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The History and Dirty Little Secrets of Psychiatry · Millennial Mental Health Channel

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  Other times, Yeah, but not this time. Not this Yeah. I've
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  interfered in plenty of elections, but not this time. This is Millennial Mental
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  Health Channel. I'm doctor Justin Romano, a child adolescent psychiatry fellow, and
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  I'm Medi Koreo, a licensed clinical therapist. Our podcast is here because we
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  wanted to start a much newer conversation about mental health. Our goal is to
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  teach you as much as we can by sharing our own experiences and interviewing experts
• 0:26
  in the mental health field. We will discuss topics like mood disorders, psychotic
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  disorders, substance use, personality disorders, and many more. Millennial Mental Health
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  Channel buy Millennials for everyone. We hope you enjoyed today's episode. MMHC is
• 0:40
  a production of Speaker from iHeartMedia mid I Heartmer. Welcome back to MMHC today.
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  We have a very special topic for you, guys we are excited to
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  talk about. But before we get going, I want to give a huge
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  shout out to my co host, my good friend mister Eduardo, who made
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  a website for us. So if you are interested in checking out our website,
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  check out MILLENNIALMHC dot com. We're official. We have a website we
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  did not use. Go Daddy Kenny. Thanks for doing that, man,
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  of course, check it out. We got some blogs we just talk about
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  shit. You can find all the episodes. It looks nice and pretty a
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  shout out to WIS. Not sponsored, we have to pay for it,
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  but shout out to WIS because it's pretty cool. It was easy to do
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  it after a lot of tries, so that was really cool. In the
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  spirit of shout outs, I need to make it clear that if you enjoy
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  any of the episodes, the content that we talk about, there's a good
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  chance that Justin wrote the episode, So thank you, my friend. If
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  it's a shitty one, you could blame me, that's fine. But thank
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  you to Justin for always being supportive and getting a lot of the show notes
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  done. Since we're showing each other out, we're a pretty good team,
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  which is one of the reasons why it's so much fun to do this show.
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  Absolutely, and we want to hear from you too. We get thousands
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  it into perspective, but we feel like we are a little disconnected from our
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  about the show, what you guys don't like. So if you've ever thought
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  email whatever, like, we want to hear from you. I want to
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  to hear too, we're all yours. Yeah, we get the email,
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  We got the social media. Everything is on the website, thanks and easy
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  like automatically if you don't change it. It automatically posts a question under every
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  There's always going to be topics to talk about. But if there's anything specific
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  that our listeners want to hear, we can make it happen. And speaking
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  of topics, today, we are talking about the ugly history of psychiatry or
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  the dirty little secrets of psychiatry. And I know Eddie had a song that
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  he wanted to sing for us. So the floor I was driving getting ready
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  for today, and I listened to the song the All American Dirty Little Decret
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  Dude that was on MTV and v H one. The video like all the
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  time, I'm pretty I'm I might be messing this up, but I can
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  like picture it in my head where people have like note cards and they're going
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  through like cut scenes of people with different note cards with like different like secrets
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  and shit on it. Like as soon as you sent the show notes that
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  was it said dirty secrets or whatever. The first thing that popped into my
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  head. Isn't that funny how songs just pop you they take you right back.
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  There's early two thousands that song came out right, So our younger listeners
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  are our gen Z's and our gen alphas. Go check out All American Rejects
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  dude. I was looking up on our like attendance system. I can look
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  ahead to like next school year and incoming freshmen are going to be born in
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  like twenty ten. Oh, that's wild, wild, but it's like it's
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  wild. Yeah, yeah, that's crazy. We're getting old. We're are
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  getting old. Time flies. When you're having fun, that's that's how I
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  try to do. Yeah, and boy are we having fun. So psychiatry's
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  ugly history, psychiatry's dirty little secrets. So these days, psychiatry has become
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  all about inclusion, acceptance, being a judgment free zone, which is a
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  good thing. We like it. That's the way psychiatry has gone. That
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  has not always been the case. There's lots of examples of bad things happening
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  in mental health and medicine in general, and we feel like it's really important
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  to address the things that you have done so you know about the future.
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  There's a lot of bad examples. I talked to my students a lot.
