A while back a downtown Auckland tower-block was evacuated after the occupants fell ill with what was first thought to be gas from the air conditioning. It wasn’t. But a dozen people were hospitalised. That evening, more people fell ill and the building was closed.
Before a formal investigation reported on the problem, a university lecturer told the media that: ‘The most likely scenario is that it is psychogenically transmitted‘. According to the report, she qualified the assertion with the point that the victims were not making up the symptoms and more research had to be done. However, the idea that it was an imaginary panic was taken seriously enough that media approached someone at UCLA who commented on the phenomenon of mass hysteria in general.
Setting the particulars of this incident aside, to me the fact that comments implying a ‘psychological’ component emerged ahead of a technical investigation – and were seized upon by the media – echoes a mind-set I’ve seen in the medical profession. It’s where highly qualified medical professionals seem to think that, if they cannot immediately explain something in a patient, it can only be psychological – which, irrespective of the way ‘psychology’ has been abstracted by the academy, boils down to blaming the victim. The implied stigma of being ‘psychologically weak’ as a result renders such claim a pernicious form of invalidation. However, this general attitude is one to which medical professionals sometimes seem to fall back as default.
I first saw this in the GP I had as a teenager, who was a useless doctor; but he was a master at intellectualising his way out of an issue. If there was something he couldn’t explain – which was most things, because he was that useless – it wasn’t that he didn’t know, it was because the patient had psychological problems they wouldn’t admit to. This happened virtually every consultation because once he’d decided you were mentally weak, that was that, and it got him off the hook.
Luckily my experiences since have been mostly positive, with a couple of exceptions in which the pretense of ‘psychological fault’ was mixed with open invalidation of any rights I had as a person. The first was in 2006 when I had a deeply unpleasant encounter with an ‘allergist’ whose behaviour – in front of a witness – was so aggressive and abusive that, had he been confronting me in a pub, I’d have assumed he was trying to provoke a fight. He began abusing me as soon as I handed him my prior test results, which he threw down and told me were worthless. That set the tenor for a consultation in which he invalidated everything I said at every turn – a relentless barrage of abuse that didn’t stop until I left. He actually told me that no matter what I said, he would say something different, which basically laid out that he wasn’t interested in helping or diagnosing me, just using me as a punching bag for his ego. His final diagnosis was that I had no allergy and therefore what I had was psychological – and before I could speak or react he leaned towards me and added: ‘why don’t you believe me?’ Yup – he’d already decided on my reaction and was attacking me for something that I hadn’t even said. See what I mean about this asshole being provocative?
Later I discovered he’d missed the clinical results shown in his own tests. Afterwards I went to the Medical Association to see what redress I had. I also found out from other sources that I was far from alone – I was told of patients this guy had so badly hammered when seeking help that they left his consulting room in tears. But I could see how he’d got away with it: when push came to shove, I declined to lodge a complaint. He was such an openly nasty, arrogant, angry and abusive little man that – despite my witness and my legal rights – I figured the only response would have been a threatening letter from his lawyer.
The other incident came in 2017 when a specialist I’d never seen before wasted $295 trying to hammer me into a diagnosis he’d clearly decided upon in the first three minutes, totally without empirical evidence. The problem was that he then failed to show the slightest respect for my integrity when reporting symptoms, still less any genuine concern for my well-being. Everything I said was either dismissed or ‘translated’ to fit what he kept insisting was the problem, and I staggered out of his consulting room feeling as if I’d just lost a fight known only to the other guy.
Of course I never went back; but afterwards I tackled him about his failure to correct an error he’d made in his record of the consultation, which I’d asked him to fix at the time he made it – he was taking notes as we went. He refused. I felt I needed to push it – if only so that I got some recognition from him that he had any respect for my rights. Alas, he only complied on the third attempt when I pointed out my legal position (doctors are legally required to correct errors in records on request).
To me, the supposition by medical professionals that their expertise sets them them above any need to follow the law and normal social morality, with no requirement to show such basic human values as care for others, or even simple courtesies, are a clear demonstration of human nature. As a species, it appears we have evolved so our first response is to invalidate those around us in an apparently zero-sum game of power and status. It must have produced some advantage for the group as a whole during hunter-gatherer days. The issue, as always, is that none of the successful hunter-gatherer social behaviours – conducts this evolution has hard-wired into us – work well when society is scaled beyond ‘group’ level.
Into that mix has to be added the fact that western society – particularly – conditions us to suppose that the professions upheld as ‘expert’ also have a social and ethical status that cannot be challenged. When mixed with the usual range of human character the result is a field that seems to attract superficially capable intellectuals who score well on IQ tests, but need to validate themselves as people by being seen to have the answers. If they don’t, they have to invalidate the challenger, irrespective of the fact that this challenger may be someone who is vulnerable, sick, and came to them for help. And they do so using the power available to them, irrespective of the outcomes, in ways that also avert liabilities in terms of normal human ethical obligations – often, it seems, by weaponising ‘psychology’.
Copyright © Matthew Wright 2018