Please place a “1” before any of the following statements that cause an improvement in your mood:

_ We all have problems.
_ It could always be worse.
_ Everyone feels that way.
_ This, too, shall pass.

Now, add your scores.

Despite my lack of psychic abilities, I predict you scored zero. Therefore, you’re probably considering paying a visit to a psychiatrist. Guess what? You’re right: Paying is one thing you’ll definitely be doing, and plenty of it. Meanwhile, you imagine being treated by a person who practices what Merriam-Webster calls “a branch of medicine that deals with mental, emotional, or behavioral disorders,” a/k/a psychiatry. It sounds like some kind of love. It sounds astonishing. It sounds like it’ll take your breath away… and it just might!

But before the breaking of your brain’s hymen, remember that, in layman’s terms, once fucked by a psychiatrist, your mind will never be a virgin again. Therefore, aim for abstinence, the only form of mind control that’s 100% effective in preventing brain impregnation by drugs for which the average psychiatrist has never bothered reading the manufacturer’s prescribing instructions, much less the truth.

We understand you may have passed the point of caring. For whatever reason, you’re determined to sacrifice your virginity. You’re only human.  So, assuming that you’ll act upon this decision, you shall now be guided through the process of brain impregnation and, we hope, avoid getting pregnant upside-down.

First, let’s get real. Psychiatry is only rarely practiced in the United States. The goal proved too difficult and the profit margin too slim for almost anyone to bother trying. Psychiatry was abandoned for easily-attainable and profitable goals, that being guesswork, drug dice throwing, abject apathy, and, of course, check cashing. Derived from Freud’s daughter Anna, this brand of malpractice is unknown as capitalanalysis. This has never been disclosed, and no one will admit it, yet capitalanalysis has been and remains the almost-ubiquitous form of “mental health care.” They even still call it psychiatry! But it’s still capitalanalysis, and the only things analyzed are the degree to which any psychiatrist is not a doctor and the degree to which any psychiatrist is not a psychiatrist. A minus sign precedes almost all such ratings.

You shall now be walked through your first visit to Johnny the capitalanalysist. You’ve come this far, and you might as well come all the way. However, surrendering your virginity need not equate the surrendering of your self-authority. Tell yourself, “If you’re going to stick it to me, buster, you’d better treat me real good.”

So let’s begin with the proper greeting. Upon entering the capitalanalysist’s office, which capitalanalysists call “the brain’s bedroom,” immediately shout, “Where’s the mustache, Adolf?” Now you’ve told Johnny, “I know the facts, Jack:” Exactly what do you know? That you’ve accepted the risk of entering the bedroom of a “medical field” born in Nazi “medicine.”

Next, while being “evaluated,” you must evaluate the psychiatrist. The latter carries all the weight, while the former bears none. The purpose of this process can be easily remembered by the acronym ASIF (Avoid Sadistic Ignorant Fascists). The odds of your accomplishing this task have been estimated in Vegas as approximately 1 in 9,234. Whether you ever accomplish that mission depends on how much money you can blow. Capitalanalysis entails the fact that only the wealthy can afford psychiatry-psychiatry, not psychiatry. Don’t try to keep this straight in your head; it’s crooked on purpose.

As the evaluation continues, interrupt one of the “doctor’s” boilerplate questions and state, “Just to be clear, I’m employing you, not the other way around.” You’re the authority figure. You take charge even in the capitalanalysist’s own bedroom. After all, it’s your virginity on the grill.

Soon, you’ll be diagnosed. You may or may not be told your diagnosis. The diagnosis is the capitalanalsyst’s theory. From this point forward, the capitalanalsyst’s sole concern is proving his theory correct. No capitalanalsyst can feel what you feel, nor would any capitalanalsyst care. Your treatment is entirely designed to prove the capitalanalsyst’s theory, and you will be blamed if you fail to assist in proving that theory. The theory is never wrong; you’re wrong. Otherwise, the insurance companies might cost Johnny his virginity in the last place he wants to lose it.

