Coercion

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I am a psychiatrist who has deep concerns about the short and long term effects of neuroleptic drugs.

I am a psychiatrist who does not believe in the fundamental validity of the DSM.

I am a psychiatrist who is deeply troubled by the distortions of the pharmaceutical industry.

I am a psychiatrist who believes some people can recover from psychosis without the use of medications.

I am a psychiatrist who is working actively with my patients to reduce their use of neuroleptic medications.

I am a psychiatrist who is working side by side with my patients and I am eager to learn from them.

I am a psychiatrist who believes people in extreme emotional distress should have options for non-pharmacologic treatments.

I am a psychiatrist who believes that involuntary treatment is rarely effective in the long run.

I am also a psychiatrist who sometimes forces people into hospitals against their will.  I have patients who are on court ordered outpatient treatment and this may include the requirement to take medications that I prescribe.

I do not select or screen the people I treat. I work as a community psychiatrist and I am sometimes asked to see people who do not want to talk to me.

I do not want to overly dramatize or assert that all people who are in extreme distress are dangerous, but I do know that there are some who are.

Some of the people who I send to hospitals against their will would be in jail if they were not in a psychiatric hospital.

I attended a talk by Jim Gottstein and I was relieved to learn that we agree on many points. Doctors are given enormous power and authority and the bar for civil commitment needs to be high.  I have worked in states where the commitment hearing was perfunctory. This is not fair and I try to remain cognizant of the imbalance of power. I try not to assert as fact ideas that are conjecture or speculation. I am aware that my ability to predict dangerousness is low.  We need to insure that people who are poor and disenfranchised have access to adequate and aggressive legal representation.  This is likely to be an ongoing struggle.

I also know that some psychiatrists are less circumspect about the risks of medications and the limits of psychiatric expertise than I am. I understand that laws give equal power and authority to all psychiatrists – even those with whom I disagree.  I know that the system is arbitrary and therefore unfair. In the same circumstance, one judge would release a person who another would rule for forced drugs or forced hospitalization.  One family would favor hospitalization and another would favor discharge.  One crisis worker would see clear evidence of dangerousness and another would not.

I am fortunate to work in a state that leans heavily towards the protection of civil liberties.  Court hearings for civil commitment in Vermont take hours. They took 20 minutes in Pennsylvania.  Economic forces favor freedom – hospitals and jails are expensive.   Some may argue that managed care compromises human rights; in my experience economics have been a huge factor in pushing doctors to discharge people from hospitals or choose to not admit them.

I am fortunate to work in a state that values, builds, and funds non-hospital alternatives.

I try to keep my sense of humanity and fairness foremost in my mind.  What would I do if this were my child, my mother, me?  I understand that families are not perfect but even in families with strain and rupture, there are parents who deeply love their children and their worry for their safety is deep and genuine.

I have had the conversation with parents and children of individuals who died by suicide; in some instances, I was the clinician who discharged that person from the hospital.  I have had the conversation with the parent who is exhausted from being awake night after night but who will not ask his child to leave his home. I have had the conversation with the parent whose child has disappeared.  I have had the conversation with the child who ran away from persecution – it may be some combination of real and misperceived.  I ask, “Can you call home just to let them know you are alive?” and many times the answer is no. But I also talk frequently with people who are angry that they were forced into hospitals and are forced to accept treatment that they do not consider treatment.  I know this is ultimately a failure on our part to connect and understand.  But I also work with these people for years and try to forge some sort of mutual underrstanding and collaboration even in the midst of our disagreement.

This is the most serious thing I do.  These decisions are hard but I say that not to ask for forgiveness or pity or sympathy.  I chose this job although when I found that I had this deep pull towards this work I honestly did not think carefully about this part of the job. I did not do this to have the chance to force people into taking drugs or being in the hospital.  It came with the job and I have tried to face this with the seriousness it deserves.

Robert Whitaker has taken psychiatry to task for its lack of intellectual honesty. I believe it is dishonest – or at least an error of omission – to talk about some of my work but not all of it.  I do not pretend to have the answers.  At least I will be honest. What do we do for the person who is wielding the knife or dismantling the electric wiring in his apartment or walking outside at night in a t-shirt and bare feet when the temperature is below freezing?  If someone is screaming obscenities all night at his voices is it better that he get jailed for disorderly conduct or put into a psychiatric hospital?  We try to engage, join, understand; but when we are not successful in that moment, when that person still wants to walk away, what is to be done?

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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219 COMMENTS

  1. “I do not want to overly dramatize or assert that all people who are in extreme distress are dangerous, but I do know that there are some who are.

    Some of the people who I send to hospitals against their will would be in jail if they were not in a psychiatric hospital.”

    You might try having the decency to ask people if they prefer jail. I prefer jail. If I haven’t committed a crime, what right do you have to insert yourself into my life? and you’re not a cop so why are you even getting involved? Oh that’s right there’s something special about a fake medical specialty that labels and drugs people.

    I don’t consider a building filled with quackery and forced drugging to constitute a ‘hospital’.

    I know of many people, and I am one, who chose not to work in a job where abusing human rights would be part of my job. You chose the opposite. You now give us excuses like extreme stories of people ripping out electrical wire.

    “What do we do for the person who is wielding the knife or dismantling the electric wiring in his apartment or walking outside at night in a t-shirt and bare feet when the temperature is below freezing? If someone is screaming obscenities all night at his voices is it better that he get jailed for disorderly conduct or put into a psychiatric hospital? ”

    This is what all apologists of forced drugging do. They give extreme examples of crimes and behaviors that they think should be remedied by initiating violence and forced drugging against that person. I don’t buy it, I don’t accept it.

