Doug Berger Psychiatrist, Tokyo Japan

Douglas Berger Psychiatrist in Tokyo Comments on Overview Comment

Tel: 03-3716-6624E-mail日本語  Japanese version

We would like to write here to clarify some issues about our service and the points raised by some posters. At the bottom are links to Part 2 and Part 3: Scope of Service and Credentialing/Licensing.

As a number of posters have noted, the vitriol of many of the posts are far above the usual negative reviews one can see on-line so that the threads are clearly a type of cyber-harassment, cyber-bullying, and competitor-bashing on reddit. Statements with descriptors about myself like: “fucking maniac”;“piece of shit”;“gives patients the creeps”;“scam artist with a doctorate”;“cast-iron racist”;“a charlatan”and other similar statements makes it clear that the discussion has malicious intent over and above being a review.

Reddit has a long history of being used as a platform to harass individuals, and described by media outlets as full of toxic subreddits with rampant harassment and hate speech.

Any past or current clients can and do write to us with any concern about the care they have received, and we always respond to on a personal basis after reviewing their consultation data. The person in question is then free to post our reply about themselves if they wish. While the vast majority of our clients have positive experiences, we cannot say we have never made a statement to a client that did not go well, but we have never held any intent other than to help people with their issues. We will clarify more below in this comment and in further posts to come shortly.

First and foremost, the statement that I have sued "patients" or "ex-patients" is patently false. To be clear, a lawsuit was filed in response to anonymously authored reddit blogs which contained defamatory, harassing, and farcical statements about me on the Internet. While I am strongly in favor of the right of the public to make rational and logical reviews (and non-defamatory non harassing posts were not part of the suit, a common misconception among posters), I am equally in favor of the rights of those attacked by outright false and derogatory statements to seek available and appropriate relief through the legal process.

Fortuitously, the suit has engaged a new incarnation of reddit bloggers to dig into my practice, finding and proving for themselves I indeed am a Board-Certified U.S. psychiatrist (Board Certification Verify), I have a Ph.D. in Japan from a Dept. of Psychiatry in Japan (Ph.D. Verify), and my research papers are from (as quoted from a recent redditor): "reputable journals and some have a decent number of citations, meaning this is considered of value in that research community". It also galvanized some rational reddit bloggers to post that the blog was getting out of hand, with irrational reviews, irrational hateful speech, and even name calling between redditors themselves. Redditors started calling each other “morons” (usually the rational redditors get the brunt of this bullying), and downvoting anyone who called for rational reviews (not necessarily positive reviews even), forcing redditors to tow the bully-line or not post.

To many of us who see these threads from outside, it is shocking how much vitriol can be thrown out on an anonymous blog. Some of the posts are indeed from dissatisfied client stories and/or their confidants (who only know 1-side of each story), some are exaggerated jeering from persons who are not related to anyone associated with our service who wish to inflame discussion for the sake of discussion itself, and some have plugged competing counseling services known to take advantage of these kinds of threads to plug themselves.

Finally, some redditors have become sick of the posts rationally noting that, "many of the remarks went way beyond feedback (I gave a list of some of the comments which I felt could easily be defamatory)", and another poster said, "there is more to the story than the negative Reddit comments suggest....99% or more of the people down-voting this comment do not have personal experience with the clinic in question and are just taking Reddit comments as gospel. I don’t either, and that’s why I’m not going to write the man off if I was in that situation". Redditors who think these persons are sock-puppets should look at these persons' posting history and confront these posters directly, but I have no idea who they are.

Counseling persons who may have significant emotional distress is not always easy. Most of the persons that come are largely satisfied with the care we can provide, however, some clients have issues that are quite intense. Their expectations of what we can really do for them may be unrealistic, they may not agree with our recommendations, may not pay agreed upon fees etc., and sometimes we have said something in a way that in-retrospect we regret we should not have. Again, we admit there are dissatisfied clients, but the vast majority are not. Persons who are satisfied have little interest in writing on blogs so that these kinds of vitriolic threads are not a balanced view.

Some of the posters are recognizable to us as persons who have harassed us or our service, they have written abusive e-mails to us, taken a number of appointment times, cancelled and did not pay, one has become livid upon our recommending taking medication for their report of severe depression and desire for suicide, one is a volunteer at another counseling center in Tokyo, and one is the owner of another counseling service in Tokyo. These persons' identity were given away either in their post history, a report from a third-party who knows the poster's real name and history of abusing our service without prior information from us, or the person had used their real name associated with their reddit name on other media with matching content. Persons consulting with other counseling centers have also reported an occasional therapist to us who derogates our center to them (which we-and the reporting clients-found quite unprofessional).

While the ex-client poster is a small minority of persons who have come to see us, these persons write numerous posts, some from more than one reddit account, without noting their troubled history of engaging with our service and other persons in their lives. Because of our need and wish to maintain confidentiality of these persons' data, it is impossible for us to publish abusive e-mails or record and publish sessions so that we cannot name these persons, nor do we think it appropriate to name other counseling services on-line other than that the services plugged themselves on the threads as an opportunity to "advertise over a bashed competitor".

True and actual rational reviews of our service can be found on this page: real reviews. While I do not have approval from any of these persons to prove they are actual clients, some of them have indicated they wish to set the record straight. It may be possible to arrange for a neutral third party to confirm the review if you send me an e-mail with your LinkedIn profile, copy of your business card, and Japanese Residency Card. After confirming your other ID and the purport of where you might publish this information, I can approach some of these persons to see what can be arranged in terms of direct communication while keeping identifying information confidential.

The majority of persons who see us have some significant problem: anxiety and depressive disorders, manic depressive spectrum disorders, ADHD, panic disorder, OCD, personality disorders, drug and alcohol use, and some with varying degrees of mild psychotic symptoms (all diagnosed by a licensed Japanese physician-and I personally concurred). These disorders by definition include emotional instability, low moods, angry moods, paranoia, fearful moods, and various associated cognitive distortions. These symptoms lead subjective distress, problems in daily functioning, often conflict with others, and on rare occasion conflict even with their therapist over therapy, what was said, payments, etc.

These are the problems we provide service for, few persons with little problem wish to bother to come for help. While most persons are kind and cooperative, a small few willing to engage in conflict even after a short encounter with a therapist can add up over the 25-years we have been seeing numerous persons in Tokyo. Other persons are willing to vent on an anonymous blog and carry along vitriol from others, I suppose this fits the term "hive mind" as noted in other threads.

Again, both myself and other therapists I have worked with have made statements to clients that we regretted in the end, and we try to learn from these. We certainly encourage all to exercise their right to free speech, we also urge everyone to do so responsibly, within the confines of the law. These same rights and responsibilities of freedoms apply to myself, to redditors, and to anyone who wishes to enjoy living in our modern free society.

Douglas Berger, M.D., Ph.D., U.S. Board-Certified Psychiatrist in Tokyo

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