Jeffrey Lieberman is the high priest of US Psychiatry. A former president of the APA, he’s a devotee of the psychiatric ideology and he also has a questionable relationship with the pharmaceutical industry. I’ve blogged about him in some of my recent posts (see here) but in this Reddit post (9th April 2015), where Lieberman gives a live question and answer session, he really surpasses himself in terms of talking nonsense. There are some real humdingers in there, many as equally unsettling as they are ridiculous. The most interesting and challenging questions, largely remain unanswered by Lieberman, which isn’t surprising because guys like Lieberman always ignore criticism or disparage critics. They always deny patient’s negative experiences of psychiatry because it doesn’t fit in with the image they are trying to sell, the narrative which they want to believe about themselves, or the schtick which they have been peddling most of their lives. Lieberman avoids the awkward, challenging questions because he really wasn’t there to engage with the public, he was there to sell his book.
Take a look here:
submitted 22 days ago * by DrJLieberman
I am Doctor Jeffrey Lieberman, the chairman of the Department of Psychiatry at Columbia University, Director of the New York State Psychiatric Institute, former president of the APA, and author of Shrinks: The Untold Story of Psychiatry, now on sale.
Here is my proof: http://imgur.com/MRkIx8V
I’m here with Shrinks co-author Ogi Ogas to answer your questions about the evolution of psychiatry: the good, the bad and the ugly.
UPDATE: Unfortunately, that’s all the time I have today. I have to get back to my day job. Thank you for all of your wonderful questions today. We had a great time. Click to learn more about Shrinks: http://www.jeffreyliebermanmd.com/shrinks.html
To continue the conversation, you can reach me @DrJlieberman on Twitter.
Hi Dr. Lieberman, Do you see a role for psychotherapy in the practice of psychiatry – or does it all boil down to drug therapy now?
Modern psychiatry is not solely about the brain and psychotropic drugs, it very much will continue to involve the psychiatrist understanding each persons individual circumstances and psychological makeup. Nothing will eliminate or replace the importance of the personal relationship between a patient and physician at its best psychiatry is a pluralistic profession which focuses on the mind and the brain.
Hello Dr Lieberman! Thank you for taking the time to do this AMA. What is your response to the criticism that psychiatrists are prescribing too much and doing too little?
For a long time, psychiatrists really did very little for patients, because there were simply few effective treatments. But today, there are a wide range of effective pharmaceuticals and effective, evidence-based psychotherapy, not to mention many other therapeutic advances such as [team-based care], sophisticated brain imaging, genetic testing, better integration with other medical specialties, more rigorous diagnostic criteria, and a greater appreciation for the role of compassion (psychiatrists used to be trained to be as aloof and detached as possible!)
psychiatrists used to be trained to be as aloof and detached as possible!
Do you think this had a negative effect on the public image of psychiatrists and on their relationships with their patients?
If the transition from aloof to compassionate happened during the time that you’ve been practicing, was it difficult to adjust?
Dr. Lieberman, thank you for your time. I hope my question doesn’t sound hostile; it isn’t intended. For 17 years I battled severe depression and literally tried nearly everything to help, including a few psychiatrists. I did not deal with the psychiatrists very well because our sessions maybe lasted eight to ten minutes with me, none of them really listened and I can tell. It was a few questions they didn’t let me answer fully, a prescription pad and an I will see you next month. One of them even started escorting me to the door as I was trying to tell him that I knew the prescription he was giving me was going to react with another I was taking in a very bad way. And, of course, the bill for the entire hour that was exorbitant. My doctor and I finally decided to go it alone and I became his first MAOI patient and have been depression-free for over four years. He helped because he cared, he took the time to listen to me and respected me as an intelligent person who truly understood my condition and my body. What happened to psychiatry? Why have they become pill-happy doctors who treat us like we are wasting their time and don’t know what we are talking about? Granted, medication is what saved me but I had a doctor that explained it and took my choices seriously.
I’ve just finished my doctorate in history and am beginning med school, with an interest in psychiatry. Coming from a humanities background, how do you respond to the (admittedly dated) criticisms from Foucault and Goffman which assert that psychiatric diagnoses are problematic because are (at times) subjective and because the labels they apply reduce complex cultural, social, and historical phenomena contributing to an individual’s mental state (along with physiological factors, of course) to a medical problem. I suppose Allen Frances’s criticism that psychiatry is defining increasing swathes of ordinary behaviour as “mental illness” would be a contemporary follow up to these earlier works. What do you say to such people, and to those who claim these labels are sometimes a burden and a judgement, even if they facilitate communication with other mental health care providers?
Unfortunately i have observed as has the American public too many civilian massacres, many of which involve people afflicted with mental illness. In some of these i have professionally consulted as an expert advisor. In virtually all cases the perpetrators who were uniformly young men had a severe mental disorder and were not receiving treatment. So in my opinion, the key factor which permitted these disasters was the lack of treatment that was available but not administered for whatever reasons to these individuals. In this regard, the notion that SSRI’s being a causal factor is completely inaccurate. First because most of these people were not receiving medications and were impelled by their symptoms and even if they were receiving an SSRI this does not motivate violent behavior.