Wednesday, September 29, 2010

Good Shrink. Bad Shrink.


Over time, I've noticed some trends among our blog commenters. Some readers comment on the content of our posts, others link us to Viagra spam, and finally, some readers talk directly to us. We hear about their own experiences of the topic we've blogged about, or simply about their day. This is good, though I could do with a little less Viagra or AirJordan spam in my life.

Sometimes readers inject enough of themselves into their comments that it becomes clear they have opinions about us, the Shrink Rappers, feet, ducks and all. Sometimes it seems like readers are poised to like us, and other times it feels like readers are lying in wait, looking to attack. I was particularly struck by the comments people made on my post about The Texting Shrink. Rachel says I have a kind-heart and another commenter (?--I think it was Retriever) noted that I do this to increase my availability to patients. Dr. Steve put it bluntly: I am idiot! I hope I do have a kind heart, but I text with patients because I've found this to be to my convenience--- it's a quicker way to deal handle brief messages, and none of it's about being more available. My life is better if I get a "stuck in traffic" text and know I have time to run to the restroom or eat a snack. And if a patient needs me to phone a pharmacy or return a call, it's so much quicker to click on the texted number than it is to re-listen to my messages and try to decipher that phone number 6 times by replaying voicemail -- and oh, I don't have a pen and can I memorize it quickly enough?.

Am I an idiot? I believe I've thought it through, but I may be.

The Texting Shrink was only one example. In our years of blogging, many posts have inspired strong reactions, and I've come to be very careful about my choice of words, especially when discussing medications. Sometimes it feels like no matter how gently I word things, someone is poised to simply say, psychiatry is bad, no one should see a shrink, no one should take psychotropic medications, all shrinks care about is money.

Some people think their psychiatrists don't care about them -- and for all I know, they may be right -- others believe their doctors think and care about them a lot, in a way that may not be realistic. Obviously, doctors think and care about their patients (oh, I hope), but docs are people with their own lives and problems.

I'm hoping for a happy medium somewhere. Like Dr. Steve says, I may be an idiot.

19 comments:

jessa said...

What is this?! Transference in relation to psychiatrists?! Preposterous! I think that psychiatry tends to be a pretty emotionally charged topic. How can it not be? Emotions are the work of psychiatry. Add to that the fact that mental health care can vastly improve lives, but sometimes increases the already unbearable suffering in other lives (hello, that would be me). For my part, I try to be diplomatic in discussing mental health care. Yes, it made my life much more difficult than it already was, yes I have strong feelings about what needs to change, but I also know that it helps a lot of people and I try to believe that the professionals really do want to help their patients. A lot of mental health care professionals do not bother to return the favor of being diplomatic in discussion with me, but the Shrink Rappers are most definitely diplomatic, something I deeply appreciate.

HappyOrganist said...

I like hearing about doctors. I think it's funny that I continue to follow having never ever heard your show ever (I don't even think I would like it). But it's fun (your blog here) - EVEN THOUGH you're done with that book.
=D

Sarebear said...
This comment has been removed by the author.
Sunny CA said...

I think it is possible people express their feeling here because there's no other forum for that expression. Almost nobody in my world knows I am under psychiatric care so there's nobody to talk to about my shrink. My shrink does not want to talk about previous psychiatric care beyond the history aspect. He is anti-establishment and anti-pharma (except as needed), but it's not a topic of discussion because we are on the same page about that. And yet I have built up resentment against the awful practitioners I have encountered. You provide a forum. It's not really about you, I don't think even thought it seems directed at you.

I for one am glad you write this blog. Sorry for the times I was hostile. I don't think it was hostility at you, even though it was posted here. It was hostility and resentment at the bad treatment I have had and awful experiences suffered at the hands of other practitioners.

ps: Does anyone else have to go sign in to Gmail, then click on "more" then click on "blogger" then sign in to blogger, then come back here and enter password, then have it reject word verification then enter again, to post. Every time I have to go through that because it always rejects my password.

Anonymous said...

Posted for Laura (such nice words for the Shrink Rap bloggers!):

Hello shrink rappers!



I’ve tried to post a reply many a time to your site (I just don’t give up) but it’s my work/home computer and my computer blocks me from posting (from Shrink Rap? Say it ain’t so!). So anyway, I love your blog for its mix of humor, ducks, pharmacology-related emoticons and for your thoughtful topics and insightful blogging. A few times it has caused me to laugh so hard that it’s a good thing I work from home. Other times, it has caused me to probe deeper into an issue or expanded my knowledge. Mostly, it’s always entertaining on one level or another. I have forwarded your links to my shrink a few times. Keep on keepin’ on and good luck with your book! Can’t wait ‘til it comes out.



A big fan, http://img1.blogblog.com/img/icon18_wrench_allbkg.png



Laura



(OK to post on my behalf if you wish.)

jcs said...

So, it seems that you've noticed the tendency for blog commenters to vent their anger towards medical professionals, even if the rant is only tangentially related (or completely unrelated) to the post where they are commenting.

This phenomenon is not unique to your blog. It's something that I've noticed on nearly every blog where medical professionals are found. For example, the comments on kevinmd (a popular doctor blog) are split between (1) professionals engaging in "shop talk", (2) patients or "patient advocates" who are furious at their doctors and are looking for a forum to vent, and (3) alternative-medicine advocates who take any opportunity to accuse the "medical establishment" of collusion against their beliefs.