    This old BS about how ‘serious’ the coercers take their ‘responsibilities’ to forcibly drug us, it’s vile. It’s like some white man’s burden BS.

    I don’t care how ‘seriously’ someone claims to take their CHOSEN job as human rights abuser. We just want you to stop thinking it is acceptable to earn a living doing things ‘to’ people.

    ” We need to insure that people who are poor and disenfranchised have access to adequate and aggressive legal representation. This is likely to be an ongoing struggle.”

    Representation to fight YOU in the court when YOU try to rip away their rights. Never forget this. You have chosen to do this.

    Own it. Live with it. I live with the trauma of what your colleagues and laws decimated in my life. I’m just the collateral damage. I know this. My destruction is pushed to the side in favor of scare stories about kids walking around in the wintertime with no shoes on in freezing temperatures. Whatever gets you through the night. We just want you people to be honest, and tell us how many lives you’re prepared to destroy in terms of collateral damage, in order to complete your utopian project of ensuring no distressed criminal ever goes to prison. How many non-criminals need to be terrorized in order that you people can feel good that nobody is in prison who YOU THINK would be better off with a thorazine needle in their ass and psychiatric label slapped on them?

    “I do not select or screen the people I treat. I work as a community psychiatrist and I am sometimes asked to see people who do not want to talk to me.”

    I think I heard a Texas executioner say the same thing.

    Nothing will convince somebody who engages in for profit forced drugging as an agent of the state of the immorality of their cause.

    So long as some extreme mangled story with a grain of truth and sob story can be rallied, it is OK that every other person live in fear of forced drugging and that it hinder their recovery. So long as one guy wearing no shoes on a cold night has a ‘safety net’ set of coercion laws and a cadre of willing coercers to ‘help’ him, it doesn’t matter how many people are ensnared in said ‘safety net’. Because the ideologues have bonded themselves in blood, and shared self righteousness, with their colleagues, that force is justified. It’s how they sleep at night. It always helps someone who knows deep down in their soul how abusive the system they’ve earned their living in is, and how much of line they’ve crossed, to focus on the kid walking with no shoes on in the cold icy night, than to focus on the four other kids who had to be driven to suicide and lose their faith in humanity due to being violated by the system.

    The above article represents nothing but lip services filled with qualifications with an overarching message of smug superiority that you “know what’s good for us”.

    Stay out of my body and I’ll stay out of yours. Deal? obviously not.

    The fight for human rights continues in the face of people who in the absence of any real justification for raping our biology with toxic drugs, throw up stories of the occasional human who walks barefoot on an icy winter road.

    You have all these designs on who should and shouldn’t go to prison. Let me ask you… if I break into your home, take you down, and forcibly inject you with a substance, do I deserve to go to prison? Am I allowed to break your window, bash down your door, and do that to you? even if you paid for that said door with money you earned forcibly drugging other innocent people?

    And can you also please consider donating every dollar you earned coercing people to charity? Or do you feel you should profit from doing violence to innocent people?

    Whatever. You’re not convinced all humans deserve human rights. Good for you. Aren’t you impressi

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    • Reply to Anonymous – You have said exactly what my dear son would have said, were he able. But right now, he is in such severe rebound withdrawal, paranoid and delusions, he is suffereing. I feel for the psychiatrist you are referring because I thing she is genuinely walking a tightrope, just like I, a parent, am walking a tightrope. I know there are psychiatrists out there that don’t feel anything and will tell you, “I don’t talk to family members!” and hang up the phone on you. Where are the places that my son can go and be taken care of while he detoxes from prescribed psychiatric drugs. There are none for the common man. Those places are only for the rich. I’m afraid to be around him and he’s afraid to be alone because of his fears created by rebound withdrawal. My heart grieves that he is alone and I’m praying to my Triune God for help for my dear son. I help him as much as I can with my limited means. I cry a lot knowing my limitations. As I write this, I notice the blog below about restraints. Twenty years ago, my son ran away from being force drugged and was trying to survive on the street and he usually ended up in jail or in a psyche ward some place. He was in the Northeast somewhere and I was on the phone with a psychiatrist. I live in OK. I heard this screaming in the background. I asked to talk to my son and was told that he was “down” right now. I asked, “By down, do you mean strapped down in restraints.” He was in restraints because he was walking, pacing, in the hallway and was told to stop. What one has to understand here is that he was suffering from the side effect of medication called akathisia, where one cannot be still because it is a very painful internal restlessness that causes one to have to move about. And he was strapped “down.” I was 2000 miles away and that’s what I heard. But no psychiatrist ever, ever told me that psychotropic medications cause dependence, and, indeed, probably does not even realize it. As late as 10-18-2011, a psychiatrist over my son did not know psyche drugs cause dependence. Even my son would not acknowledge it because he thought that drugs that cause dependence are supposed to make you feel good. And psyche drugs cause tortuous side effects, so he though, how could they be addictive or cause dependence? And he would stop them cold-turkey every opportunity he got which is very dangerous. It’s been 20 years and it’s happened so many times now, that he has fixed delusions that I’m not his real mother, that he is 61 years old (he’s 43), and other delusions. He can’t keep an apartment. I cannot allow him to live with me anymore. He’s on the street, in poor health, won’t go to shelters. I need to find out the state this psychiatrist lives in because she has said that she lives in a state that “funds nonhospital alternatives.” That’s what we need here in Oklahoma. We absolutely must have these kinds of places. How do we get the State Legislatures to fund these kinds of places?

