It was my observation when I was employed in the the insurance biz that for every physician who could detect whiplash, there was another who would see nothing at all. In the same way, for every doctor who knew pain and suffering when he saw it on an X-ray, there were others who could look at the same X-ray and swear, under oath, that the pain and suffering was limited to what the (lying) plaintiff wanted the insurance company to experience.
The trial of John W. Hinckley Jr. teaches us--if we did not know it before--that psychiatrists are physicians and then some. A person is sane or not, depending, it appears, not on the sanity of the person, but on the views of the psychiatrist. Like beauty and whiplash, insanity is in the eye of the beholder.
All this has done nothing to upgrade the image of psychiatrists who, along with psycholgists and therapists of all kinds, are already having a rough time of it. The public seems weary of them, tired of being told, among other things, that sometimes there is no such thing as bad--that "bad" is really sick and that sick should not be punished, but treated instead.
In Idaho, for instance, the insanity defense in criminal trials (the sort of thing Hinckley is attempting) has been banned. In California, in many ways our most progressive state, the public mood has hardened against child molesters. Sick or not, they are now given mandatory sentences and are no longer released on a doctor's approval.
Other states are thinking of following California's example. It is clear that the public mood is changing, becoming more conservative, reverting to traditional and comfortable notions of punishment and retribution. Some of this is understandable. Too often child molesters and other criminals have been certified cured by psychiatrists only to strike again when they were freed. The lesson seems clear: While the mistakes of doctors sometimes kill their patients, the mistakes of psychiatrists can sometimes kill others.
There is a general antipathy toward experts in general. To some, they seem to have done nothing but gum things up. They tell you how to raise your child, support school subjects that seem silly or immoral (sex education, for instance), seem to have no religious values and--different experts this time--tell you that just about everything you eat is going to give you cancer. Particularly when it comes to the criminally insane, the mood seems to ignore the experts--throw away the key--and any psychiatrists who happen to be in the vicinity.
But this cynicism has its limit. Never in all history has less knowledge been preferable to more knowledge. It is no different when it comes to psychiatry and the entire field of mental health. It is, after all, a relatively new field and it is still groping, trying to find answers to what may be the most inexplicable puzzle of all--what determines human behavior. To know yourself is a difficult task. To know someone else may be close to impossible.
Most people in the mental health field will admit to this. Like doctors or lawyers, there are things about which they do not agree and things they do not know. But there are things they do know, and to summarily reject this knowledge because it is not as all-embracing or comforting as primitive concepts of criminology like "bad" and "good," is nothing more than a return to know-nothingism.
For some reason, there seems to be a special kind of hostility reserved for psychiatrists. People understand that physicians sometimes fail, but don't think these occasional failures invalidate all of medicine. When it comes to psychology or psychiatry, though, the failures take on a greater and wider meaning. Maybe this is because to some people psychiatry seems to promise more than it can deliver. Maybe because to others it seems almost religious in nature--not merely a science, but a theory that could explain the virtually inexplicable: why we are what we are.
The point here is not that psychiatry has all the answers when, in fact, it has only some of them. The point, instead, is simply to treat it like anything else. Sometimes it works and sometimes it does not. To consider it either a panacea or a fraud--one or the other--is, almost anyone would agree, worse than illogical. It's crazy.