As I entered the Kahuna’s office, I was well aware that my research ideas were too early in their development for me to discuss with him. Rather, I was told, amidst some snickering, that the meeting was for the Kahuna to get to know me. I could tell from the smiles that they were questioning whether I would survive the Kahuna’s implacable gaze.
The meeting included three of us—Kahuna, the PSU psychiatrist, and me, the only non-medical person in the room. Almost immediately upon seating myself, Kahuna shoved a paper at me and asked me in the sonorous Kahuna voice what I thought of its contents. What he had given me was the first page of an article which contained the abstract of a research study in which two personality tests were structurally analyzed and compared. Both are still in frequent use today. As the abstract informed me, the construct “Depression” in each test, which should have been identical or nearly-identical by definition, was shown to be unrelated. Each measured Depression in a way that was unrelated to the other and, if the construct of their factors was different, meant that they have nothing in common at all. (If true, these results would undermine the validity of the construct “Depression” in either or both tests, raising questions about both, if not rendering each test useless.) Having read the abstract while the two MDs conversed, I waited for a break in their discussion and the re-focusing of the Kahuna eyeball on me so that I could inquire, “Are you asking me to respond to this?” Kahuna offered a brief shake of the head, and then returned to his discussion.
(I have since added Kahuna’s abbreviated head shake to my informal list, which is rather extensive at this point, of the number of ways that one can say, F*** you!)
This long introduction is not to denigrate the person or office of Kahuna, but rather to dramatically illustrate the state of mental health today and show why it is hard to survive in the mental health system, not to mention be successfully treated.
First, be aware that most, but not all M(oney) D(octors) have little training in research and statistics and that, if they participate in development of medicines at all, their involvement is indirect. As a result, when physicians review articles, they mostly are looking at abstracts, more specifically at the results, not at the way the research is designed. It is as if they have no idea that a study’s design can influence outcome or that a design can be so flawed that no question is answered. The results of such flawed research may in itself be useless, but may nevertheless be published.
But, Kahuna showed no interest in my thoughts about the abstract nor was he interested in what my years of study in research and statistics informed me about the merits of the abstract he had given me. Given the easy with which he handed me the abstract, I suspected that he kept several copies in the top drawer of his desk to dispense to psychologists under his supervision as a reminder to them of how irrelevant their profession is, at least to him. As my imagination was running away with me at that point, I also thought that he must have had a drawer full of multicolored, multi-shaped pills to pull out so that any upstart psychologist might better understand what he or she was truly up against, the entire medical profession and the drug companies.
Compared to physicians, most psychologists have to take a year of statistics along with classes in research development. All this to learn methods that may permit light to be shed on a grain of sand that sits somewhere on a beach among other similar grains so that, in the end, a Ph(ony) D(octor) may be eligible to provide some sort of therapy to patients, an exercise which many psychiatrists see as useless when compared to the more effective pill-swallowing procedure. The techniques or therapy, even as practiced by a psychologist, is most often just loosely related to anything they may have studied and almost certainly is unrelated to any research they may have done to earn their degree.
“So”, you might ask, “who is better trained?” I still recall the startling argument rom one of my professors that PhDs were better trained. He said that Medical Doctors are technicians who study the body, much in the same way that a mechanic fixes on a car, while we Doctors of Philosophy, no matter the field, are trained in the philosophical discipline underlying our area of study and are, therefore, better able to do research and to reveal new knowledge, knowing how to approach a problem progressively, logically, and syllogistically, from x to y to z etc., with greater discipline.
“So, who is better trained?” Well, it sort of depends doesn’t it?
For the layperson, almost certainly, it depends on which profession is better positioned politically and who is paid more money. Ask Kahuna! If he says psychological testing and research is ridiculous, then there is an entire institution that will follow him in that assertion. But the best answer is that sometimes Kahuna’s nostrums will work as promised and other times they won’t. However, occasionally something else less intrusive is required, maybe a little sound advice about how to weather an emotional storm or what to look for to make better judgments in order to increase the possibility of Survival.
If we were all so dependent on pills to manage our moods with the purpose of making us better adapted as survivors, we would never have left the caves, but may still be waiting for extra-terrestrials to deliver our medication on time and in the proper dose so that we may continue in our evolution to our rightful place at the top of the food chain in front of the television.
