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Hush, hush.... voices carry

Posted Mar 20 2011 8:11am
Let's say there was a field, a field treating a very serious illness. In this field, anyone is allowed - even encouraged - to be an expert. The range of opinions, treatments, and results in this field is wide: from life-saving interventions leading to lifelong remission to actively harmful treatment. Yet inside the field it is taboo to question one's colleagues, and real discussion and debate sends people into their little corners in resentment and hurt. Progress is glacially slow.

I'm a layperson: an outsider to this field. It may be troublesome to have me and others asking difficult questions and exposing internal dissent to the wider world, but I find it deeply troubling that patients and their families have to be the ones, largely, pressing for clarity. The Emperor is largely undressed, and those in the field know it, but seem resigned to it as well.

If you are treating OUR CHILDREN you have a responsibility to be at the cutting edge of knowledge and science and that what you believe and do be an open book. If you treat eating disorders and you are NOT speaking up in your field to improve it, then you are part of the problem. If you are treating eating disorders and the minutae of the science is over your head, get more training or find another specialty. If your field is in disarray and you don't want parents and patients to know it then you are part of a dysfunctional "family" that needs to get to work. For a field that so values open communication and not hiding from feelings and the skills of discussion: the conflict avoidance and low distress tolerance bodes ill.

To be more afraid of dissent than the dangers of a field where any opinion and any approach is equal and unassailable is sad indeed. It is infuriating to me that professional courtesy would override righteous indignation - or denial - of a field without moorings.

For dissent and serious questioning to come from OUTSIDE the field is a slow process. People inside the field need to start engaging in real discussion and maybe even in public Effective eating disorder treatment includes psychotherapy is a rare view into someone speaking out directly, and someone exposing the sad truth that the taboo is not just dissent but dissent in public.

Mutually respectful, awkward, and sometimes painful discussion is needed in this field. Now. Holding people accountable for their public statements and writings and speeches is part of that.

I don't like some of my reviews on Amazon and elsewhere, but I need to hear them and be accountable for any valid critique - and engage that critique with openness and humility.
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