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      • Marilyn,
        My heart aches for you. I am sitting here in tears after reading your post. There is no greater hell a mom can go through than this. I know because I’ve been through it. Sending you a big tight hug. Thanks for having the guts to post your story here.
        Yes, we need non-hospital alternatives. We need refuges, peaceful places of healing. Keep speaking out. I am with you. Feel free to look me up. I’m in Ohio. (And Bob could connect you with me too.)
        Big love to you,
        Suzanne

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    • I would also choose jail over a psych unit, if not for the fact that it’s at least as easy nowadays to get forcibly drugged in a jail. It has been a little over two years since my last run-in with the psych system and not since my child hood have I been trapped long-term in it and yet it is still at the front of my mind all day, every day. It is an abuse that lives with me constantly and probably for the rest of my life. I feel that even if I were so mentally or emotionally disturbed that I really did need treatment, I would prefer to die instead just for the sake of principle due to the fact that it was the treatment in the first place that caused my mental problems.

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      • Thank you. Stay strong. Many people kill themselves immediately after they are released from a fresh session of psychatry’s brutality aka a ‘hospitalization’. That you haven’t decided to leave this world shows me you’re strong. Try and stay strong. It’s not easy living in fear that you’ll be tortured and violated at any time they see fit. I know.

        I find it interesting how you say you think about it every day. I do too. It’s what happens to all victims of extreme violence. Rape victims think about when they were raped, children who were molested are haunted by their molesters, people who nearly die in auto crashes relive the crash over and over, and we, well we’re stuck with the handiwork of psychiatry choosing to use violence against us. They sleep at night, move on to the next person to be forcibly drugged, and make their six figure salaries while we try somehow, some way, to come to terms with a world that thinks it is OK to violate our brains. You said it, you’d rather die. That anybody, any professional could carry out force and violence against random members of the public, strangers, violence and brutal irreversible coercion that violates the dignity of human life in one of the most invasive ways imaginable, violence and force that is proven to make at least some those subjected to this violence and force rather die, is incomprehensible.

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        • I’ve read many of your responses but this one really made me realize that you’ve experienced horrific trauma. I hope your participation in these discussions is helpful for you. I know for many the effects of extreme trauma never go away per se they’re just “managed” to varying degrees. Keep posting A-

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    • I was on benzodiazepines for years. I was Iatrogenically addicted to tranquilizers for years. I never knew I was on “tranquilizers.” I was told they were anxiolytic. I was told they were anti-seizure. Never ONCE was I told they were tranquilizers.

      My doc began asking me if I was hallucinating (a “side effect” of benzodiazepines) I always answered, “No.” She seemed disappointed. She actually wanted me to begin hallucinating so she could pump me full of the major tranquilizers rather than taking me off the offending drug.

      I was put on the benzos because of a seizure disorder (migraines) and the depression resulting from the migraines. Before you know it, I was having many of the negative effects of the benzos (there ARE NO *side effects* – only DIRECT effects. You get the effects as a *direct* result of taking the drug. Therefore – they are *direct effects.*)

      When a person begins to accumulate the “side effects” (direct effects) many times they begin to think they are going crazy. I never did, so I got out alive.

      The facts are that people on these drugs die 25 years earlier than their peers.

      The facts are these drugs are toxic and deadly. If you cold turkey from benzos you can have seizures, go into a come, or you can die. These are addictive drugs!

      I navigated through life and never became addicted to drugs, and so I was considered a non-addictive personality. And because I was a non-addictive personality … my doc thought it was O.K. … to addict me?

      No.

      Just because you navigate through life and never get involved with street drugs, does not mean you are a non-addictive personality. All this means is that you never played around with addictive drugs–possibly because you KNEW they were DANGEROUS?

      So what logic is there in a DOCTOR addicting a patient to benzos?

      Except that it makes them money?

      Stevie Nicks says benzodiazepines are the worst drug ever. I believe her.

      I say benzodiazepines are Choreographed Insanity – they can dumb you down and numb you down so much that you trust the doc completely. Well, I never did completely trust the doc.

      I have never, ever done cocaine, speed, heroin or dropped acid … or anything of that sort, because I did not want to risk my health and become an addict.

      So the doc gets me addicted by calling it an anxiolytic and anti-seizure drug and never once telling me I am on a tranquilizer?

      Everybody knows tranks are addictive. I would have absolutely refused a tranquilizer. I felt safe taking an anti-seizure and anxiolytic, though.

      A pile of dung by any other name, is still a pile of dung.

      An addictive drug by any other name, is still addictive.

      Funny thing though. A person who addicts themselves is at an advantage when the drug starts making them feel sick, because they simply blame the drug.

      When a patient is Iatrogenically Addicted, they don’t blame the drug – they blame themselves, because they just can’t believe their doc would ever put them on an addictive drug – for life … and this is why I call it Choreographed Insanity.

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      • No matter had bad it is – you’re lucky you at least remember your life. One of MIA’s bloggers was on benzos for years and he doesn’t remember anything from that time – the drugs turned him into a Henry Molaison patient with no ability to form long-term memories. I was so close to suffer the same fate had my family not pulled me out.
        Psychiatry’s own guidelines say you shouldn’t prescribe benzos for more than 2 weeks yet I am still to hear about a doctor who loses a malpractice suit over that.
        I am fed up with psychiatrists defending their own criminal practices and covering up for others and justifying it with “we know better what you need”.

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    • “kids walking around in the wintertime with no shoes on in freezing temperatures”
      I did that and I have not even got a cold from it. What I got from psychiatry who just “tried to help me” is trauma that is likely never to go away and anger and feeling of violation and … I could go on.
      To the author of the article: what makes you think that you have a right to decide what is best for me? What makes you think that I prefer your drugs and your terror than the blade I cut my skin with? Why are you so arrogant to think you know what’s best for me?
      If you want to help people – listen to them. Everything else is just abuse.