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  The one thing I bring up is like, if you really want to learn
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  about middle aged white men and the psychology of them, just read any psychological
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  article from the sixties, seventies, and eighties, because that was it.
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  Yeah, and even like not even I mean, honestly, we could probably
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  even say like two thousands all that, like anytime I read an article and
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  it says it's something like a specific finding or whatever, I always got to
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  read like who is a part of the study, because I still don't think
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  we do a very good job of like keeping studies diversified and as good representations
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  of like the overall population. Oh absolutely, And this is something I learned
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  in medical school too, is that the majority of medical research has been done
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  on white men, So even converting it to women doesn't always transfer over converting
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  it to any different race. Which something that I heard something on NPR a
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  couple of years ago, or it was a person arguing like, we're all
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  the same, humans are all the same, we should be treated the same
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  and get the same medical treatments, which I always find to be an interesting
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  argument because yes, we are all the same, but genetically we're a little
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  bit different and that's okay. And so this person was arguing, like,
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  well, African Americans get different blood pressure medicine just because they're black. And
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  it's like, yeah, but those ones work for them better. That's why
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  they get the medicine, not just because they're black. But their argument was
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  that shouldn't matter. They should get the same medicine. As white people.
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  So that's always an interesting argument of are we different genetically and should we be
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  treated differently in medicine because of it. If we just treat it every case
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  it's its own individual case, and took the time to really pour into it
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  all of our effort to find every single piece of information out, we'd be
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  fine. Obviously that's not realistic, So I get why we end up with
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  these generalizations and stereotypes whatever, like that's where these things come from. But
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  you remember that one time I talked to you about the book The How Doctors
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  Think? Yeah, which you gave me a copy of that when I graduated
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  medical school. Yeah, it's so cute. It makes you think about it
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  a little bit like should we treat everybody differently? Like yes, and no
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  almost of like we should just treat everybody as an individual and then go from
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  there. Like there's probably high percentage of the time like all these symptoms kind
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  of align and lead to like a singular or like cluster of things that our
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  possibility. But then there's those oft times where it's completely different. So that's
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  why it's just important that we keep things as individualized as possible. But then
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  I also understand that we can't keep it as individualized as possible because there's such
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  a need for it. So it's a cycle. Yeah. The long answer
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  or the short answer is it depends. It's such a tricky thing. Yeah.
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  Last week we did talk a little bit about a similar topic. We
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  talked a little bit about deinstitutionalization, where the government shut down the asylum system
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  but did not properly fund community mental health programs, which led to an increase
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  in houselessness and people with severe and persistent mental illness ending up in prison.
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  So if you want to hear about that, learn more about that, check
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  out our last episode. We do want to address the past because we want
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  to be honest and open about the things that have happened in our career in
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  our field. Because if there's one thing we've learned in trauma therapy in mental
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  health stuff is that you have to address the past. You have to have
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  to process it so you can learn from it and grow from it. So
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  this is us doing that. Another shout out time if you haven't seen it
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  yet. On our Instagram honor TikTok. On our YouTube, we posted a
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  short ish two minute clip of justin just kind of like giving like the historical
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  breakdown. That shit was like eye opening for me, Like it like it
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  was one of those things where it just kind of like clicked and like made
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  sense of like oh shit, no wonder we and then like I want to
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  compare it to when I was in world history, when I was in high
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  school and like the teacher being able to see, like so the reason why
• 9:20
  we have this is because this happened during Mesopotamia or whatever. I can't even
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  give an example because I don't remember that shit, but like it was like
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  that, Yeah, this is the second time in less than six months that
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  we've talked about Messopotamia. I did that on purpose second time, but it
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  started to click. So anyway, if you want to have like a cool
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  not it's cool the right word. If you want to have a moment an
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  aha moment, check out the clip because I thought that was justin did a
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  really good job of explaining it. Well, thank you apparently. Yeah,
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  TikTok thought it was a pretty good video too, because you said, what
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  in less than fifteen minutes it had like a thousand views, But then talk
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  took it down because it had it said it had election misinformation, had to
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  appeal, it got it back, but by then it was anyway, it
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  was lost it. Yeah, that's okay. I couldn't believe it. It
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  was like election interference and it's like that's crazy other times, Yeah, but
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  not this time. Not this Yeah, I've interfeared in plenty of elections,
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  but not this time. So story time. Is there anything? Yes?
