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Campus Psychiatry Comes Clean

Dr. Anonymous offers blunt diagnoses of students as neglected, emotional wrecks.

By 12.5.06

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Unprotected: A Campus Psychiatrist Reveals How Political Correctness in Her Profession Endangers Every Student
by Anonymous, M.D.
(Sentinel, 224 pages, $23.95)

IT'S NO SECRET THAT college campuses tend left. A professor brainwashes his students here, a radical student group opposes fighting al-Qaeda there. Until now, though, little attention has been paid to another aspect of collegiate life: mental health services.

It's a touchy subject indeed. The author of Unprotected: A Campus Psychiatrist Reveals How Political Correctness in her Profession Endangers Every Student goes by "Anonymous, M.D." The work has moments of stunning brilliance, though the author strays from her areas of expertise and sometimes writes with overexuberance.

Chapter I is the book's crown jewel, with Anonymous walking the path of hot coals known as promiscuous sex. She's not concerned with STDs or morality yet, though -- it turns out sexual activity has emotional consequences particularly pronounced in women.

The author tackles the topic almost effortlessly, starting with the story of "Heather," who began experiencing "moodiness and crying spells" after obtaining a "friend with benefits." Anonymous argues that Heather's problem is oxytocin, a hormone that induces birth and, more importantly for a 19-year-old, creates a sense of attachment and trust.

It's released during sexual activity, even when Heather is "'hooking up' with men whose last intention is to bond." Anonymous also cites evidence that sexually active teen females experience more depression and suicide attempts than inactive girls, and that romantic involvement hurts young females more than it hurts males.

Worst of all, the mental health profession is silent. There are no brochures, no policy statements from prominent organizations on the topic. The establishment is too focused on the dogmas that men and women are the same and sex with protection is harmless.

Perhaps most interesting is the case Anonymous builds from this information: Campus mental health professionals should actively promote student chastity -- not necessarily in an abstinence-only fashion, but in an abstinence-encouraging one. A health nannyism of the right, if you will.

Many, libertarians in particular, will have a problem with this. The argument goes that doctors should inform patients of their risks and let their customers work out the tradeoffs. A physician is obliged to tell a patient that smoking kills, but the patient gets to decide whether the benefits outweigh the risks.

A fine point, yet this view does not hold sway in medical circles. It is common practice for professionals to nag patients to floss, exercise, eat right and drink less. In this way Anonymous's argument is intellectually honest; there is no case for behavior molding in these areas that wouldn't apply to sexual activity.

Anonymous is also convincing when it comes to post-abortion stress. Again starting with one of her patients ("Kelly"), the author lays out an undeniable pattern of women who have abortions, only to experience depression and sometimes Post-Traumatic Stress Disorder.

The writer is careful to point out these cases are rare; by one study about 20 percent of women become depressed to some degree, and one percent get PTSD.

But in the cases that do occur, the symptoms go largely untreated, with not so much as a follow-up exam. During standard psychological interrogations, doctors don't even ask if women have been pregnant. Anonymous logs on to the website afterabortion.com, finding that the Internet is the only place many sufferers have to talk things through.

The writer makes a good point that, with most medical procedures, patients are warned of every possible complication no matter how minute the chance. With abortion, she says the rush is to put the operation in perspective, to show the woman how harmless and routine it is.

She's also correct that post-abortion stress is not an argument against abortion -- at least no more than stretch marks and postpartum depression are arguments for it. Something medically risky is bound to happen when a woman gets pregnant, whether it destroys a "fetus" or gives life to a baby.

But the psychiatrist is a little inconsistent in her recommendation -- that physicians communicate a patient's risks along with her options, and later provide support groups. No encouragement not to have the procedure, as with the promiscuous sex that starts these problems in the first place.

The third worthwhile chapter focuses on the tension between psychiatrists and religion, an odd scenario because faith has positive psychological consequences. Textbooks only mention God in sections on pathology, and a past American Psychological Association president even called for an end to religion. A married Mormon student trying to have her sixth child is seen as a curiosity, and it's harder for her to get fertility medication than for a promiscuous student to get birth control.

ASIDE FROM THESE TOPICS, HOWEVER, the book stands on shaky ground. It's not a lack of documentation, as each section is meticulously footnoted. It's not that the arguments are radical or unheard of, either.

The problem is that Anonymous strays from psychiatry and into physician territory, challenging orthodoxies along the way. No matter how right she is, it's hard to trust an anonymous campus psychiatrist to tell the whole stories about childbirth, AIDS and HPV.

Psychiatrists are trained medical doctors, but like psychologists they focus on mental instead of physical health. Her patient anecdotes reveal Anonymous doesn't deal with these issues much as a doctor.

"Amanda" is moody because she's almost 39 and childless -- she wants help for the moodiness, not the childlessness, because she's unmarried and Anonymous does not work at a fertility clinic. With former Chlamydia patient "Delia," the topic of having kids just popped up during a psychiatric exam. (The woman comes in for Ritalin refills, and Anonymous doesn't even review the records until the patient leaves for Texas.) The heterosexual AIDS case is merely worried about it, and the homosexual one came in for help quitting smoking "Stacey" visited Anonymous for help with self-mutilation; an HPV diagnosis happened to have caused some of Stacey's stress.

The first issue is so tired it's amazing the publisher even bothered to include it. Everyone knows conception and healthy birth get more difficult as a woman ages. It's no shocker than Chlamydia isn't good for the system either, though some may not know a case "cured" long ago can still hurt fertility.

And on HIV, Anonymous does little more than re-state the thesis from Michael Fumento's The Myth of Heterosexual AIDS. It's a case that's faded in recent years -- any author who cites it shows some guts -- but a rewrite doesn't add much to the debate.

Centers for Disease Control and Prevention statistics support the argument, of course: Of the 944,305 people ever diagnosed with AIDS in the U.S., more than 500,000 were men who had sex with men (about 60,000 of these also injected drugs, making it unclear how they got the disease). A small percentage of the population represents a majority of AIDS cases.

Anonymous also successfully argues that, where tuberculosis cases bring strong government control efforts, AIDS sufferers remain anonymous and their partners aren't even always notified. But again, it's not really a practicing psychiatrist's point to make.

Finally, Anonymous makes a somewhat alarmist case against the sexually transmitted virus HPV. She not only points out it can cause cervical cancer but adds women should rely on premarital abstinence, not the new vaccine. (The latter is "good news" but "medical technology for a quick fix." Apparently that's bad.)

On the whole Unprotected is a worthwhile read, a breath of fresh air in a cloudy field. The writing is conversational and easy to understand -- sometimes to a fault, what with the exclamation points and occasional bald assertions of opinion. And every young adult should hear what Anonymous has to say about oxytocin and post-abortion stress.

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About the Author
Robert VerBruggen is an associate editor at National Review. You can follow his writing here.