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  2. Sandy,

    Thank you for being honest and clear about what you do, including stating directly that you sometimes use your power as a psychiatrist to deprive people of their liberty, and also that you sometimes participate in state-sanctioned forced drugging. I consider these practices human rights violations, but I appreciate immensely that are you are upfront and direct about your actions. This transparency saves a lot of time and is a necessary condition for dialog. So thank you for that.

    I would be interested to know your thoughts on restraints and seclusion. When I was first hospitalized 15 years ago I was shocked to learn that restraints were still in use. I am much less naive now, but still amazed at the amount of oppression that occurs in mental “health.”

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      • I expect and predict your reply will be yet more of the same. Excuses and extreme anecdotes justifying the foolish and immoral decision to coerce. Maybe a dash of hollow rhetoric about ‘communicating better’ with the people whose bodies you ask the court to become the owner of.

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      • Sandy,

        No hurry! I am happy to read your contributions because of your forthrightness.

        I sometimes wonder what I would have been like had I been a psychiatrist instead of a patient. I imagine my views would have been almost identical to yours. Although I have taken a different path and reached different conclusions I can understand why you hold these views.

        Thank you again for not obfuscating or asking for sympathy. That really helps.

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  3. Hi I’m a psychiatrist I’m really into psychiatric reform guys but I’m sorry, I reserve the right to mess around not just with your life by force, but your body. I haven’t ever seen inside your biology because I’m a quack. Can’t prove shit about it’s function or alleged dysfunction but hey, hundreds of years of the law allowing me to push around mental patients says I can violate your body whenever I deem it necessary.

    But chill, don’t worry, don’t live in fear, although you’ll have absolutely no say in the matter and be dehumanized and objectified and turned into a subhuman who I can order my goons to shoot up with thorazine, although I’ll ignore your screams of terror and write them off as a symptom of a brain disease, don’t worry guys, just enjoy your recovery there guys, don’t mind me, standing ever ready in the background with a loaded needle ready to petition a court at any given moment and sleep easily at night. Don’t mind me guys, but remember, even if by my actions and I show I don’t believe you deserve human rights I expect a constructive dialogue on this site where we can agree to disagree about your right not to live in fear of coercion.

    And remember there’s always a news story of a homeless guy shoving someone onto the subway tracks I can use to convince the wider public of your inherent defectiveness, dangerousness, and otherness, because we slapped the same label on the subway criminal as we did you. I know you have never hurt anyone but hey, life wasn’t meant to be fair kid. Do you know how radical it sounds when one of the crazies demands the right to feel safe from psychiatry being forced on them? don’t you know that’s your lot in life, has always been so for hundreds of years, if you’re labeled crazy, just deal with it pal, you forfeited your equal rights the day you dared display any behavior listed in the DSM. Not living in fear of being hauled away is a luxury only we ‘normal’ people deserve.

    Hubris. Arrogance. Paternalism. Group violence. Dirty hands. Blood doesn’t wash off. Blood money. Dirty money. Money earned traumatizing people in torture chambers. Disagreements about definitions. I’m more powerful = my voice prevails. Society is scared of subway killers = sorry son, deal with it. Maybe human rights are something you’ll get in the next life. I’ve got a job to do. Shut up and take your psych drugs you filthy animal.

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  4. If only things were so simple anonymous. You should check out the blogs of “Suicidal no more” or Asley Smith on “Overcoming schizphrenia”: they are two of many more who are actually grateful to the people who hospitalised them and forcibly drugged them. They say: they saved their lives. Mind you if you look further into their story and how their problems started, you will quickly come to the conclusion,that their are not more “schizophrenic” than you or me. (They believe they are though) Their problems were due more to social circumstances and from finding themselves alone without emotional support , worrying too much, not sleeping etc. By the time they broke down though, they needed help and quick and the meds did the trick. I think that is what happens to a lot of young people. By the time the psychiatrist gets to see them, they are often so totally off the planet, that something needs to be done. I am not condoning coercion but sometimes no amount of reasoning will help. A bit of haloperidol will: I saw it happening in front of my own eyes.
    Where psychiatry goes wrong is when they start forcibly drugging people for months and years instead of trying to find out the root of the problem.

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    • Why does everyone else have to lose their rights or have their rights threatened just so these people can be grateful they were saved from themselves?

      Do you honestly think you telling me about these people is the first time I’ve given thought to who benefits from me losing my rights?

      Of course someone benefits, many people benefit from threatening the rights of everybody. The problem is it is not justified.

      You constantly speak, not from personal experience I might add, about the wonders of Haldol on this site. Maybe it’s time to try some yourself.

      You are like all apologists for forced drugging. ‘just a little bit’ of forced drugging you say. I don’t accept this.

      You don’t seem to mind that people live in fear of the terror of forced drugging and incarceration and this it hinders their recovery.

      Alix there are millions of people in this world who fail to manage their finances. If you passed a law forcing a financial planner into their lives and their bank accounts some of them would wind up ‘thanking you’. Are you prepared to give up control of your bank accounts just because someone elsewhere in the city blows their money on foolish things and can’t balance their checkbook? Are you prepared to suffer that intrusion?

      Alix I’m sympathetic to the drama and crises that your son had. I’m happy for you that a process of rapid tranquilization with forced drugging got him to shut up and stop doing or thinking what you didn’t want him to do or think. I’m not as ‘impressed’ with this process as you seem to be, as it can be seen in other guises on any big game hunt in Africa or any zoo where they tranquilize animals.

      I’m not convinced and nor are the majority of people who hear about nonviolent alternatives and psychosocial interventions that violently forcibly drugging your son was the only option the rest of humanity/you/society/the government had. In millions of instances of self defense people or groups or cops defending themselves don’t resort to invasive chemical restraint, which you seem to be advocating.

