In response to my recent post, “The drugs are hurting us more than they are helping us”: How Not to Talk to People With Mental Illness, Episode 563,304, I received this comment from one Timothy Matias:
Just my two cents:
“It is seriously fucked-up to undermine people’s [efforts to improve the lives of mentally ill people] for the sake of preserving their ” relationships with their health care providers.”.
Here’s a bit more than two cents, based on my experience:
[link edited out, since I don't want to reward him with blog traffic; if you really want to see it, I have not edited the link out of the original comment -GC]
Everyone’s entitled to their opinions. When you call them “fucked up” for expressing their opinions about medication, the only “fucked up” person is you!
This kind of closed-minded, self-righteous response is no different than a Christian telling an atheist that it’s fucked up to suggest that a person should quit God. HOW DARE they risk damning the person’s soul to hell because of personal experiences of feeling better living without God. HOW DARE they undermine the relationships and trust between Christians and their church elders and leadership?
This kind of closed-minded approach to medicine, and the application thereof, is nothing short of RELIGIOUS :/
I will say that again: I received this comment, in direct response to my post explaining why it was a bad idea generally to give unsolicited amateur medical advice to people with mental illness (or with any illness, for that matter), and specifically to tell people with mental illness to ignore their doctor’s advice and not take prescribed psych meds, and saying that the blog posts here discussing this matter were not the right place for these debates. (And yes, just to be perfectly clear, that policy applies to this post as well. Meta-discussion of how to discuss mental health care with people who have mental illness is acceptable (although I’ll be keeping a close eye on it); unsolicited medical advice to people with mental illness is not, and will result in the commenter being put into comment moderation.)
Okay. I’m going to spell this out as clearly as I possibly can.
Do you really not see the difference?
Apparently not. Okay, I will spell out the difference.
First: There is a significant difference between offering your unsolicited advice about religion, and offering your unsolicited advice about people’s medical care. The existence of God is not a topic on which anyone is an expert. Some people are experts on religion, theology, apologetics, etc. — but nobody is an expert on God. You don’t need any special training to reasonably come to the conclusion that there are no gods. (The fact that nobody is an expert on God, and that nobody can say anything about God with any degree of certainty or hard evidence, is actually one of the best arguments supporting the conclusion that God does not exist.)
This is not the case with medicine. Medicine is a field where some people really do know more than others. Trained medical providers are very far from infallible, but they still know a hell of a lot more about medicine than Some Guy On The Internet. (It’s hard not to notice that the link you linked to doesn’t actually contain any research, or even any links to any research — it’s just your opinion.)
At the same time, medicine is a field in which some people have special training and expertise — but it’s also a field in which, by its nature, that expertise is often not precise or universal. This is especially true for psychiatry and mental health care. What works for one person often doesn’t work for another, and providers often have to proceed with some degree of educated trial and error to find a care plan that works for each particular person. Therefore, it is incredibly arrogant for Some Guy On The Internet to assume that they know what mental health care plan would work for me — better than my medical providers, who have detailed information about my particular condition and priorities and medical history, and better than me, who knows more about my condition and priorities and medical history than anyone.
It is depressingly common for sick people — people with mental illness, with chronic non-mental illness, even people with common colds — to get deluged with unsolicited amateur medical advice. At best, it’s annoying; at worst, it undermines your ability to make your own decisions, and your confidence in that ability. When you’re trying to make medical decisions for yourself, it’s already difficult enough without a barrage of uninformed, under-informed, and ill-informed advice filling your head. And it’s already difficult enough without advice that amounts to the message, “You’re doing it wrong. I know better than you. If you want to please me, you’ll do it my way.”
And for people with mental illness in particular, this is especially difficult. Mental illness has tremendous stigma, which people with mental illness often internalize, and we often (a) feel like we’re letting people in our lives down by having mental illness, (b) feel like having to get treatment for mental illness is a sign of weakness, and (c) are barraged with paternalistic messages telling us that simply having mental illness makes us incapable of making any decisions about our care. Unsolicited advice in this area is more than just annoying. At best, it is patronizing and demoralizing, which itself undercuts our mental health. At worst, it can lead people to make terrible decisions about their mental health care, with devastating results.*
So unless someone tells you that their health care provider is prescribing actual quackery (like homeopathy or something), or unless you have some crucial piece of information that you’re pretty sure the person you’re talking with isn’t familiar with (and “Psych meds are all horrible and nobody should take any of them/ the entire mental health care profession is borked and is not to be trusted” doesn’t count — believe me, we’ve heard that before), or unless you have some more substantial evidence for your position than “I know that the established standard of care is (X), but this one guy disagrees and wrote a book about it,” it is seriously fucked-up to undermine people’s relationships with their health care providers.
I absolutely want for there to be vigorous, rigorous public discussion and debate about medical standards of care — especially when it comes to mental illness. I am well aware of serious problems in the medical system (especially in the United States), and people speaking out about those problems is how they get addressed. And I understand that there is serious debate, even within the medical community, about how to best handle mental illness. I want that debate to happen, and I want people in the general public who are affected by the medical system (which is to say, everyone) to participate in that conversation. But have that discussion and debate in public spaces, where people agree to discuss and debate. Don’t shove it in people’s faces who are trying to make good decisions for themselves, and who haven’t asked you for your opinion. People who want advice will generally ask for it. If they don’t, then offer empathy, and shut your cakehole about how much smarter you are than they are.
Which brings me to my other point.
Second: Even if you don’t accept this difference between debating religion and debating medicine? There’s a difference between simply debating religion, medicine, or anything else — and doing so in a space where the host has specifically said that they don’t want these debates.
Yes, I am a big advocate of arguing with believers about their beliefs in God (for atheists who want to do that, that is). But even I don’t advocate telling believers, “You’re wrong to believe in God, here’s why,” in spaces where people have specifically said, “I don’t want to debate this.” There are plenty of other spaces for those debates.
You have every right to express your opinions about mental illness and mental health care. You do not have the right to offer these opinions in personal spaces, to people who have not asked for them. And you definitely do not have the right to offer them in spaces where people have specifically said that they don’t want to host that debate.
You have violated my clearly- and repeatedly-stated request about comments. I am putting you into comment moderation. Future comments from you will have to be approved by me before they are posted.
* Here are a few particularly eloquent things that other people have said on this topic in these discussions here.