In mid-February, Medscape published an article by Professor Lieberman entitled What Does the New York Times Have Against Psychiatry? in response to an article by Professor Luhrmann that appeared in the New York Times (Redefining Mental Illness). As a result, the medical portal published a polemic between a psychiatrist mainly involved in schizophrenia research and a text by an anthropologist whose interests include such issues as witchcraft, but also ... psychiatrists. This polemic triggered a wide-ranging discussion between users - representatives of various medical professions registered on the portal. Although anti-psychiatry is a movement that originated in the 1960s, in the polemic cited, one can hear the repetition of the arguments of the time on both sides. Prof Lieberman also issued a response to the New York Times, but this has not yet been published. Readers of the website alternately criticise and praise his arguments regarding the facts of the validity of including currently existing pharmacotherapy in the treatment of schizophrenia, or the usefulness of making diagnoses of mental illness (and distinguishing between a symptom such as auditory hallucinations or suspiciousness, and an illness constituting a whole set of symptoms). Some readers are outraged that a person with no medical training has taken it upon himself to comment on psychiatry. There seems to be something inappropriate in this accusation. After all, psychiatry is commented on primarily by non-psychiatrists, probably most often by patients or their families, and wise specialists enter into a dialogue with them, because only this form gives a chance to correct possible cognitive distortions. It is interesting to note that also among the doctors themselves, beliefs about the scientific nature of psychiatry vary widely, as became apparent in the online comments under the text.

This debate, although taking place on a foreign portal, is also very topical in the context of what the Polish media publish. In Polish newspapers, a psychiatric hospital is a crowded place where unspecified 'lunatics' are kept in poor conditions. It is not difficult to guess that nobody sensible deals with such lunatics. The press strives for sensationalism, so the psychiatrist is also the kind of person who exonerates various thugs from criminal responsibility by giving them insane status. One searches in vain for reports of those who were examined by an expert psychiatrist and yet were later convicted by sentence. Thus, the availability heuristic begins to take effect and the average citizen develops an attitude full of aversion to psychiatry in general. The balanced formation of an opinion is not facilitated by Polish legislation either, with its scare 'beast laws' that allow for the existence of institutions that isolate, rather than treat, dangerous criminals, but which come under the Ministry of Health rather than Justice.

What may surprise some, mentions of anti-psychiatry appear in psychiatry textbooks (vide, for example, "Psychiatry. Sedno."). This is a very good trend. An adept in psychiatry should have at least a general idea of the phenomenon, although its very existence gives food for thought. For Lieberman rightly points out that there is no anti-cardiac movement. Why? Cardiology is progressing faster than psychiatry, with the arrival of management algorithms and new active substances. In psychiatry, the progress is less spectacular, the work on new drugs less intensive, and schizophrenia is also less media-savvy than a heart attack. The average bread eater is less afraid of having a heart attack than of being conceptualised by a psychiatrist who may make a stigmatising diagnosis. It is the stigmatisation that anti-psychiatrists accuse psychiatry of, and in doing so they dangerously fall into relativism by commenting on individual symptoms as a variant of the norm. Breaking illnesses down into symptoms leads to an obfuscation of the picture as a whole, and runs the great risk of forgetting that mental illnesses mostly bring with them real suffering (distress) and often motivation for treatment. Lieberman cites the scientificity of psychiatry, the accuracy of the dopaminergic hypothesis of schizophrenia. True, he does not, however, cite other concepts, such as the glutaminergic one and the fact that there is a lack of antipsychotic drugs acting on this transmitter system. Only a substantive discussion is able to explain such nuances to a non-medical person. Only a balanced discussion of (anti-)psychiatry will contribute to reducing the stigmatisation of psychiatric patients.

The pillar of a good relationship should be empathy, sensitivity to him. Therefore, thearguments of the anti-psychiatrists should also be addressed with empathy. In volume 3 of the textbook Psychiatry, edited by Pużyński, Wciórki and Rybakowski, the discerning reader will even find a subsection entitled Psychiatry and Anthropology (p. 676), right next to Psychiatry and Feminism. It is from this textbook that doctors learn for their specialisation exam. The diagnostic criteria for mental illnesses may not be perfect, but they certainly take into account cultural norms in interpreting symptoms and even distinguish culturally specific disorders. Work on diagnostic criteria is ongoing and involves a variety of methodologies, including consultation with practitioners. These practitioners are also immersed in the culture. Psychiatry is not a monolith, but a dynamic creation. As such, it even benefits from anti-psychiatry. Certainly, these influences can be seen in terms of organisational and legal arrangements and the very explicit formulation of the principles of non-consensual treatment and direct coercion. It is thanks to the influence of antipsychiatry that soterias have also been created.

Professor Lieberman notes the risk of some of his patients not receiving appropriate help due to messages of potential medicalisation, the alleged ineffectiveness of treatment and the unscientific nature of psychiatry. For those without insight into illness, not trusting psychiatrists, it is easy to turn away from potential help. Persistence in this decision may be supported by Szasz's conception of mental illness as a myth, or Laing's conception of psychosis, which values psychosis positively, arguing that illness enables the expression of the true Self. It is indeed difficult for most clinicians to imagine that the depleting psychotic process has anything to do with some hypothetical concept of a truer Self than the true Self. If current research results are to be trusted, the illness slowly robs rather than enables the expression of this Self. Does the morality of anti-psychiatrists allow them to bear the burden of responsibility for potentially dissuading someone from treatment that offers a chance of remission?

To avoid such misunderstandings, a dialogue between psychiatrists and antipsychiatrists filled with mutual respect and the aforementioned empathy is essential. In the spirit of this dialogue, we can count on the New York Times to publish Professor Lieberman's response to the article by anthropologist