      So it is simple, Alix, you want the government to call on whenever you want your son forcibly drugged and locked up, even when he has committed no crime. In contrast, my rights are threatened by you have this easy ‘solution’ at your disposal.

      In other words, it doesn’t matter how many raving reviews of forced drugging from parents who had their sons committed like you, it doesn’t matter how many ‘suicidal no more’ BS websites and books you can list and how many people you say are ‘thankful’.

      You cannot justify coercion of a large group of people which comes at great to many of them to the benefit of a few. It’s an immoral involuntary and rough trade, where I am asked/forced to give up my freedom, because you believe freedom gets in the way of you having Haldol shoved into your son’s bloodstream.

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      • I never justified coercion on a lot of people. I only said that meds help in emergency for a few days. It certainly helped when my son ended in hospital. The psychiatrist took him off haloperidol two days later.

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    • If someone believes they are “schizophrenic” or whatever else they call their dependency on others, and that they have no agency to save themselves, but need others to do that job for them, something is horribly wrong.

      No one can save another person’s life. You can save another person’s biological existence, but to think you can save their life is simply arrogant, and all it creates is learned helplessness and eternal victimhood.

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      • “No one can save another person’s life. You can save another person’s biological existence, but to think you can save their life is simply arrogant, and all it creates is learned helplessness and eternal victimhood.”

        Now that… is beautiful. You are so right! Saving someone’s biological existence is a far cry from saving a LIFE being lived, that’s gonna be lived, claiming credit for how it is lived, etc.

        Your blog is also wonderful. Wish you updated more regularly.

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      • Exactly! I’m not alive after a very horrible attempt to kill myself because of anything that anyone, psychiatrists, friends, or otherwise said or did. I’m alive because I myself decided to turn loose of my destructive attitudes and to move on with my life. The medical nurses and doctors saved my body but only I saved my life.

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      • Marian, you are not judgmental usually. The tragedy is that often there is no help available when people start going off the rails. They end up in psychiatric care when they have lost it completely and then the psychiatrists are left to pick up the pieces.And yes, I agree, they often go about it in the wrong way mainly because of the severe mental illness theory. I am only trying to be practical and fair.

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        • “They end up in psychiatric care when they have lost it completely and then the psychiatrists are left to pick up the pieces.”
          …and that will keep happening if we have a system which allows to neglect people and when they break down just dump them into another system which is going to keep them drugged and locked up. Sometimes it has to get worse before it gets better – I wonder if there was no psychiatry people might just be forced to deal with the roots of the problem instead of sweeping it under the rug and out of sight.

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      • Wow Marian, I really disagree with you there. My life has been saved by others (generally through love). And I have also amost lost my life because no one helped me. People can certainly save each other from time to time.

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        • Why is the current fad to insist that absolutely no one can be helped by anyone else, that the individual is the only one who can help him or herself? That’s ridiculous. Our society has taken individualism to extremes.

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          • ssenTC, although it may look like it, I am not a neo-/liberalist. No one is an island. Human beings develop the ability to love themselves, and others, respect themselves, and others, and so on, through being loved and respected by others. But the thing is that the moment you try to force somebody to practice self-love and self-respect, and stop being self-destructive, you yourself are not showing them the unconditional love and respect they need to get from you in order to find the same unconditional love and respect for themselves inside themselves. If all I display toward another person is a “I will love/respect you if you do as I want you to do, and don’t count on me still loving/respecting you if you’re self-destructive, because, you know, *I* can’t handle your pain, so *I* will have to say ‘no’ to it, close my eyes to it, instead of accepting it, looking at it with my eyes wide open, trying my best to understand it”, then all I will get is someone who maybe is in-love with themselves (as in “narcissism” = neediness, being in need of having one’s existence continuously and to an ever increasing degree justified, saved by others), but who’ll never be able to say “yes” to themselves, unconditionally. What you get is someone for instance walking past the nurses’ office at the psych ward, where everybody is sitting drinking coffee, saying: “I’m leaving now, going to off myself!” Read: Come on! Come running after me, grab me, drag me back to the ward, restrain me, make an effort to save me! Because my self-worth is measured in the effort you are willing to make, and without you making an effort, I am worth nothing. That is just so sad.

            No one can have self-love, self-respect, self-worth for somebody else. Everybody needs to find it in themselves. All you can do as a bystander is acting from a place of self-love, self-respect, self-worth yourself, so that the other can see that this place actually does exist, and that it is possible to get there. Maybe some people call this “saving” another person. I don’t. To me it is helping them to save themselves.

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        • I think that when you save someone through love that’s empowering them, that’s something different than being a savior. People who fight wars are “saviors.” And the very things that they invest in needing the materials to be a savior is what causes the problem for others, who then need to be “saved” by them.

          And the topic here Marian brought up was “schizophrenia” where the mental health system says it’s saving a whole population from something that doesn’t exist. They act like they are saving another person’s “emotional” life here, as if that can be saved by dousing it.

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          • Yes Nijinksy, that’s how I experienced it. Being loved felt being empowered, and that’s what saved me. I was dying/going crazy for lack of love, and if there was one thing I knew it was that the power WAS NOT in me to save myself. I had done everything I could, and it wasn’t enough. I needed someone on the outside to believe in me, support me, and be there for me, and thank god that happened. My salvation was found and is still being found through relationships. So I question the relentless emphasis on the SELF that seems to be in fashion these days — I know that for me, being made to feel ALONE is the worst thing, and that’s what all this SELF rhetoric conjures, at least for me. Maybe because being alone and independent has never been foreign to me – I’ve known it’s a must to some degree – what I have lacked is that healthy DEPENDENCE otherwise known as love – we all are dependent on each other in some ways, or should be. Interdependence is a key trait of our species — our society, at least in the U.S. and I think in parts of Europe — seems intent on denying that. The key is finding the healthy balance. Maybe I’m just coming from a different place, having always felt self-responsibility (probably more so than most). I guess that’s why all this SELF rhetoric is so depressing, individualistic, robotic, cold, & unhelpful to me. I think love is a primary and extremely powerful force in our world and I think that so many people could be helped if our society would just take a warmer and more loving approach to dealing with distress (and to life in general).

