Thread by @tylerblack32

I care about good psychiatric care. I care about my patients and all psychiatric patients. I support and teach informed consent. I care so much about every benefit and harm. I care about good science and human connection. I love being a doctor and take my job seriously.

And yet, routinely, I am told that I "torture patients," "am a pill pusher," "[I am] like the Nazis," or "[I] use labels to lock people up."

The bind this puts me in. I try to engage, but there is pain and hurt on the other end, and they don't want to engage, they want revenge.

I try to demonstrate common ground, for example a shared cause like "informed consent" or "teaching proper tapering." I try to honestly answer questions, provide the best science, and use my expertise and significant experience with severe illness to shed light on my perspective.

I hear about awful practices (cold turkey stops of meds, lack of side effect disclosure, rudeness) and empathize - this is completely unacceptable and beneath the standard of care that I hold myself and my peers.

I listen. Pain. Anger. Mistrust. Often, it's earned. Sometimes, it's not (due to misinformation). I do my best not to judge.

But still, at the end of the day, I end up having to ignore people. I have to simply negate the misinformation online because in their pain they will actually hurt, not help, others in need. I have to block people who I would have tried my best to help.

I'm ok. I'm very aware that I'm lucky to be healthy, I've survived and flourished despite my own illnesses, and I've been fortunate to have the support of amazing colleagues and friends.

But the double standard of antipsychiatry really get to me sometimes.

In advocating for their own autonomy, they completely and utterly wish to rob others of theirs.

As for those who have been harmed, I am powerless to undo what happened to you. All I can do is practice ethical medicine with the best humanity I can.

Psychiatry helps people.