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  Our system is still not perfect. Is there anything you feel like still traumatizes
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  people about our healthcare system? Right now? All of it just kidding.
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  I think the thing that I thought about in terms of mental health, and
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  maybe it's not so much retraumatizes, but maybe it like it's not really helping
• 10:48
  the case is like costs of school, cost of programs, like to go
• 10:52
  to a master's level program or doctor level program is fucking and pricey, and
• 10:58
  if you're gonna go to a doctor program like that is long. Right,
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  So there's that. The requirements to be a therapist, I think it can
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  be pretty tough, thankfully in the state of Oregon. I think in other
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  states they're decreasing it a little bit. An example is it used to be
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  you needed twenty four hundred direct clinical hours, so like providing therapy, treatment,
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  planning, diagnosing, assessment, you needed twenty four hundred post graduate hours.
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  Four hundred of those hours you can count from your internship in grad school,
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  but so basically you needed two thousand hours, but then they took away
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  five hundred of the hours, so now it's only nineteen hundred. And then
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  if you count four hundred from your internship, only fifteen hundred. It still
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  takes over two years at least to get But and it's weird because a lot
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  of people don't know this, but like the data for the other ones,
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  But I think being a therapist has got to be like a nation's level licensed
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  therapist has got to be one of the only professions where you go to school,
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  you graduate, and then you still have another couple of years of working
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  and training before you can even be licensed. Other places you take the exams,
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  like while you're in school, it's holding. So that's that's one of
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  them. And then the last one I want to mention was just like certifications
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  cost a shit ton. We talked about internal family systems and how it's kind
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  of shaky, and then like EMDR, all these things cost a lot of
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  money. So then because they cost a lot of money, then it can
• 12:20
  be expensive to find a provider that has these specific certifications if that's important to
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  you, and then it's just like it almost makes it so we're like gatekeeping
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  certain aspects of therapy. In all of these steps, there is a lot
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  of greed and there's a lot of money to be made on people trying to
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  help other people, which is wild in terms of like the costs to become
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  or to work in mental health. Yeah, I think probably on average it's
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  at least a quarter million dollars to become a psychiatrist between undergraduate and medical school.
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  And luckily for me, the state of Wyoming pretty much paid for all
• 12:52
  of my schooling, which boy am I happy about. But yeah, it's
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  just it's a crazy amount of money to to get into this profession. Yeah,
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  the startup cost is unbelievable. In terms of things that I think really
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  do further traumatize people is ed wait times. Typically mental health in the emergency
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  room is just not a great setup. I've heard stories of people waiting for
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  five days in the emergency room waiting to get a bed for the psychiatric hospital,
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  and it's just they're not helping anyone. If someone's just sitting in the
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  eed for five days straight, waiting for a bed to open up. People
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  only being able to get help if they have insurance also sucks. I wish
• 13:35
  more people had insurance I have. I think in all of the patients that
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  I've seen so far, only one of them is uninsured, and so most
• 13:45
  people have Medicaid. But I know there are so many more other people without
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  insurance that need to be seen, that feel like they can't afford it,
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  and yeah, it's so expensive, it's impossible. And then the last thing
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  would be like in patient psych units. So if you've ever actually gone in
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  and you know, the movies are kind of right in this aspect, you
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  usually have to badge in. It opens up a locked door and get it
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  on the unit and everything. They're just not very healthy places. There's not
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  a lot of sunlight, there's not a lot of places to get exercise,
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  there's not really a lot of healthy, good plant based food. It's just
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  we expect people to get better in these places, but we don't really give
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  them any of the tools that they need because it costs too much. So
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  I think a lot of things could still be a lot better in the world
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  and in our country. The psych ward that's what people, Yeah, I
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  have such a hard time with them. But it's like, I'm not gonna
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  I'm not gonna tell somebody you're like, if you've been to an impatient,
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  I'm not gonna tell you not to call it the psych word. Or people
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  will call it like the the grippysock vacation. That's the one that gets me.