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    • ‘If only things were simple’. I know a lot of scoundrels and rotters who take solace in comments like that. It functions for many as a thought and dissent terminating cliche.

      Haloperidol works? Well it certainly worked for dissidents in communist Russia! Not only is that drug pathogenic by design, but it should be classified as a pharmacological torture mechanism. I was on that drug for half a week, and it is only second to stelazine-induced neuroleptic malignant syndrome in terms of the most torturous, terrifying experiences in all my years on this insignificant piece of excrement floating around in the toilet bowl of creation.

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    • We are supposed to look at facts and not psychiatry’s self righteous bullshit so – where are the studies which show that coercive treatment prevents suicide or violence? Because I failed to find any. The fact that someone got better despite of coercion and drugging is as much proof for the validity of these approaches as the fact that I may have cured my tonsil inflammation while drinking coke is proof that coke is an antibiotic.
      It’s not the same as leaving people behind and alone to deal with their problems – nobody’s advocating that. But what kind of healing can occur when the person you’re trying to help hates you? It’s like going to a rapist to get treatment from childhood trauma.

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  5. “Where psychiatry goes wrong is when they start forcibly drugging people for months and years instead of trying to find out the root of the problem.”

    No, once the person has been injected with “a bit of haloperidol” there’s no going back.

    Maybe you’ve never taken haloperidol, but it is a torture drug, with absolutely no reason to be used on anyone.

    It makes the person quiet down on the outside, but inside it is a prison. You saw it happening in front of your own eyes, not from inside looking out.

    How dare you.

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    • My dear son is terrified of this drug. He has said, “Just put a bullet in my brain, mother. It would be a kindness.” He has run to the streets to not be forced to take this drug and other first generation psyche drugs.

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      • A short story.

        The Helper.

        There once was a person who wanted to help.

        He wanted to help the poor, the downtrodden masses, the drunkards, the gamblers, the junkies, the lost, the people at the end of their tether.

        He wanted to help the spiteful, the wasteful, the overindulgent, the shiftless, the restless, the spineless, the helpless.

        He wanted to help. But the people didn’t want his help. So he passed a law saying they had to accept his help, and decided that their will didn’t matter.

        For he knew best.

        He knew they’d thank him later. And those that didn’t thank him, where just misguided ungrateful fools, complainers, malcontents.

        So he wrapped the world in protective foam. Nobody had rights any more. Anyone seen with a cigarette or some liquor was endangering their own health. Anyone who went skydiving was reckless, and needed help. Anyone who bought a house they couldn’t afford, would be helped. Anyone who wasn’t chipper and polite on the street would now be helped. Anyone who didn’t agree that this was helpful would be forced to listen to the stories of the thankful people who are glad the helpers took away their rights and treated them like children and can’t understand why anyone would be against such benevolent help.

        Knock at the door. We’re from the government and we’re here to help.

        Rights don’t matter. Liberty doesn’t matter, other people you’ve never met don’t matter, just your ability to get your son into that chemical straight jacket ASAP.

        I wrapped the world in chains and fear, and I point to the poster boys who love the outcome that this had for them in their particular lives. I point to these success stories with glee, for if I admitted the travesty and atrocity of the truth, the lives I had to destroy in order to mold the lives I claim to have saved, I would crumble as they did.

        Give psychiatry a blank check to rip anybody off the street, put them away and play with their brains and lives. Bury the bodies of those killed in the process, ignore and ostracize the crippled and maimed survivors who try and alert society to your harm, and point to the poster boys.

        They always point to the poster boys. Look, they say, my son was going to do something stupid. Haldol saved his life, they say.

        How many had to die in this involuntary human experimentation for the poster boy to be created?

        Would I feel good if my continued life had to come at the cost of some poor soul roped into a meat grinder of a system?

        Give any zealous ‘helper’ the legal right to ‘help everyone’ and stand back and watch the mangled mess they make of millions of lives. Sure there will always be the ‘thankful’ and always be the destroyed.

        If intervention inevitably destroys a lot of lives and helps a lot of lives, how do you look the destroyed person in the eyes? Is it better to let the shoeless live with his choice to walk outside in the icy road without shoes live with the results of his choice, however misguided, than to have the arrogance to set up snares all over the road upon which we all walk?

        And can the trappers hold their heads high? Can they rightly justify ensnaring all those people and treating formerly free adult human beings lives’ as though they are play-doh. And are we supposed to be impressed when they hold up one of the more appealing play-doh figures they’ve molded and point to it?

        If coercion in psychiatry screwed up your life, the message is, shut up, we believe it is justified, we plan to continue doing it unabated, and all we care to point to are the pretty play doh figures we molded out of human lives, not the ones we pounded into oblivion.

        A hidden human rights atrocity epidemic belies every smiling poster child for coercion.

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    • Many people don’t know that haldol and thorazine were derived from chemicals that were used to dye synthetic materials and to kill insects. Now, I’ve always been amazed that anyone ever thought it was okay to put this stuff inside of human beings! But of course, we are only “mental patients,” and it makes us shut up and sit quietly in the corner, so it’s perfectly okay to zap us with it! Who cares if the stuff drives us insane inside, we are only “mental patients” after all.

