sophisticated’ about it; no one should be forced to ingest ‘medication’ of any kind.

The same goes for ‘psychotherapy’; no one should be forced to interact with anyone stupid enough to think they have all the answers.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279991 Fri, 03 May 2024 23:57:06 +0000 https://www.madinamerica.com/?p=255900#comment-279991 Correction: I also sensed he secretly resented me for my not being someone HE COULD RELATE TO.

Which I consider not merely his personal failing, but also an indictment of the ‘mental health’ system as a whole.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279976 Fri, 03 May 2024 19:50:45 +0000 https://www.madinamerica.com/?p=255900#comment-279976 [Comment by moderator: I removed this paragraph].

By far one of the most awful experiences of my life was seeing a psychiatrist who right off the bat judged me negatively because I hadn’t yet achieved certain ‘milestones’ like marriage and full-time career at the advanced age of 24! He paid no attention to the fact that I had recently survived a devastating auto accident. He had no curiosity of the life I’d led so far nor the things I had achieved up to that point which would have informed him of the things I valued.

It was easy to see the guy was fixated on outward forms of achievement, which was very disappointing, but I chalked it up to his own impatience and insecurities at finding himself few years older than most doctors fresh out of residency. I also sensed he secretly resented me for not living a life he could understand. I sensed he was unaware of his own immaturity.

Dynamics like this are impossible to eliminate, no matter the care or context.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279968 Fri, 03 May 2024 18:55:50 +0000 https://www.madinamerica.com/?p=255900#comment-279968 In reply to Birdsong.

CLARIFICATION: Psychiatry REFUSES TO ACKNOWLEDGE that THEY ALONE write their crap-happy DSM, which is the FOUNDATION their crap-happy ‘profession’ —-

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279960 Fri, 03 May 2024 18:06:11 +0000 https://www.madinamerica.com/?p=255900#comment-279960 7. Psychiatry CARELESSLY poly-drugging people into oblivion WITHOUT A SECOND THOUGHT —

8. Psychiatry playing on people’s fears and insecurities through direct-to-consumer advertising for so-called ‘medications’.

Care and context have been thrown out the window.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279956 Fri, 03 May 2024 17:27:14 +0000 https://www.madinamerica.com/?p=255900#comment-279956 “…about 50% of cases of depression do not require any kind of intervention that is professional…. It’s the other half that don’t get better who require the medical intervention.”

50%? I don’t agree with that at all. I don’t think it’s anywhere near 50%.

There’s no way to determine the best thing to do when it comes to relieving psychic distress. But caution is rarely used when it comes to ‘medicating’ people, which is problematic since psychiatric ‘medications’ ARE KNOWN to significantly aggravate problems in the long run—which is something most medical professionals REFUSE TO ACKNOWLEDGE as this makes them question what they’ve been taught, which in turn makes them question themselves, which is the opposite of what they’re trained to do! So their flawed reasoning usually goes like this: “Well, if someone ends up in my office, that must mean my services are necessary because in the end medicine knows all the answers!”

But that’s turning out not to be the case, as many people are finding out ON THEIR OWN.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279904 Fri, 03 May 2024 04:20:14 +0000 https://www.madinamerica.com/?p=255900#comment-279904 In reply to Birdsong.

It seems anthropologically inappropriate to not have discussed following:

1. Psychiatry’s stigma-enhancing DSM

2. Psychiatry’s lax attitude regarding informed consent

3. Psychiatry’s ‘medications’ causing debilitating iatrogenic harm/protracted withdrawal

4. Psychiatry’s continual use of coercive practices such as involuntary hospitalization and/or drugging

5. Psychiatry’s excessive use of ‘drug treatments’ causing the exponential increase in ‘mental health’ disability claims

6. Psychiatry’s role in guardianship abuse

Softball interviews like this one are the reason psychiatry KEEPS GETTING AWAY with peddling its garbage.

I expect better from MIA.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279875 Thu, 02 May 2024 18:45:07 +0000 https://www.madinamerica.com/?p=255900#comment-279875 This podcast is about context. But Kleinman didn’t say much of anything about the fact that psychiatrists are trained in a medical context, that the DSM is written by psychiatrists, that medical doctors are the ones (over)prescribing psychiatric drugs, something that usually happens WITHOUT INFORMED CONSENT.

Looks pretty contextual to me.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279865 Thu, 02 May 2024 16:29:19 +0000 https://www.madinamerica.com/?p=255900#comment-279865 “Psychiatrists have been turned into prescribers of medication. That is the role that the healthcare system forces them into. Healthcare insurers would much rather pay social workers to do psychotherapy than they would a clinical psychologist or a psychiatrist because social workers are a lot cheaper in providing care.”

There you have it, folks, psychiatry’s typical cop out answer! They continually blame everyone BUT themselves for the situation they find themselves in while REFUSING TO ADMIT that THEY ALONE write the crap-happy DSM, THE VERY THING health insurers rely on to keep the money rolling in for psychiatry and its offshoots!

It seems odd that a medical anthropologist neglects to directly mention the DSM, the symbol of modern psychiatry. Nor does he mention forced treatment! Were these deliberate oversights? Perhaps. But evading issues comes naturally to people continually seeking to dodge the bullet.

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By: Birdsong https://www.madinamerica.com/2024/04/context-and-care-vs-isolate-and-control-an-interview-on-the-dilemmas-of-global-mental-heath-with-arthur-kleinman/#comment-279815 Wed, 01 May 2024 21:49:58 +0000 https://www.madinamerica.com/?p=255900#comment-279815 “We have at least eight studies that show that if you compare first-year and fourth-year medical students’ interviewing skills, in paying attention to the person and the social context, first-year medical students are actually better. This is deeply disturbing.

NO SHIT. This is the reason why medical doctors should GET THE FUCK OUT of the ‘mental health’ business.

Any idiot intuitively knows that emotional problems are different from physical ones, even though emotional problems sometimes manifest physically (and sometimes vice versa) which makes seeing an M.D. the LAST thing ANYONE should do —

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