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  So people call it like the grippysock vacation or whatever, And I'm like,
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  do you guys not understand you get grippy socks in the hospital no matter
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  what, just because you're in the fun Yeah. Yeah, anyway, Okay,
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  Justin's gonna talk about lobotomy, but I need to share this. This
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  was like just my chance or maybe I don't know. I don't know.
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  Okay, I'm just gonna say it was just my chance, but it probably
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  wasn't. I was on the TikTok and I was scrolling and there was one
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  of those ones where they have like you swipe and you can see like pictures,
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  and one of them was a fake like news article or like website page
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  for Claire's that said, like now doing lobotomies. The next one was like
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  the next one was a sticker that said I got my lobotomy at Claire's and
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  I thought that was all the funny. That's where I got my ears pierced.
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  So Player's just really stepped up their game. It's pretty cool they you
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  know, all sorts of piercings your ears, nose, brain, whatever you
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  need Claire's as you covered. Yeah, so botomies, this is one of
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  the most interesting cases in psychiatry. This was a surgical technique that was used
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  primarily in the nineteen forties, so it's a little old at this point,
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  but this was essentially a doctor putting a pick in through the back of your
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  eye and so that broke that little piece of bone separating your orbit to the
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  socket around your eye and the brain. And they would swirl around this pick
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  to separate the frontal lobe from the rest of the brain. It only took
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  about ten minutes to perform, so it was a quick and not painless procedure.
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  Down and dirty, Yeah, quick and dirty, and it essentially turned
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  people into vegetables. They were no longer themselves. They had apathy, they
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  couldn't care about anything anymore, They had an inability to concentrate, and a
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  significant decrease in their range of emotions and This was used for all sorts of
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  mental health issues like schizophrenia, bipolar disorder, and mania in bipolar distat I
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  even read a story about someone coming back from World War Two who had such
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  bad PTSD that he elected to get a lobotomy because he couldn't control his anger
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  and his shell shock, all the terrible PTSD from World War Two, and
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  he was he felt like he was re traumatizing and traumatizing his family because of
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  his PTSD, so elected to actually get a lobotomy and essentially make himself a
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  vegetable because there weren't many other options back then. But what a sad thing.
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  As you can imagine, there was definitely a lot of pushback from the
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  neurology and mental health community at the time. They're saying that the procedure was
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  inhumane. Who would have guessed the inventor of the procedure. His name was
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  Antonio Monice. He was Portuguese or portug Yes, he's really good at marketing
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  and using the media to sell it as a cure to many issues, so
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  it gained popularity. So basically he was like one of those like sleazy used
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  car salesman. It was like, hey, we got nothing else left like,
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  come through, we'll take care of you with a quick lobotomy, No
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  big deal. I liked the Portuguez. That was very nice. But Monice
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  even won the Nobel Prize for this procedure for the lobotomy in nineteen forty nine,
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  which shows you that, yes, there was pushback on this, but
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  generally it was well received. The world thought it was an amazing procedure that
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  helped reduce violence, helped reduce aggression, helped reduce significant severe mental illness.
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  Luckily, it fell out of favor in the nineteen fifties once antipsychotic medications started
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  to hit the market, the first one being thorazine or chlorpromosine, and you
• 18:37
  could use chemicals and medicines to help people instead of just permanently damaging their brains.
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  Instead of physically damaging, will only chemically damage. It's so much better,
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  and it's reversible. It's reversible, it's good. Fair neuroplasticity. Somewhere
• 18:56
  in there, I don't know. We can use that. Hand me up
• 19:00
  with the next one because this is new to me. Next up, we
• 19:03
  have a term called the schizophrenogenic mother. So I was of breaking down words.
• 19:07
  So schizophrenia schizophreno genic, meaning born so that your mother causes you to
• 19:15
  have schizophrenia. This was a theory that was popular again in the nineteen forties
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  through the nineteen seventies, so it was it was around for decades, and
• 19:25
  it was the idea was that the way your mother was raising you caused the
• 19:30
  schizophrenia. Mothers who were too overprotective or completely rejecting their kids cause their kids
• 19:37
  to have schizophrenia. And here's a quote that we have that mothers with their
• 19:41
  own psychological problems gave birth the healthy children and then literally drove them mad.