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  6. ad¡mit
       [ad-mit] Show IPA verb, ad·mit·ted, ad·mit·ting.
    verb (used with object)
    1.
    to allow to enter; grant or afford entrance to: to admit a student to college.
    2.
    to give right or means of entrance to: This ticket admits two people.

    I guess Mandela was ‘admitted’ to Robin Island then, since we have permission to label somebody incarceration an ‘admission’.

    hos¡pi¡tal
       [hos-pi-tl] Show IPA
    noun
    1.
    an institution in which sick or injured persons are given medical or surgical treatment.
    2.
    a similar establishment for the care of animals.

    I guess mental hospitals fit into number 2 because they don’t fit number 1.

    From dictionary.com

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  7. As a mother who lost her precious son as a direct result of SSRI’s I am releived to see that there are still a few honest physicians who really want to help people, not ALL are the pill pushing “psychiatrists” who bow to BIG PHARMA, subscribe to the absolutely ridiculous DSM and have little regard for the outcome of pushing poison and destroying lives.

    Thank you Dr. Steingard for having integrity and for sincerely wanting to help people. “First do no harm….”

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  8. This article is a great argument for a Soteria House or Open Dialog kind of program for people who fit the description of Sandy’s involuntary “patients.” While I don’t think involuntary detention, especially to the current kind of institution where restraints and drugs are the main “treatments,” is in any way helpful, I empathize with her statement that there are people who will probably hurt themselves without some kind of assistance. I’d love to see some models in states or countries where they don’t have involuntary commitment laws (I believe such do exist) and start building on what works.

    Maybe involuntary commitment wouldn’t be “necessary” if we had places to go to that people felt actually helped them!

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    • I agree. I am planning to study Open Dialogue next year and we are in the midst of developing a program that could utilize that approach. There are also plans in the works to develop a Soteria House in Vermont. In my experience there will still be people who oppose even these options.

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      • And why shouldn’t there people who oppose things being done to them against their will?

        A person’s will MATTERS. You take the irreversible step to force yourself on someone rather than persuade them of the products you’re selling/services you’re providing you better be prepared to be reviled for the line you’ve crossed.

        You can’t undo assaulting somebody’s brain. Once you violate the deepest most sacred part of a living human being, the place they consider should be the most inviolable of all, their mind, once you mess around using brute force altering someone’s brain, you become one of the most egregious human rights abusers. A rapist of brains. All in the cause of your self justificatory high mindedness, you’ve steamrolled someone’s most basic human sanctity. There is no way you can undo such an assault. The least you can do is not reserve the right to repeat the assault and not have the victim live in constant fear of you assaulting them again, should you and them cross paths ever again.

        There are people in this world who believe their beliefs about ‘helping’ are more important than freedom, and believe they are justified in destroying somebody in the name of help. Like many who do violence to others, they push to the side the pain and devastation unleashed in their victim’s life.

        Try living with the violation of having your mind assaulted by your government. Try living in a world that doesn’t respect your basic dignity as an equal human being.

        What part of no don’t you people understand?

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    • “people who will probably hurt themselves without some kind of assistance”
      Yes, and these people usually both a) know they need help b) will scream and fight you when you send the cops for them and drag them to the ambulance.
      It should be voluntary.
      I would have really benefited from having a safe place to go and just take time off my life and deal with my problems but there was no such place for me to go. Hospital was not such a place, I knew about it and resisted it and was taken there anyway and guess what? I hasn’t helped. I was traumatised and abused. Everything what caused my problems in the first place is solved and gone but the trauma that the involuntary “treatment” (read: torture) inficed on me is still there.

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  9. Thanks for as always bringing the big picture, acknowledging the system is flawed, but exists for a reason. And that sometimes uncomfortable decisions have to be made, because not making them would be even worse.

    I was wondering if you have a take on the questions related to antipsychotics long-term effects, it seems everybody agrees they are overused. But do you believe they actually hurt significantly people in the long-term by actively modifying the brain for the worse (even when used in monotherapy at normal dosage)? Or do you believe the bad on-drugs results reported by R. Whitaker are only “correlated”, but not “caused” by the drug itself (among many possible correlations, in the same way drugs sometimes work with a powerful placebo effect, one can imagine that a combination of drug/diagnosis/prognosis might have a powerful nocebo effect).

    In the same way that “pro-drug” thinking has hurt people, do you think it’s important to be honest that some excessive drug-bashing scaremongering might actually also have the unintended consequence of hurting people (for instance those that have taken drugs in the past) with a nocebo-like effect. You see sometimes people complaining that their life has been ruined by drugs given to them during a hospital stay. Would it be reasonable to say that “ruminating constantly about your life being ruined by a short-term treatment is a more powerful way to destroy your brain than taking some drugs”, and that ruminating could be encouraged by unbalanced drug-scaremongering.

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    • You say

      “Would it be reasonable to say that “ruminating constantly about your life being ruined by a short-term treatment is a more powerful way to destroy your brain than taking some drugs”,”

      No it wouldn’t be reasonable to say that. Any more than it would be reasonable to tell a rape victim to ‘get over it’.

      You think victims of violence should just stop ‘ruminating’ do you?

      I think what you’ve said is deeply offensive to all violence victims. Victims of psychiatric violence or any violence.

      You win a prize. You’ve officially written, Steve Holmes, the most offensive victim blaming comment I’ve ever seen on this site. Congratulations.

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      • I disagree that equating victims of rape with law-sanctioned hospitalization is appropriate.

        I apologize for an awkward formulation, I did not meant that somebody that looks traumatized should be told to ‘get over it’, that’s the opposite of what I would recommend.

        Let me reformulate: how the person and environment react to trauma is quite important to enable recovery. And of course we have to let people take whatever time they need to recover, we have to recognize their status of victims whenever appropriate. That said, it is important to have a culture where people can believe that total recovery from drugs is possible.

