Open Medicine EU

The Limits of Psychiatry?

This post is a slight digression from the core themes of the blog but it does have some connection to medicine and science, or at least to how not to do it.

I dislike reading in the media quotes from psychiatrists offering a quasi-diagnosis of living people whom they have never met. There was a recent case of it here in Belgium.

This country, where I live and which I like very much, is in a political and constitutional crisis. Since the general elections on 13th June, the Dutch-speaking Flemish and the French-speaking Walloons cannot agree on the formation of a new government or constitution.

Even in normal times, each side can find it hard not to get up the nose of the other but feelings are running higher than ever now, with insults traded daily across the linguistic divide. Leaders of each side are demonised by the other. Among francophones, the greatest villain of all is Bart De Wever, or “Monsieur Non”. He is leader of the biggest Flemish party, the N-VA, the most “nationalist” of the mainstream parties.

Enter the psychiatrist.

A francophone child psychiatrist, a professor emeritus of psychiatry no less, was quoted in La Derniere Heure (mainly a sports newspaper) along the following lines – my rough translation, original French here:

Without actually saying that the cap fitted Mr De Wever, he first described a type of child: “The temperamental child, the child-king, can go very far in his verbal outbursts to get what he wants. He makes crises with all his power, especially when he sees that it works. He is a child who was given his way. The child who learns to play on a small scale to get what he wants often imprints in himself this way of acting and uses it on a larger scale. “

More directly the learned professor was quoted as saying: “It is pointless to advise him (De Wever) to make himself understood by the French (speakers) for he does not want that. You can give advice to people whose intelligence allows them to reason better, but this man does not want that. At best, it would seem only to annoy him and nothing else. He wants to be hated by the French (speakers), which also shows his strong will for power. He has a very dominant personality. The Flemish will find later that it will not be easy to argue with an egocentric like him.

We are born with a certain character but then it is influenced by our education…. His family history, the fact that he was raised by a collaborator (his grandfather actually, JM), may have developed in him the desire to atone for his family past. He wants at all costs to show he is the best, that he is the light of Flanders. That does not in itself make him abnormal.”

Oh dear. This is pretty eye-watering stuff and in fairness is not typical of Belgian political discourse. Indeed, the newspaper itself described the psychiatrist as having, “unlike others, agreed to involve himself with the personality of the most feared Flamand in the country”.

I have seen no sign of the francophones closing ranks around the professor. There has been some discussion about the limits of fair comment about a public figure and about professional ethics but no more than that.

At least, we were spared a war of psychiatrists. Mr De Wever who, ahem, might be described as feisty, did not wheel out his own psychiatrist to attack the Francophone leaders (your leader is madder than my leader…). At first, he ignored the attack but later, on the advice of one of his supporters (a doctor) he made a formal complaint to the Ordre des Medicins, alleging a breach of professional ethics.

I suppose this is a storm in a teacup but not the kind of thing to encourage confidence in psychiatry. Some may argue that allowances might be made for a professor emeritus, but retired people should mind what they say too …

A few years ago Jacques Chirac, with magnificent arrogance, said of thirteen other sovereign member states “They have missed a good opportunity to shut up”. (« Donc, je crois qu’ils ont manqué une bonne occasion de se taire. ») That advice might have been apposite here.

I hope to have more serious stuff in my next post, when I have finished a (very) long trawl through the Zyprexa documents.

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