3 ms·

I think it's more likely that we're just not that great at "curing" mental illness (whatever that means) than it is that the entire industry has a conflict on i

I think it's more likely that we're just not that great at "curing" mental illness (whatever that means) than it is that the entire industry has a conflict on interest where they COULD be helping people get better faster but they don't. I've never had a therapist bat an eye when I tell them I'm doing well and I don't need to come in for a while. My last therapist went on maternity leave and recommended me to a colleague who they thought I might enjoy working with. It's been great and I'm not going back to see my original therapist. I guess they should've sent me to a bad therapist so that I would come back and be their client again, but the person they recommended me to is great.

DoreenMichele 8y ago
Conflict of interest means you can never be sure why they recommended X, not that X was recommended with malice aforethought. That's precisely why it's such a thorny issue. People with malice aforethought are relatively easy to root out compared to people who mean well, but can't quite get it right for reasons no one can quite put their finger on.
- askafriend 8y ago
  How far do you take this kind of logic though? Do you never go to a dentist because you can never be sure they're fixing your teeth? You don't know if they're superficially treating your teeth just enough to warrant another visit instead of "fixing" them once and for all. Do you never hire an engineer onto your team at work? You can never be sure if they're putting bugs into their code on purpose for job security. I mean if you take this kind of thinking to its logical conclusion, it gets pretty ridiculous. In any case, "be skeptical to some extent, but don't be _scared_" seems like a good middle ground in this debate.
  - jacobolus 8y ago
    > Do you never go to a dentist because you can never be sure they're fixing your teeth? You don't know if they're superficially treating your teeth just enough to warrant another visit instead of "fixing" them once and for all. Shady dentists performing unnecessary procedures so they can rip off their patients is a rare but serious problem. Do go to a dentist when you have a clear problem you know about, and do go to the dentist from time to time for routine checkups / cleanings, but be careful about choosing a dentist and skeptical when a new dentist suggests your apparently healthy teeth actually need extensive work.
  - TheOtherHobbes 8y ago
    Well - "drill and fill" (i.e. unnecessary work, supposedly for medical reasons, but actually just for cash) is a recognised problem in the dental industry, at least in the UK. Some dentists even had their contracts changed to encourage them away from the practice. https://healthmedia.blog.gov.uk/2016/11/14/drill-and-fill-culture-to-end-as-dentists-paid-to-focus-on-prevention-instead-of-cure/ https://healthmedia.blog.gov.uk/2016/11/14/drill-and-fill-cu... Realistically, blind faith in professionals is as unrealistic as blind paranoia. I don't think it's possible to say "Of course we should trust psychiatrists" in one sentence and then add "But of course we don't really know much about mental illness anyway" in the next. The reality is that pharma in general has a mixed reputation, and psychiatric drug treatments have a very spotty scientific record - as do the various kinds of talking cure. Psychiatrists probably won't encourage session dependency, but psychotherapists might - especially in countries where you can hang out a shingle with no training or background at all. Getting help for difficult personal and emotional issues can be a minefield, with minimal consumer protection. You literally have more guarantees that your toaster is going to work as advertised.
    - chickenfries 8y ago
      Your last point seems so obvious. It’s much easier to toast bread than it is to treat chronic mental illness. Of course your toaster roasts bread. Doctors can’t cure plenty of things, despite all of our efforts. Psychiatry is an even younger field than modern medicine. You have tons of consumer protection in psychiatry.

DoreenMichele 8y ago

Conflict of interest means you can never be sure why they recommended X, not that X was recommended with malice aforethought. That's precisely why it's such a thorny issue. People with malice aforethought are relatively easy to root out compared to people who mean well, but can't quite get it right for reasons no one can quite put their finger on.

askafriend 8y ago
How far do you take this kind of logic though? Do you never go to a dentist because you can never be sure they're fixing your teeth? You don't know if they're superficially treating your teeth just enough to warrant another visit instead of "fixing" them once and for all. Do you never hire an engineer onto your team at work? You can never be sure if they're putting bugs into their code on purpose for job security. I mean if you take this kind of thinking to its logical conclusion, it gets pretty ridiculous. In any case, "be skeptical to some extent, but don't be _scared_" seems like a good middle ground in this debate.
- jacobolus 8y ago
  > Do you never go to a dentist because you can never be sure they're fixing your teeth? You don't know if they're superficially treating your teeth just enough to warrant another visit instead of "fixing" them once and for all. Shady dentists performing unnecessary procedures so they can rip off their patients is a rare but serious problem. Do go to a dentist when you have a clear problem you know about, and do go to the dentist from time to time for routine checkups / cleanings, but be careful about choosing a dentist and skeptical when a new dentist suggests your apparently healthy teeth actually need extensive work.
- TheOtherHobbes 8y ago
  Well - "drill and fill" (i.e. unnecessary work, supposedly for medical reasons, but actually just for cash) is a recognised problem in the dental industry, at least in the UK. Some dentists even had their contracts changed to encourage them away from the practice. https://healthmedia.blog.gov.uk/2016/11/14/drill-and-fill-culture-to-end-as-dentists-paid-to-focus-on-prevention-instead-of-cure/ https://healthmedia.blog.gov.uk/2016/11/14/drill-and-fill-cu... Realistically, blind faith in professionals is as unrealistic as blind paranoia. I don't think it's possible to say "Of course we should trust psychiatrists" in one sentence and then add "But of course we don't really know much about mental illness anyway" in the next. The reality is that pharma in general has a mixed reputation, and psychiatric drug treatments have a very spotty scientific record - as do the various kinds of talking cure. Psychiatrists probably won't encourage session dependency, but psychotherapists might - especially in countries where you can hang out a shingle with no training or background at all. Getting help for difficult personal and emotional issues can be a minefield, with minimal consumer protection. You literally have more guarantees that your toaster is going to work as advertised.
  - chickenfries 8y ago
    Your last point seems so obvious. It’s much easier to toast bread than it is to treat chronic mental illness. Of course your toaster roasts bread. Doctors can’t cure plenty of things, despite all of our efforts. Psychiatry is an even younger field than modern medicine. You have tons of consumer protection in psychiatry.