Are you anti-psychiatry?

One afternoon after passing finals, I was walking down the high street past the building in which we had taken our exams. I saw a placard positioned outside – 'alternative careers fair'. On impulse, I took a quick look around to ensure no one medically-inclined was in sight, and dipped inside.

In the limbo after 6 years of lectures, patients and essay crises, only houseman-hood loomed ahead. Perhaps this nudged me inside to glimpse what else might be out there! Of course, nothing that delivered the satisfaction of doctoring but bypassed weekend on-calls – TEFL or charity administration didn't appeal.

Then I found a rather different stall. The Citizens' Commission for Human Rights (CCHR) had a plush display with a laptop showing clips from a DVD. Curiosity drew me in. The laptop was screening a range of disturbing scenes, with a sinister accompanying soundtrack. The DVD cover pictured a roll of bank notes in a pool of blood. The title read: ‘Psychiatry: An Industry of Death’. The hairs prickled on the back of my neck, but I was drawn to engage the middle-aged lady behind the table in conversation.

Our exchange covered some of the CCHR's concerns – ‘child-drugging’ (Ritalin for ADHD in America). I agreed there was probably some overzealous prescribing out there. ECT with no muscle relaxant – I explained to my new acquaintance (by now she knew I was a doctor-to-be) that this was an historic practice and things are very different now in the UK though she didn't seem relieved by this.

Our unfolding discussion brought the strangest experience. The lady leaned over and asked with a warm smile and the expectant tone of making a like-minded ally, ‘And are you anti-psychiatry?’ I paused and considered my response. She was in high heels and I reckoned I could make the stairs a good deal faster than she, if things turned nasty.

‘Umm – well – I don't think I can be anti-psychiatry, as I want to be a psychiatrist.’ Her face fell. No like-minded friends were to be made that afternoon.

‘Well,’ she began, ‘do you want to help people?’ I hesitated – this sounded like the kind of trick question consultants ask you on ward rounds.

‘Err – yes?’

‘Well, that's a good start’ she replied, clearly struggling with a polite young man who did not quite fit her box of ‘human-rights-abusing-psychiatrist’.

Our parting was not disagreeable, but as I walked away, my heart was racing and I couldn't wait to get away. I had never felt so resented for occupying what seemed diplomatic middle ground. Only after I left did it occur to me that I had had to defend what I wanted to do with my life to a complete stranger with strong feelings against psychiatry.

The CCHR and its allied Church of Scientology as I later discovered are well known for their hostile attitude towards psychiatry, but my brief encounter highlighted for me the need to work reflectively and be able to justify our practice. I hope acquiring an understanding of other perspectives will go on helping me strengthen that middle ground where mutual understanding can alleviate sometimes irrational hostility and salvage therapeutic relationships.