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© Copyright 2011 by Paula J. Caplan All rights reserved
I call this essay "Bumps in the Middle of the Road," because I want to tell you what often results from critical thinking. I learned critical thinking from the family in which I grew up, as well as from key high school teachers (Donal Stanton, Jack Bush) and Bruce L. Baker, my favorite undergraduate teacher at Harvard, and it has pervaded the work I have done in every field into which I have ventured.
In much of my work, I believe that I am in the middle of the road, plodding along, looking at theories, research, and how they affect people in their daily lives, drawing attention to poor research and conclusions that are unwarranted by research data or to hurtful practices in the mental health system.
And I believe that I am steering a middle course between, on the one hand, those who insist that scientists have or will at some point have all of the answers people need in order to find happiness and strength and, on the other hand, those who believe that science has no merit. What I believe is that scientists have sometimes produced wonderfully helpful information but that disturbingly much of what passes for science is not good science, does not offer us glimpses of truth, because it is so poorly designed, so biased, or both, and that there is much that matters in life about which scientists currently have little to offer.
However, although I often raise questions from all possible perspectives, then draw conclusions based on what the (all too rare) high-quality research shows, those at both ends of any given spectrum consider my positions to be wrong, while apparently not considering their own to be extreme or even mistaken. Thus, when I have raised questions about some of what goes on in much of the mental health system, influential psychiatrists and psychologists have accused me of being wildly radical, even shrill (well, I am a feminist, so by definition that is supposed to make me shrill - oh, yes, and humorless!). At the other end of the spectrum, although the Scientologists have quoted some of my work on their websites, I do not, of course, recommend that instead of ever seeking psychotherapy, suffering people should instead join Scientology and hand money over to them. So for them, I do not go far enough and damn all psychotherapists. In fact, wrote an article for Counterpunch about how the United States Supreme Court had relied in a decision in part on an amicus brief by a Scientology arm in which some of my work was not misquoted but rather misapplied or mischaracterized[1] in a way that had disastrous results regarding the rights of the criminal defendant. At another extreme are some psychiatrists and psychologists who oppose all uses of psychotropic drugs for everyone, no matter the conditions and no matter how carefully monitored; more than one of them has become furious when I stuck to my view that a suffering individual should be able to try anything that might help, as long as anyone who ever recommends anything for them discloses fully (1) everything that is known about the positive and negative effects of what they are recommending and (2) a variety of other possible ways to help, as well as their pros and cons.
So I have been thought variously to go too far and not far enough. From this I conclude that radical and extremist are words often applied by those who wish you wouldn't say what you are saying. And I have learned that it's common for those in the helping professions to accuse those who don't see eye-to-eye with them as uncaring in the face of patients' pain.
Since this is only my second Psychology Today blog essay, for those of you who might want to know a bit more about me before you decide whether to return to this blog another time, I'd like to describe another middle-of-the-road matter with which I struggle. It's about trying to figure out where and when to come down between, on the one side, the rose-colored-glasses approach that certainly women of my generation (I'm 63) and many women even today are taught to adopt, and, on the other side, fortressing oneself, becoming tough and cynical.
If you don the rose-colored glasses, overlook, excuse, try to be patient with, or even try to understand someone who hurts you, you may be called a masochist, as though what you were drawn to from the start of the relationship was the loved one's capacity for coldness and cruelty rather than the care, joy, and respect they offered at the beginning. If, in contrast, you plump for wariness, reserve, and flight at early signs of trouble, then if you are a woman, you are likely to be called unwomanly and selfish, and even if you are a man, you may be condemned for not giving enough. The real-life difficulty of trying to figure out the most reasonable - even the most emotionally-warranted - approach to relationships is maddeningly hard. And as I wrote in The Myth of Women's Masochism, if a relationship if 90% good, of course you stay in it, and the same no doubt if it is 80% good. When that percentage gets down to 70 or 60, how do you decide? It depends partly on how good the good part is, how bad is the bad, and in which arenas are they manifested? But in trying to make these decisions, you know that whatever bad you endure or are willing to try to fix, you risk being thought to enjoy the suffering or to ignore danger signals, while if you leave because of the bad, you risk being condemned for demanding too much.
In light of this middle of the road matter as it applies to work, I suppose that the following is not surprising. When I checked to see if my attempt to place my first blog essay on this page had worked, what did I see? A page packed with advertisements. Had the Psychology Today editors told me there would be ads? Yes. Will I earn some unknown about of money based on the number of hits my blog receives? Yes, but that's not why I accepted the invitation to write the blog. It was because of being offered the freedom to write about a huge range of subjects. What a great opportunity!
I'd been told that advertisements appear on Psychology Today blog entries with related material, but one of the ads next to my first essay was for something about "B_polar Disorder," although (1) I did not mention that term in my essay, and (2) I have spent more than a quarter of a century writing about the unscientific nature of, and the frequent harm that results from, psychiatric labels. Furthermore, Dr. Allen Frances, the psychiatrist who headed the DSM-IV Work Group and who now writes a blog for Psychology Today, is among the many people who have written about how vastly overused this category is. I have been concerned since it first came into use, because I saw how freely and variably it was applied. It's disturbing enough that there is nothing to keep therapists from making highly subjective judgments about whether or not the term applies to people who experience intense mood changes or even, as I have seen, mood changes that by no means be considered pathological; but it is nothing less than alarming the way a few powerful psychiatrists worked with Big Pharma to push what they market as "anti-psychotic" drugs (which, as you may know, can actually cause hallucinations and delusions and which are known to have serious and often permanent, negative effects) for people who are given this label. And I realized while writing this current paragraph that because I used the term here, that might bring up more ads related to it when this essay appears online; that is why I left out a letter above, hoping that will keep it from happening. (I'm guessing that people who know how these things work will laugh when they read that.)
Also appearing next to my essay, under the term "Related Links," was a link to an article about obesity. I've written a couple of articles in recent years about how, nearly every time media people do stories about the "obesity epidemic" in the United States, they attribute it to fast food, large portions of food, and sedentary lifestyles,. Fair enough, but usually they fail to mention a major contributor, the prescribing of psychotropic drugs, which has skyrocketed during the same period when the average American's weight has gone way up. I cannot help but wonder whether the power of the drug companies in some way leads to the overlooking of this factor. And it's a terrible shame, because many psychiatric drugs cause huge and rapid weight gain in large percentages of people, and even teenagers, children, and, yes, infants are being assigned labels of severe mental illness and put on drugs that have this effect, in addition to many others that hurt their quality of life. Furthermore, as is now being documented, these drugs can drastically shorten the lifespans of those who take them. The article about obesity whose link appeared next to my previous Psychology Today essay included no mention of this drug factor.
I may sound like an innocent just discovering how marketing works, but it is ironic and frustrating to know that when I write an essay in which I criticize something, it's likely to appear next to ads that promote it...or that links will be provided to articles that perpetuate problems I've already written about. I'd love to hear suggestions from readers who are more computer-savvy than I about what to do about this.
In the meantime, here I am, thinking I am in the middle of the road but troubled by the ads on the Psychology Today site, when no doubt most Americans believe Psychology Today to be middle of the road, and yes, I know that advertising is considered part of freedom of speech. But those who can afford to buy ads for their products and services tend to have far more money and power than those who might come to this website because they are in pain and looking for surcease. Therefore, access to free speech and vulnerability to pressure from advertisers or to the harm that can come from what writers say or fail to mention are not equal for all. I hope that some who have had too little chance to speak and write might like to begin by writing something in the Comments section here.