This is almost interesting from a psychological standpoint -- what can you learn about people from their comments on medical blogs? hmmmm.....

jessa said...

jcs: I know that I am 100% guilty of this, though I do try to keep on topic. I don't go around looking for every blog post I can find that addresses suicide so that I can write about my views on suicide. Rather, I stay loyal to a few blogs where I feel like there is sufficient openness on the part of the blog writers to consider what I have to say, where they are not overly dogmatic in their beliefs about mental health, and where I don't think I will be taken as a troll. Sometimes, I still feel a bit trollish. I don't only comment when I disagree, I give kudos when I do agree or deeply appreciate a viewpoint. I have sought out these blogs to comment on because I have not found anywhere in real life where professionals have been willing to engage with me like this, willing to actually consider my views on mental health rather than dismiss them automatically. I still worry about being a bit trollish. Is there a way to sincerely and wholeheartedly disagree with the mainstream consensus on a topic, to get people to actually engage with my thoughts on the matter, when most people dismiss me automatically, without feeling or being a little trollish? I don't know, but I try.

jcs said...

jessa: I haven't been following your posts, but I can say that if you refrain from ascribing ill motives to the professionals who have angered you, then you have already earned more credibility than most of the other commenters on medical blogs.

I've seen the "all doctors are uncaring/sadistic/idiots" line on medical blogs more times than I can count.

Anonymous said...

Dinah, before I get to my point, let me express my appreciation to the shrink rappers for providing an open forum for different viewpoints. What I also like is you don't have to wait for comments to be approved. I appreciate why other blogs do this so I am not questioning those procedures. But I find your blog practice very refreshing.

Anyway, Jessa, that is a great description about feeling trollish. I definitely worry that I can come across that way. I feel I definitely did when your guest blogger posted. Sorry, I am too lazy to go back and find his name.

But on the other hand, when you raise the issue of kids being on medication as you did with the blog entry, kids and depression, that is going to get negative reactions so matter how you try to sugar coat it. In that blog, I had held off commenting even though other bloggers had raised the issue of medication. But when you raised that issue, I had to respond, especially since the psychiatrist quoted in the article, Dr. Joan Luby who is doing work on children and depression, has pharma ties as I provided the links in that entry.

I don't have any children by the way but am very concerned that medication seems to be prescribed come heck or high water for kids.

JCS, I visit Kevin MD alot and I am not seeing what you're seeing. Maybe I haven't had enough coffee:)

I do read patients speaking up who say what I wish someone had said. But I can't remember most of them slamming doctors.

If you can point me to a specific blog entry that demonstrates this, I would read it to see if I have missed anything.

Just because people are critical of something a doctor did regarding a situation, doesn't mean they hate all doctors.

I have been very critical of psychiatry and medicine in general but I definitely don't think everyone in the profession is bad. I know someone whose life was literally saved by a psychiatrist. I know that will shock some people who read my entries but I am just trying to point out, you can't assume anything from what someone writes.

AA

Dr. Psychobabble said...

Increase your penis size!!

(Sorry, I couldn't help myself.)

I do not think you are an idiot. But as a fellow blogger, I have been called an idiot, and way worse.

Ahh, the psychology of blog commenters. We really need more research into this area.

:)

tracy said...

Ha, ha! Hi Dr. Campbell! :)

Dinah said...

Who is Dr. Campbell?

And to all: I was just observing. We all love your feedback!

Dinah said...

Who is Dr. Campbell?

And to all: I was just observing. We all love your feedback!

Maggie said...

And others, like me, just want to whine about the Viagra spam?

Again, Jessa has already made several of my points for me. (Please keep that up, btw. Your writing is better than mine.)
I must say that I have a bit of trouble sometimes in figuring out what it means to give mental health professionals the benefit of the doubt. When speaking of a particularly bad treatment situations, am I giving the benefit by assuming that they're incompetent/ignorant, or malicious/deceptive?

I'd also like to make the point that the whole "someone always being poised to attack what you said" thing is a major feature of blogging, and, for that matter, of the internet in general. No matter how innocuous the topic, somebody is always ready to argue online. I recently had somebody on a sewing forum absolutely *insist* that I was utterly incorrect in referring to Windows XP as an upgrade from Windows Vista. Even after I pointed out that I consider "upgrade" to mean switching to something better rather than something newer, this woman just wouldn't stop arguing. It's the internet. People are always ready to attack over anything. You could be blogging about cookie recipes and have the same issue.

Sunny CA, since I don't have a Blogger blog, I use a ClaimID openID. Massively simplifies things-- it's so much more portable between sites and platforms, and I can use the same identity to comment in places with no relation to one another besides supporting openID.

Maggie said...

BTW, I didn't mean to say that everybody with a strong opinion on psychiatry is just trying to argue. Lots of people have perfectly legitimate bones to pick, if not with you, with psychiatry in general or with specific professionals they've encountered. I just had to point out that having people disagree with you is a prominent and unavoidable feature of expressing opinions online, and probably not something to take personally without good reason.
------

Does my advocacy of benadryl as a sleep aid come off as spammy?

Anonymous said...

Hi shrink rappers and shrink-rap-readers!

I have a question;
I need to find myself a psychiatrist.
Does anyone have any recommendations for how to find a nice shrink?
How does one find a good match without having to meet each and every possible doctor?
I'm pre-med and a little bit of a know it all. So I need someone who is happy to explain things, keep me in the loop, and answer all my why's and when's.

Any suggestions?

Is it rude to ask questions on the phone when making an appointment?
Private practice or hospital associated?

-bec (who still asks a lot of questions!)

jessa said...

Quoted by a spammer! I feel famous!

Anonymous said...

I don't think it's any surprise that people tend to respond when it's a topic they feel passionately about. If they don't care about the topic either way then why respond? I think this is why you see the separate camps: those who absolutely adore ducks and those who don't.

toleone1 said...

Buy acomplia
Buy aciphex
Michael Jackson Ben
Michael Jackson Bad acappella
Michael Jackson Thriller
Michael Jackson ABC