Motives for media work

As indicated above, professional guidance frames media work as fulfilment of a professional responsibility to public enlightenment and care. Media work is clearly not a duty for every professional, but it is nonetheless praiseworthy. Addressing a mass audience is going above and beyond the call of professional duty of beneficence toward individual patients and clients.

What remains unspoken are the realities of media work that complicate the simple picture of disinterested service to the well-being of the public (much as ethical complexities attend consultative work by psychiatrists on the behalf of organisations^{Reference Halleck and Miller4}). We might acknowledge, for instance, that inclination as well as duty motivates professionals who take on media work. Historiography has a useful role here in showing the rewards received, or hoped for, through media work. We can talk more frankly about the motives of actors in the recent past than we can about those of contemporaries who remain among the living.

Consider David Stafford-Clark, the ‘BBC's psychiatrist’ of the 1950s and 1960s and author of a highly successful 1952 Penguin introductory paperback, Psychiatry To-day. Media work was partly a vehicle for Stafford-Clark's literary vanity. He hoped that the commercial success of his laypersons’ guide would pave the way for literary renown as a celebrated national poet.^{Reference Miller5} The rising public status of the psychological disciplines encouraged this minor celebrity and committed Christian to use his soapbox in the mass media to pronounce on wider social and political issues, such as racism and sexuality. His moralising pronouncements eventually provoked a BBC editor to declare in exasperation, ‘who the devil is this dealer with sick people, to pontificate like this about the whole of human life?’.^{Reference Miller6}

Stafford-Clark's career gives us a glimpse of the personal needs that media work can satisfy. In his case, they included literary ambition and a desire to offer spiritual and moral leadership in a secularising era. He also found his celebrity status gratifying. Whatever the mix of good and bad in his career, his motives are more complex than disinterested service to the enlightenment and well-being of the lay public.

The mass media as an industry

The picture of the media psychiatrist as a disinterested educator misrepresents not merely their motives but also the reality of their work. The media psychiatrist is not an educator setting a syllabus and teaching a captive audience but rather an often freelance worker in an industry of mass production addressing a public who are consumers, not students. The product that the media psychiatrist offers is shaped by their economic position in many complex ways, whatever their intentions.

Consider the commissioning of a product, such as a book on a psychiatric or psychological topic for the mass market. Whatever the professional's views on what the public ought to know and be interested in, the contractual decision is critically informed by the publisher's judgement on the book's commercial prospects.

For instance, in Penguin Books’ post-war heyday, a non-fiction paperback in its Pelican imprint had to sell several thousand copies to be viable.^{Reference Miller5} Even this threshold depended on much higher sales elsewhere in its list. In commissioning psychiatrist J. A. C. Brown's Techniques of Persuasion (1963), on brainwashing,^{Reference Miller, Hannah, Beardsley and Redgate7} Penguin were consciously hoping to meet a lucrative market created by William Sargant's earlier bestseller Battle for the Mind (1957). Both books were the commercial result of a broader cultural fascination with the realities and possibilities of Cold-War brainwashing stimulated by historical events and amplified by journalistic, fictional and cinematic representations (in movies such as The Manchurian Candidate (1962) and The Ipcress File (1965)^{Reference Holmes8}).

Moreover, the model of the disinterested educator assumes that the media psychiatrist's commodities are consumed primarily or solely as information goods. This may be broadly plausible of the Highway Code or an Ordnance Survey map, but it seems a very partial view of the media psychiatrist's products. Goods may also be consumed as solidarity goods that facilitate a sense of belonging.^{Reference Sunstein and Ullmann-Margalit9} Owning a copy of radical psychiatrist R. D. Laing's The Politics of Experience (1967) surely marked and facilitated a sense of countercultural membership, however deeply it was read.

The media industry brings its own idiosyncratic logic. An author or broadcaster may be recommissioned because they have proven to be a reliable supplier of products that are successful in terms of quantitative measures such as sales, viewing numbers, audience research and so forth. But consumers are also choosers: their interest may be dulled by overexposure to a personality or an issue. Overexposure befell David Stafford-Clark, curtailing his media career with the BBC, as surely as it did R. D. Laing, whose Sonnets seemed to bemoan the loss of his ‘funky charm’.^{Reference Laing10} Moreover, interest in mental health and illness waxes and wanes among the public, who have a finite capacity for multiple competing social problems in the public arena.^{Reference Hilgartner and Bosk11}

