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Psychiatric Truth: Valid Or A Mere Expediency?

by Grégor Samsa

I wish to address the following: Psychiatric Truth: Valid or a mere expediency? I am a man well into his second decade as a patient of a high secure hospital. Despite the many achievements, I have made in this time - vocational, educational, and clinical - I have always had to struggle against the tendency of psychiatrists to present an interpretation of the truth rather than the direct, empirical truth that is before them.

It is not without irony when I remark that a science based on question-and-answer techniques to elicit information from a mentally distressed person, leading to a medical diagnosis, often simultaneously assets that the truth-claim of mental patients are unreliable. This is then used as a justification by the psychiatrist for accepting some reported facts from a patient and refusing others. All this seems very arbitrary. In my experience I have found that, without exception, my self-reports have been accepted by a psychiatrist when it serves his or her ends, and dismissed when they would prove inconvenient. Is this good science? Surely, truth is the truth regardless of its values as an expedient.

Furthermore, in all my years here, mental health professionals have always misattributed to me only negative ‘facts’. What does that say about the clinical bias of the psychiatric hospital system? It is an incontestable fact of my experience that not once has their misattribution of me been of a positive bent. No one has falsely claimed that I have an IQ of 200, or that I speak five languages, or that I make the best Charlotte russe this side of the Savoy. I’m not arguing that this would be better; I’m simply observing that it is odd.

Having to constantly fight against the prejudicial falsehoods (and sometimes just plain lazy thinking) of my psychiatrists has severely undermined my confidence in their ability to practice good medicine. At the risk of sounding dramatic I feel I am nothing but the false image of their own creation. My potential for recovery is zero. I walk on broken legs, breath through collapsed lungs, and converse with aphthenxia.

In conclusion, any doctor who feels he/she has the right to disregard the facts of a patient’s clinical history and experiences merely because these facts might prove awkward, or don’t fit some preconceived schema of the doctor’s own, ought not to be practising psychiatric medicine in the first place. This is the view of a man whose fidelity to truth and reason has not been matched by those who have professed to have been his carers.

By Grégor Samsa

Gregor Samsa / Grégor Samsa