Free Speech in Psychiatry is Essential, to Meet Bias, Distress, and Upheaval, and to Promote Nonviolence, Justice, and Belonging

This working paper provides a profound, innovative perspective on addressing issues with organizational communication within a professional organization representing individuals tasked with significant responsibilities to address and alleviate human psychological suffering. Words convey potential for creation in the Biblical sense, but what is the intent for creation? Hopefully, in institutional settings, words are used to create a safe forum for professionals to discuss best evidence based practices and foster a therapeutic space to allow true healing at the visceral, somatic level for clinicians and, eventually, clients. Politics in a broad sense has implications on many social determinants of health and mental health by affecting allocation of resources. A nation's budget which is spent on wars and destruction of human lives is not only morally reprehensible against those human lives directly affected but also takes away resources which could be used to create a just, saner, and more compassionate world. Dr. Chandra's reference on free association is more a metaphor for engaging in genuine discourse than a literal definition. The goal of free association to "bypass ego defenses and access unconscious processes" sounds quite rational as mentioned by Dr. Ramakrishnan, and theoretically pleasing in a sterile, ideal, therapeutic environment. However, in practice, true healing is rarely successful without honest dialogue and exchange with a practitioner who is willing to explore sensitive and sometimes controversial topics which may be causing physical and psychological symptoms. For those individuals whose suffering is a result of social injustices and health inequities, these explorations and opportunities for reprocessing traumas are crucial. I found Dr. Chandra's article to be quite enlightening, thought-provoking, and humane.

Dear Editor, I am writing in response to the working paper titled “Free Speech in Psychiatry is Essential, to Meet Bias, Distress, and Upheaval, and to Promote Nonviolence, Justice, and Belonging.” While the author’s concern for suffering is commendable, the paper rests on a conceptual conflation that risks distorting psychiatric practice and public understanding of our field. The manuscript merges two unrelated constructs: - Political free speech, a civic right grounded in democratic theory, and - Therapeutic free speech/association, a technical clinical method central to psychoanalytic and psychodynamic work. These domains are not interchangeable. Political free speech is a horizontal right used for debate and persuasion; its aim is external change. Therapeutic free speech/association is a vertical, boundary‑intensive technique designed to bypass ego defenses and access unconscious processes; its aim is intrapsychic integration/self-reflectivity. Collapsing these into a single category dilutes psychiatric rigor into generalized humanities discourse. The title “Free Speech in Psychiatry” further compounds this confusion by failing to specify whether it refers to clinical encounters, academic psychiatry, organizational communication, or public advocacy—each governed by distinct ethical and relational constraints. Without such specificity, the argument loses coherence. The abstract also makes sweeping causal claims—that “free speech” within psychiatric organizations will promote nonviolence, justice, and belonging—without empirical evidence or theoretical grounding. The result is moral exhortation rather than scholarship. Conflating political expression with clinical technique produces several professional errors: undermining the therapeutic frame, overextending psychiatric authority into geopolitical domains, and confusing the public about the scope of our expertise. When psychiatric forums become political arenas, we mirror societal polarization rather than offering psychological clarity. Psychiatry’s contribution is not to function as a political forum but to help individuals understand their own minds. Blurring the line between a political rally and the consulting room risks losing the essence of our discipline. Sincerely