Or so you’re told. Demand your diagnosis. Johnny might refuse. He cares even less than the average capitalanalysist, if that’s possible. Are you going to stand for this from the first Johnny who fingers your frontal lobe? Of course not. Repeat your demand for the diagnosis. When Johnny finally belches the diagnosis and code, and no matter how accurate the diagnosis may seem, say, “Bullshit!” If Johnny runs, he doesn’t even care enough to despise you for stopping him at third base. Congratulations: You’ve terminated your first capitalanalsyst, and you’re still a virgin. It’s too late to abort the capitalanalsyst, but at least you won’t have to terminate Johnny again.

If Johnny doesn’t run, he will produce his prescription pad as if it’s a magician’s rabbit. Where was it? On the desk the whole time; you’ve been duped by Johnny again. Didn’t you know Johnny slips everybody mickeys?

Stop!  Pause and refresh your memory. What was that diagnosis, again? Oh, yes. Odds are it was bipolar disorder. That’s because almost no other disorder “requires” so many drugs as bipolar disorder, making it a very appetizing theory indeed for capitalanalsysts. In fact, it’s their favorite excuse for cocktail hour, but you’ll be the only one swallowing anything. Get used to it. You may swallow a hundred different cocktails and never get to where you planned. Don’t worry: You can’t get your brain pregnant by swallowing, silly!

More than likely, you’ve been misdiagnosed. You’ll notice this after two years of a depression six feet deep: You might as well be dead. Hopefully, just in the nick of time, you’ll finally figure out what’s been making you “sane” made you disappear! Now you’re Johnny’s rabbit, and you’re all but pulling tricks unless you confront that dirty rotten son of bitch. You tell Johnny, “You’re not getting to home plate with me! And use your fingers on yourself, fuckface.”

Yes, even after all this time, your brain is still a virgin no matter how many time’s it’s been fingered. By now, you’ve probably figured something else out, too: You weren’t bipolar, just anxious. But you have to prove it to a capitalanalsyst, and words won’t do the trick. You wanted it, so get naked. Act exactly the way you feel. You might consider smashing the capitalanalsyst’s degree over his head. Don’t fret: That won’t hurt any capitalanalsyst. There’s nothing in their heads!

Learned your lesson yet? Rather than giving it up to any old Johnny who calls himself a doctor when he isn’t a doctor any more than he’s an Olympic athlete, keep that abstinence until you can’t stand it any longer. Your brain deserves love, not just a lousy lay Johnny will give anybody in town who calls him “Doctor.”

Finally, whatever you do, keep your eye on those mickeys. Some are worse than heroin, but don’t expect a capitalanalsyst to tell you that! With the best mickey he can give in his self-interest and the worst you can take in your self-interest, a capitalanalsyst supports whole industries, from drug manufacturers to rehabilitation centers.

Have you learned your lesson? Abstinence first! And even then, swallowing might catch you a virus they call addiction. We call it capitalanalysis, and we don’t take dick from Johnny!

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PAUL A. TOTH's Airplane Novel, already a Midwest Book Review Reviewer's Choice and the 9/11 novel, is available now. His other novels include Finale, Fishnet and Fizz. Click here to visit his sites.

13 responses to “So You Need a Psychiatrist?”

  1. Irene Zion says:


    I think that seeing a psychologist is preferable to seeing a psychiatrist.
    The latter screws up your brain with psychotropic drugs that totally change who you are.
    The former just listens to you and gives you advice.
    That’s what I think.
    (It’s good so see you posting again.
    Have you been busy writing another book?
    I like your books.)

    • Paul A. Toth says:

      Good to hear from you, Irene. I haven’t been posting because I have a great interview that’s to be posted here, with a fantastic photographer who deserves far greater recognition, but various things have held it up. I had also forgotten that when I know I’m going to write a long piece for the blog, and it amounts to an article suitable for TNB, then post it on TNB. This time, I remembered!

      As to novels, check out the preview for the next novel due in July 2011, Airplane Novel: http://www.airplanenovel.com. As narrated by Cary Grant!