• 19:48
  This was from a nineteen forty eight paper from Frieda fromen Reichmann a am Freeda
• 19:53
  was not pulling punches. So yeah, apparently the scientific papers in the forties
• 19:59
  were brutal. No one was reviewing. They're just typing over whatever. Yeah,
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  kind of like Twitter. Okay, anyway, Yeah, the theory unfortunately
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  gained a lot of steam and more papers back the idea, so more people
• 20:18
  like Freedom were just like typing up words and just putting them out there and
• 20:21
  people were reading it. A review in nineteen eighty two actually looked at multiple
• 20:25
  studies and showed distant and controlling mothers had no increased chances of having children with
• 20:30
  schizophrenia. So now we know, with now years of research and actually looking
• 20:34
  into it, child adverse events and trauma can cause schizophrenia to emerge. That's
• 20:40
  more of a precursor or a risk factor than a parenting style for the mother.
• 20:45
  And we've also seen that cannabis can also increase the risk of schizophrenia emerging,
• 20:48
  so having the use of marijuana, of cannabis, I've heard of substance
• 20:55
  induced psychotic disorder, so things like that. And then there's been a few
• 20:59
  instances where just in the medical community they blame the people or the victim blame
• 21:03
  for the disorders, and this is one of them. I want to bring
• 21:06
  up, since you're the doctor, what is a hysterectomy. I'm going somewhere
• 21:11
  with this. It is the removal of the uterus. Are you talking about
• 21:15
  just the name hysterectomy and yeah, and like hysteria, women hysterical and yeah,
• 21:22
  that's another one that's not okay, Yeah, absolutely so, yeah,
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  the word hysterectomy. They thought that women craziness came from your uterus, and
• 21:33
  so removing the uterus would remove the crazy and yeah, a lot of this
• 21:37
  stuff wasn't really ever based in any sort of research and was just speculation and
• 21:41
  sexism. Yeah. I was close to including that one on this episode,
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  but you know, we ran out of time. There was just there's so
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  much, so much atrocity. Well, we can switch to the next one
• 21:56
  if you're ready. Speaking of atrocity Nazi Germany. This one's not the US
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  though luckily it's a big wins. So between nineteen thirty nine and nineteen forty
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  one, up to one hundred thousand mentally ill people, including five thousand children,
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  were killed by the Nazis. So the Nazis, in their eugenics program
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  were trying to kill people with mental illness and were very successful at it.
• 22:27
  The Nazis also required anyone with a heritable heritable heritable yes, I don't know
• 22:36
  a lot of words illness to be put on a registry. So this led
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  to over four hundred thousand people being forced into sterilization with the intent of reducing
• 22:45
  the rates of illness, and most of these people were labeled as mentally ill.
• 22:49
  I think we mentioned it in a little bit, but this is basically
• 22:52
  eugenics, right am I remembering that correctly. Absolutely, Yeah, they're trying
• 22:59
  to pure a bloodline, get rid of imperfections in a population. That is
• 23:03
  essentially what eugenics is. But it wasn't just the Nazis. Lots of countries
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  had eugenics programs, including USA, Denmark, Norway, Sweden, Switzerland.
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  In fact, in nineteen twelve, Switzerland banned marriage for the mentally deficient,
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  which included a lot of people who were mentally ill people with intellectual disabilities.
• 23:30
  In the US, starting in the state of Indiana in nineteen o seven and
• 23:36
  spreading eventually to two thirds of the states, there were forced sterilization programs right
• 23:41
  here at home, where the government was forcing people to get sterilized so that
• 23:45
  they cannot have children. And this lasted until the nineteen forties, so it
• 23:51
  lasted decades where this was going on. In addition, mixed race couples in
• 23:55
  the US were prohibited from marion as to ensure that the gene pool was not
• 23:59
  much I have a teacher who was from Texas and married her husband who is
• 24:04
  a man of color, and for a long time, and she told me,
• 24:08
  I'm pretty sure I remembering this correctly. She told me that after her
• 24:12
  and her husband got married that a student told her that they lost all respect
• 24:18
  for her because she married a man of color and she was white. So
• 24:22
  that wasn't too long ago. She's so, yeah, maybe it's not like
• 24:26
  legal or whatever the fuck, but there's still stuff like that going around.
