The nature of psychiatric practice lays it open to potential misuse. ‘Open to abuse’ highlights the unequal power relationship with dependent and vulnerable patients whose opinions and complaints can be easily dismissed. The diagnostic process is subjective, relying on psychiatrists' assessments of the patient's motives and mental state, with no visible markers for diseases. The history of psychiatry is littered with shameful episodes of political abuse, hare-brained theories, and dangerous and barbaric treatments. The visibility of modern-day psychiatry, plus a well-informed public and a willingness to admit mistakes, is the greatest safeguard against such abuses. Psychiatry is now engaged in scientific, evidence-based medicine — facts and figures outweigh authority and opinion.