      I agree; my psychologist is a genius and creative-minded (he’s a brilliant jazz guitarist who trained with the guitarist for Lennie Tristiano). And I, too, lucked out; my current psychiatrist has figured out an approach that finally makes me feel comfortable with the necessary removal of a certain medication, which will take some time to accomplish. Until the came up with this approach, I was about to give up and stay on it forever. Well, what the hell: Let’s call a spade a Valium. Here’s the crucial twist: My psychiatrist is older. He was trained different from today’s psychiatrists. He listens, and not only to himself. That’s key. He’s conservative in terms of not tossing every pill that crosses his mind. We discussed an antidepressant change, and we agreed together — rather than the decision being made for me — let’s wait for the new medication to show its effects before we make any other changes. I have rarely encountered this kind of judiciousness. Lastly, while clearly exaggerated for satirical purposes, this piece reflects my experiences. I went through two years of robotic and depressed beyond depressed state that I should have traced to the 50 different antipsychotics tried as treatment of my misdiagnosed “bipolar disorder.” I</B? literally disappeared; only my body was present. I eventually asked to be taken off the drugs, immediately improved, and the psychiatrist even apologized. That very same psychiatrist later disputed a point I was trying to make, threw a hissy fit, and sadistically ripped off his power pad a Valium taper that amounted to a prescription for a seizure and possible death.

      So, my claim is not that no good psychiatrists exist. My point is finding one is like winning the lottery. I meant to include their training, which can be done in another post. I do know they receive eight hours in addiction “education.” What can they learn in eight hours? I’ll tell you the gist of the blather: “Send them to detox or NA. It’s not your problem.” I’ve seen psychiatrist after psychiatrist try to cold turkey me off Valium when I already had a seizure that would have killed me had Christina not been present. I am not blameless and I don’t claim to be. Nevertheless, I shouldn’t be sentenced to death for addiction or criminalized on the basis of “doctor shopping” because I can’t find a psychiatrist who knows how to properly taper people from what he prescribes, and so I keep looking. We have to go on a four hour roundtrip to visit the one psychiatrist who’s helped me. Why? I can show you what I was prescribed to help and proper tapering charts in five minutes of Internet searching. The question is, at $120 per 15 minutes, why the hell is that our job?

      I say open up the pharmacy. We can treat ourselves as well as any psychiatrist. We can drink ourselves to death. Dear Fed and state governments: Why pretend you care?

      • Irene Zion says:


        I have had experience with a very, very good psychiatrist, but then I moved and found one “highly recommended.” He was bound and determined to make me dependent on him and believe I was crazy. It took a while, but I broke free from him, although he did a lot of damage. I haven’t seen anyone in years, but if I ever feel bad again, I’ll phone my old psychiatrist and deal only with her.

        • Paul A. Toth says:

          That’s what happened to me. This guy has a “good reputation.” Why? Because he works on the cheap at about 300 local clinics to get that reputation. But I know the score. He’s going to run this game another few years, then set up his private practice with his “good reputation.” This asshole nearly destroyed me more than once. So the lesson is, if you find a good psychiatrist, stay, even if, like me, it means four hours of driving.

  2. In general I agree, however I did have one really awesome experience with a psychiatrist. I was having all these really weird symptoms several years ago & my primary care doctor sent me to a neurologist. The neurologist said it was stress and I needed to see a psychiatrist. Didn’t seem right to me. After all, I I’ve never known falling over for no discernible reason to be related to stress but I figured being stressed was way better than a brain tumor so I went to see a psychiatrist. I told the guy my symptoms and he replied that I needed to see a neurologist – that same day! Thanked the fellow and left never figuring I’d see him again. Turns out he was right that I needed a neurologist also turned out that neurologists are such egotistical f*ckers that eventually I needed the psychiatrist to treat the stress created by the neurologists. Now that I think about it maybe they were in cahoots and it was all a scam to enrich both the psychiatrist and the neurologist. Bastards!

  3. Paul A. Toth says:

    Dear Alison:

    I’ve no experience with neurologists. However, my girlfriend, Christina, has a neurological condition. She tells me she would not put them anywhere near the same pathetic league that psychiatrists occupy. I’m guessing the neurologist was trying to do the work of a psychiatrist; a neurologist would only treat an organic problem, i.e., one that can be physically located or tracked. This is what makes them at least worthy of the term “Doctor,” unlike psychiatrists, for whom medical school must consist of — well, perhaps they attend clown college — and they merely “treat” conditions that generally cannot be located, that are inorganic, nothing more than definitions, and so nothing more than language, and so nothing more than words: words they decide when and how to use. That is not science or medicine. Psychiatry is semantic game theory. They don’t treat statistics, but they think they do. They may very well see patients as bodies composed of digits, and what they hear when a patient speaks sounds like ones and zeroes converted into a digital collage of anti-language. Further, I contend that psychiatrists should all have to be put through a brief and supervised addiction and withdrawal experience before being awarded their degrees; if they opt out, they should not be allowed to prescribe addictive substances. There is no other way for them to understand what they do to people, and there is no incentive for them to care. Money talks and bullshit walks, and so everything we tell psychiatrists walks out the door. We might as well not speak at all except of course when we pay the receptionist and schedule the next useless appointment. Still, as I stated, there absolutely are a few good psychiatrists. The problem is that they’re such a minority, most stand little chance of finding them. And if you do find them, most will agree with my points, if not the way I stated them.

    In short, this piece was meant to be funny. At the same time, it’s anything but funny.

  4. Joe J. says:

    I’ve found Psychiatric Nurse Practitioners to be far superior to Psychiatrists. They both prescribe, but PNPs know the side effects, and all the latest research. It’s required for them to keep up. Psychiatrists are required to as well, but not as often. Mental health is a strange, strange world.

    Psychologists are generally not covered under most people’s health insurance plans (at least, I’ve never met anybody whose insurance covered Psychologists). Almost all of the plans cover therapists, and those therapists are generally CSWs. If you can get a really good Psychologist, that’s awesome. Really good CSWs are rare, but it is generally not their fault. They all tend to be overworked, unless they are CSW-R’s, which means they can charge insurance companies directly (thus allowing them to have their own practice, where they can control their workload).

    Yes, I have WAY too much involvement with the mental health field.

    • Paul A. Toth says:


      All those I’ve met who’ve seen PNP’s would agree. I would bet a lot they’re far more informed about what they prescribe than psychiatrists. It just boggles my mind. Here’s your job: 99/100 times, pick one of three diagnoses, dispense the standard medications, and collect your money. Is it too much to ask they bother learning the specifics of what they prescribe? Oh, they’ll pretend they know, even if you shove the facts in their faces. I’ve encountered such blatant and willful ignorance so many times that I can hardly believe it. What DO they learn in “medical school”? A mystery. All I can imagine is that psychiatry attracts absolute assholes. The exceptions exist. Good luck finding one. I would go to a PNP myself, but I’m tapering off Valium, which I don’t believe they can prescribe. I could be wrong.

      Anyway, keep at it. We need people like you who, you know, give a flying fuck whether they help or harm. The psychiatrist’s oath should be revised: “Do no harm; but if if you can’t bother reading prescribing instructions, then make an exception and do some harm…to yourself…as in fatal harm. Spare us all your useless existence.”

  5. Gloria says:

    I think discouraging people from seeking medical help could be very dangerous for certain people who need that type of assistance. Sure, some have had only 8 hours of formal addictions training, but from what I can tell, you’ve had zero. Nor does it appear that you’ve had any formal medical or psychiatric training at all. I apologize ahead of time if I’m wrong. However, if I’m correct, I think this post is a bit irresponsible.

    Sure, there are bad psychiatrists. But there are also bad every kind of everyone. I once had a gynecologist doing an in-office “procedure” that involved him having his assistant photograph my vagina with a Polaroid camera. I reported him afterward. However, at no point after that did I discourage any women from ever seeing a gynecologist.

    Joe’s solution-oriented recommendations are great.

  6. Paul A. Toth says:

    First, you’re confusing psychiatry as the equivalent of medical help. Second, you’re correct: I’ve had no formal medication and yet time and time again know far more about commonly-prescribed drugs by psychiatrists; that’s what frightens me. Thirdly, only someone psychotic beyond the ability to grasp satire cannot be treated by actual doctors. Lastly, I merely urge caution, and as to research, you can read any number of recent and well-known books proving the abject failure of psychiatry to what it purports to be its job, which isn’t much: “Code ’em; drug ’em; bill ’em.” Given your agreement to the photography episode, I’ve done you a favor should you ever visit a psychiatrist. The lesson beneath the satire is clear: Assume a psychiatrist is at best willfully ignorant until s/he proves otherwise.

  7. Paul A. Toth says:

    Sorry: “…no formal medical training…” I meant.

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  9. heemo says:

    it’s too late.. they already raped me

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