• 24:30
  Yeah, this stuff lingers and gets passed down verbally from one generation to the
• 24:37
  next, if you believe in a lot of this stuff. Speaking of prolific
• 24:41
  racists, John Harvey Kellogg, best known for Kellogg Cereal, Hey, did
• 24:45
  you know that the man who invented Kellogg cereal was a racist? I do?
• 24:52
  Now you do that? Thank you MMHC for the groundbreaking. So in
• 24:57
  nineteen eleven he created He was a big eugenicist and he did not want racist
• 25:03
  to mix, so he founded the Race Betterment Foundation in nineteen eleven to prevent
• 25:10
  race degeneracy was the word that he used, which not great. Eugenics in
• 25:17
  the US was racist, it was sexist. It was overall horrible. But
• 25:21
  one of my actual positive thing that came from the eugenics program is that it
• 25:25
  did actually eventually lead to the invention of birth control because they were trying to
• 25:29
  sterilize mass amounts of people and they figured out that if they mess with a
• 25:33
  woman's hormones that they can prevent her from getting pregnant. So when I guess,
• 25:41
  I just don't want like, I don't feel comfortable saying that. At
• 25:44
  least eugenics did this. A lot of good came out of the eugenics program.
• 25:51
  What good? Yeah, not good. So there it is. There
• 25:56
  are some examples of how medicine, psychiatry, and surgery have grown own.
• 26:00
  No more lobotomy is at least that I know of the other stuff. Maybe
• 26:04
  some of this, like eugenic thinking and other shit still lingers, but hopefully
• 26:11
  as a whole we can say that we've kind of grown and we've tried to
• 26:15
  make improvements and we've learned. I'm hoping so too. Yeah, that's the
• 26:18
  big thing is that we want to learn. We want to grow. Just
• 26:22
  like with trauma therapy, we got to learn from these things that happen.
• 26:26
  We got to learn from our traumas in the past. We got to grow
• 26:29
  from them. And you know, some people are still skeptical because of the
• 26:33
  terrible things that have happened in the past. A lot of people say they
• 26:37
  don't trust doctors, they don't trust mental health, they don't trust psychiatrists because
• 26:41
  bad things have happened from those people in the past. So that's one of
• 26:44
  the reasons why we want to address it, to try and encourage people to
• 26:47
  get help in the future. That things are really changing in the world of
• 26:51
  mental health. They're still not perfect, but it does seem like the overall
• 26:55
  focus is that we want to be inclusive. We want to help people.
• 26:59
  We want to be the trauma informed. We want to understand where people are
• 27:03
  coming from so that we can help them get better. And so we think
• 27:06
  it's important to address the history because the history in psychiatry has not always been
• 27:11
  stellar factual information. Yes, that's Justin's take home points. I think I'll
• 27:17
  hit with some of mine. I think we can acknowledge that stuff was shitty
• 27:22
  in the past and we can make improvements, and that is the important part.
• 27:26
  Today's episode has been kind of cool. This is just straight stats and
• 27:30
  facts. That was nice. I like that cruise. I mean, it
• 27:33
  wasn't like all fun stuff, but still that was good. That was good
• 27:37
  information. So I enjoyed it. I hope you all enjoyed it too.
• 27:41
  Thank you for listening. Thank you, as always for everything we enjoy getting
• 27:45
  to do this every couple of weeks. We enjoy that you listen to it.
• 27:48
  So, like Justin said, if you have anything you want to share
• 27:49
  it, hit us up in the DMS, we'll answer you send us an
• 27:52
  email. Check out the new website Millennial MHC dot com, Instagram, TikTok,
• 27:57
  Twitter, YouTube, it's all the same thing at Millennial MHC. We
• 28:02
  might have done that on purpose. Find the show, recommend it to friends
• 28:06
  wherever they find their podcast on Spotify. We'd love to see if you want
• 28:08
  to leave us a comment on what you thought on the episode. You can
• 28:11
  leave us a five star review as well, and then on Apple Podcasts same
• 28:15
  as always, you can leave us a five star review or leave us a
• 28:18
  comment on what you think of the overall show. Thank you, thank you,
• 28:21
  thank you, and as always, take care of y'all. Mentors