As a neurosurgeon, my patients occasionally refer to me by numerous friendly slang terms, including “doc”, “sawbones”, “spine guy”, “pop the topper”… I’m most commonly mistakenly called a neurologist, which is a similar specialty, but a non-surgical and completely separate field treating the nervous system.
However, I’ve found it interesting that psychiatrists are routinely called “shrinks”. Where could this term have come from?
It is difficult to know for sure, but the term “shrink” may come from the field of phrenology, where many medical phrases have roots. Phrenology links the shape and size of the cranium to personality and character. The size and development of each particular area implies a greater or lesser disposition to each attribute. Therefore, “shrinking” an undesirable area with psychiatric treatment could improve our minds. As weightlifting tones muscles, the brain could be exercised for strength.
Another possible origin is from Amazonian tribes, including the Jivaroan, who shrunk the heads of their adversaries. It may have been perceived that after physical and worldly death, and a person’s soul could return to torment the tribe. By decapitating the head, removing the contents, boiling the remains in saturated herbs, and sewing the orifices shut, the head could be shrunk and displayed on a necklace. This not only would scare away any future Jivaroan threats, but also maintain spiritual control over a vengeful soul.
Some early psychiatrists working in the entertainment business may have satirically compared themselves to ritualistic heading shrinking. The practice of psychiatry may have reduced the size of “swollen egos” in show-business. Alternatively, psychiatrists relieve stress and anxiety and therefore metaphorically “shrink” their patient’s brains.
Interestingly, newer research may prove that psychiatrists literally, and not just jokingly, alter the physical size of their patient’s brains.
We know that as people age, our brain volume diminishes. Brain cells simply die with time.
However, medications may alter this timeline. Studies show that long term antipsychotic medications, like those used for schizophrenia, may accelerate brain volume loss beyond the normal aging process.
On the contrary, antidepressants may slow brain degeneration that may otherwise occur in chronic depression, in some patients. Volumetric MRI alterations may predict the biological response to the antidepressant. A new study published this week in Nature suggests an electroencephalogram (EEG) may also predict the effectiveness of certain antidepressants, specifically Zoloft. Depressed patients responding to antidepressants may have less brain volume loss than those not responding.
In summary, we should be more “woke” and semantically shift our slang terms for psychiatrists. Some may be “shrinks”, but some may be “preservers”.