We made a large marketing error by identifying ourselves with medicine. It occurred sometime after Freud since he was more in the shaman tradition than that of plumbing. By joining medicine, we subscribed to the notion that weakness is the reason for consulting us. Unfortunately, a lot of stubborn children and mulish, oppositional husbands refuse to admit to an impairment. Buchwald (see related posting on Buchwald and mania) put it well when he stopped his lithium because he "wanted to do it on his own."
Psychiatry is perhaps the ultimate degradation because the alphas place so much value on their being right. Domineering males will accept or boast about injuries to a knee or a fist. It's mechanical and we all understand the need for a mechanic. However, visiting a psychiatrist implies the possibility of weakness, of error, of inferiority in that part of us that plans, evaluates, and competes.
Manics, however, listen to other alphas, to gods, or to the stars. If forced to a doctor, they seek the best doctor so that even if admitting to a weakness, they are superior in their choice of a mechanic. Manics will sometimes believe in non-observable sources of power and influence. Thus, one bipolar grandmother chose her orthopedist because his secretary performed astrological readings. Thus, the bully husband (2) can be attentive, polite, and even receptive to orders from a greater alpha than himself.
There would probably be a lot more of these guys in treatment if we wore fancy robes and consulting us was an affirmation, rather than a negation of power.
1) Lewontin R (1991) Biology as Ideology: The Doctrine of DNA, NY: Harper, has identified similarities between science and religion. The similarities include: use of a specialized language, the implication of truths that have constancy beyond the present moment, and the creation of a specialized group of practitioners.
2) Of course, we all know the shallowness of their bluster. If you want to see them crack and crawl, have their wife put the suitcases, packed, on the porch. The Taproom Toms, the Flitting Franks often lose 20 pounds overnight, cannot sleep, and will attend "therapy" and even take medication in order to get their wife back. Despite several generations of misimpressions, women do wield the ultimate power. We guys run around, swell our chests, swill our beer, and shout orders but always orbit back to the woman. She keeps our kids and knows our relative's birthdays; when we marry, we often join her family instead of the reverse. My stubborn son once met a girl equally stubborn. He announced himself as usually getting whatever he goes after. She responded with similar claims. He parried with, "If it's a contest between what I want and what you want, you will probably win." I think it was Sinatra in Pal Joey who asked, "Why is it when a guy has trouble with a woman, the first thing he looks for is another woman?"