The messages of medium and form

The media in which psychiatrists work also bring implicit meanings. This is particularly obvious with broadcast media, which are particularly apt for the formation of a so-called para-social relationship between viewer and broadcaster. The viewer feels about their largely unilateral relationship with the broadcaster as they would about an everyday face-to-face relationship. Although sometimes denigrated as an ‘illusion’ of intimacy,^{Reference Horton and Wohl12} the para-social meaning in the viewer–broadcaster relationship has analytic significance. The broadcaster has to talk with their audience, not at them, or down to them; they have to speak as if they were conducting an ordinary, unforced conversation with an equal.^{Reference Scannell13}

A psychiatrist in the broadcast media is, phenomenologically speaking, a guest in the viewer's (or listener's) private space. In the earlier days of television, this might mean a domestic room, though now media devices can accompany us almost anywhere. To patronise, offend, irritate or bore the viewer is to invite expulsion at the press of a button. Nor are such considerations limited to television. Even a radio psychiatrist must adapt their voice to a conversational style (as has been shown in D. W. Winnicott's career with BBC Radio^{Reference Karpf14,Reference Karpf15} ).

But the implicit sense of an egalitarian, freely chosen, personal relationship may belie the realities of everyday psychiatric practice. Should the viewer ever become a patient, they may find themselves in a bureaucratised and administered relationship, with no choice in their interlocutor, and in a significantly disempowered position. Psychiatrists encountered in medical care cannot be changed as readily as the channel or simply switched off and ignored. The broadcasting medium must necessarily misrepresent psychiatry in this respect.

Moreover, broadcasts come in definite forms that carry further meaning. The expectation of balanced news reporting may, for instance, create ‘false balance’ wherein a heterodox opinion becomes unduly authorised, as with the autism–vaccine controversy.^{Reference Dixon and Clarke16} Quasi-psychiatric formats have their own peculiar meanings. Consider the long-running BBC Radio programme In the Psychiatrist's Chair (1982–2001), in which psychiatrist Anthony Clare interviewed a wide variety of public figures.^{Reference Kelly and Houston17} Contemporary academic analysis understands the programme's ‘therapy talk format’ as promoting a model of self-discovery in which a skilled intermediary helps to disclose a truer, inner self. This format became a model not only for the public to adopt but also an expectation upon well-known people that they should publicly perform scripts of transformative self-narration.^{Reference Nunn and Biressi18}

The therapy talk format bears only a vague family resemblance to routine clinical psychiatric practice: no guest of In the Psychiatrist's Chair was diagnosed or treated for mental illness during these lengthy interviews, despite the programme's title and the occupation of the interviewer. An early reviewer in The Times concluded that there was ‘little more to this series than the prying impertinence of the popular journalist’.^{Reference Sibley19} Psychiatry was there to lend its cultural and social capital to the para-social intimacy offered in a newer form of celebrity interview, one that had been pioneered in the late 1950s by journalist John Freeman in the BBC TV series Face to Face.^{Reference Nunn and Biressi18}

Accruing and converting celebrity capital

Media psychiatrists are to some extent celebrities. Their celebrity may initially be ‘achieved’ by virtue of their professional standing, but they will also gain ‘attributed’ celebrity by virtue of their sustained media representation.^{Reference Rojek20} Celebrities from any background can use their celebrity as a kind of capital that allows them to ‘migrate’ into other fields.^{Reference Driessens21}

Stafford-Clark, as mentioned, used his fame to leverage literary endeavours, as did Laing. Clare was very active in Irish political networks and even stood (unsuccessfully) for a seat in the Irish Senate.^{Reference Kelly and Houston17} All three tried on the mantle of the public intellectual,^{Reference Posner22,Reference Collini23} offering diagnoses of the age or, in Clare's case, of contemporary masculinity in crisis.^{Reference Clare24} To assume that these three figures were necessarily qualified for these activities would be naïve. They were using celebrity to accrue literary distinction, enter powerful networks, exercise cultural authority and wield political power.

The phenomenon continues in migration of other mental health professionals whose celebrity capital facilitates their entry into political networks and the processes of government – psychiatry is not alone in this regard. But professional models of media work seem indifferent to the contemporary significance of ‘celebritisation’, by which celebrity is increasingly detached from achievement, open to a wider range of entrants and used as a pathway into other fields of activity.^{Reference Driessens25} At the very least, awareness of celebritisation might temper professional concern about unqualified media commentators on mental health and illness. The social media personality (or superfluous royal) who converts their celebrity capital into purported psychiatric authority is the shadow image of the psychiatrist who uses celebrity migration to diversify their own professional portfolio.