Is psychiatry an illegitimate medical field or is this a malformed critique?
I find this need for psychiatry to be “fake” or not real medicine is generally an emotional argument.
A lot of what people around here believe is perfectly consistent with a field of medicine in which many providers are poorly trained or malfeasant, where the medical science is in its infancy, and where diagnosis is syndromal and treatment based on trial and error. Other conditions or forms of treatment scattered throughout the rest of medicine will generally have all the same shortcomings. Psychiatry is not fundamentally different, it’s just that it’s on the far end of some of these spectrums.
The most telling thing is that almost all physicians and all medical schools, professional societies and accrediting bodies consider psychiatry a “real” medical field, even if they agree with a lot of the shortcomings mentioned. No one seems to ask themselves why there are zero hospitals, medical schools or licensing bodies who have decided to simply remove psychiatry from their purview. Psychiatry has become an increasingly popular and competitive specialty amongst medical students, not the other way around. But whether medical students want to do it or not is irrelevant to the question at hand.
It will sometimes be claimed that other physicians do not consider psychiatrists real doctors, but this is mostly untrue or at best a half truth. A surgeon might sarcastically, or as an ego boost, say that a psychiatrist is not a real doctor. But only in the same way that they don’t consider dermatologists or radiologists real doctors either. And the moment their patient cries or refuses antibiotics they will be calling psychiatry for help.
Most doctors have no issue with psychiatry as medicine because psychiatry is necessary for a functioning medical system and other docs want to be able to call psychiatry when they get out of their depth. Different specialties practice medicine very differently, but they all speak the same language because they all have the same foundational training. You don’t ask a psychiatrist to workup chest pain, but you don’t ask radiologists, dermatologists or pathologists to do that either. Psychiatry is a much more clinical discipline than some of these other ones mentioned, but they are all a part of medicine and the practicioners are all doctors because you have to go to medical school to fill those roles.
Anyway, it’s a dumb argument unless one first states clearly what specific criteria must be met for a field, a diagnosis or a treatment to constitute “real medicine”. That is never where these posts go though, they just declare psychiatry is not legitimate medicine and then follow that with a fairly standard list of complaints. Again, other medical fields are not completely immune from those complaints, even if much of what they do can be excepted So the insistence on making this fake medicine thing the core argument actually only degrades very legitimate antipsychiatry critiques.
I will take issue with one specific comment as well - that is also not novel. People say that there is no other area of medicine with an anti- movement and use this as evidence that psychiatry must be fake. But this is not true. Any time medicine touches a controversial issue there will be resistance that is more or less organized. There is no anti-pulmonology movement because there is nothing controversial about the lungs and pulmonology does not touch on any polarizing societal or psychological issue.
But there are large, well organized anti-vaccine, anti-abortion (or anti-reproductive medicine more generally) and anti-gender affirming care movements. Regardless of what you think about vaccines, the existence of an anti-vaccine movement is hardly proof that vaccines are fake or that immunology or infectious disease is an illegitimate branch of medicine. There are folks in opposition to cosmetic surgery or performance enhancement medicine, who don’t believe this is medicine in the sense of treating human illness.
Anyway, I would argue that one’s efforts are much better spent exposing and confronting some specific issue with psychiatry rather than this.