        Occasionally you see some claims hinting that antipsychotics are causing permanent irreversible damage to the brain. And I question that claim. I am also saying that making this claim is dangerous, because people believing it will tend to think of themselves as forever damaged goods. The damage from that belief will be worse and more permanent than the possible temporary damage from the drugs.

        In summary, my question was whether it is true that “words can sometimes cause more damage than drugs”. Hope I was more clear this time.

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        • I don’t think people with damage such as permanent, irreversible TD caused by antipsychotics (which is common after long term use) are merely suffering from the belief that they have it. That is incredibly offensive.

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        • Stanley, I have read that Nancy Andreasen’s extensive MRI brain imaging studies have shown that antipsychotics cause atrophy (i.e. tissue loss) of the pre-frontal cortex – as much as 1 percent per year. The loss is not reversible. So I think it is fair to say that the drugs are dangerous and damaging.

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        • “I disagree that equating victims of rape with law-sanctioned hospitalization is appropriate.”
          Wow. It’s totally the same. It’s both physical and psychological violation. In many ways it can be even worse than rape since a rapist cannot affect how your brain works the way the drugging does. Have you ever been a victim of it or you’re just telling us victims what we are supposed to feel or not feel?
          Involuntary “treatment” is torture, it’s a crime and it’s rape.
          How can a victim of rape recover when they see their victimiser walking around as an authority figure and doing the same to other people? Justice is for most people a prerequisite for recovery and none of us has ever been given justice.
          “Occasionally you see some claims hinting that antipsychotics are causing permanent irreversible damage to the brain. And I question that claim.”
          http://en.wikipedia.org/wiki/Tardive_dyskinesia
          How’s that for “permanent irreversible damage to the brain”? And I bet you people who are affected don’t need to be explained that.

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    • Quoting Stanley Holmes, “Would it be reasonable to say that “ruminating constantly about your life being ruined by a short-term treatment is a more powerful way to destroy your brain than taking some drugs”, and that ruminating could be encouraged by unbalanced drug-scaremongering.”

      It would be reasonable to say that ruminating constantly about (anything) actually is a powerful self-harm. Remember: abuse hurts worse when it stops. See the motivation then, to continue ruminating? It’s unconscious, but those of us who have experienced the end of (perpetual cycle goes here) know what it is and for us … it isn’t unconscious anymore.

      Drug scaremongering is just as righteous as any other scaremongering. One must hear the call and respond, if they seek to solve the scaremongering. It wouldn’t be a gigantic, gnarling shadow if it received due attention to begin with.

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      • Yeah, because we all just choose to ruminate. Because there is nothing like a trigger for traumatic memories. Because PTSD is something that you get from rape and physical assault, EXCEPT when it’s done by a psychiatrist – then it miraculously turns into a beneficial healing procedure.
        It reminds me of talking with my family – they constantly tell me I should just “stop thinking about it and move on”. Because that’s just how it works, right? You just forget about your trauma and it magically disappears and you’re OK. I’ve never heard anything more ignorant.

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  10. Thank you for this excellent post, Sandra.

    You’ve opened a conversation that must take place.

    I’ve corresponded with Don Farber, the California attorney for the Paxil withdrawal class action lawsuit. It had 40,000 plaintiffs and was settled more than 12 years ago with the addition of the tapering warning on the Paxil package insert, followed by similar warnings on all psychiatric drugs.

    He told me that for many years he could not justify psychiatric drugs for anyone, but eventually came to see they may be crucial for a very small number of situations.

    Last winter, I was talking to a lovely young woman, very sensitive and empathetic, who was a nurse working in a city medical clinic for the homeless. We talked about the harms of antipsychotics, and how they were overused. With a pained expression, she said, “But what if it’s the middle of the night and someone is walking naked in the middle of the highway, screaming and cutting themselves?”

    Like many mental health providers, she’s faced with decisions like this frequently. If only there were respite alternatives at hand, but they’re not.

    Even Robert Whitaker allows that short-term use of drugs to ameliorate acute episodes may be helpful.

    To me, the key is being able to trust providers to recognize these very extreme cases and not to use interventions inappropriately on others.

    Sadly, because psychiatric treatment has been applied so badly to so many people, that trust has been broken and has to somehow be rebuilt.

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    • “With a pained expression, she said, “But what if it’s the middle of the night and someone is walking naked in the middle of the highway, screaming and cutting themselves?””

      You get the police to arrest and jail the person for public indecency.

      Or at least that’s what I’d prefer you do.

      The alternative is to forcibly drug him and harm and destroy other people’s lives who will be sucked into the system devoid of pesky due process that would get in the way of your forcibly drugging Mr. Naked Highway man.

      You don’t get it. You simply don’t. You don’t comprehend how forced drugging is not just going to just for Mr. Naked Highway man. It’s going to suck in a destroy many others.

      It’s nice to point out too, that Mr. Naked Highway man doesn’t want to be forcibly drugged. This is self evident by the fact that force needs to be used to get the drugs into his body and the fact he screams and says no.

      Slavery = abolished with no exceptions

      Rape = universally condemned with no exceptions

      Forced drugging = always a human rights abuse.

      People on this site who are apologists for forced drugging yet still claim to be these humane progressive people are like acquaintances of gays 50 years ago who were willing to concede gays were nice people, but they still supported anti sodomy laws.

      If you support there being a law against me owning my own body, you implicitly hate the idea of me owning my own body.

      Always with the extremely rare and dramatic highway naked stories though, just like any good propagandist trying to excuse a gravely horrific set of discriminatory laws.

      What have I said today on this site? It is INVARIABLY these ridiculous extreme anecdotes that supporters of forced drugging use to justify terrifying ALL of us with these laws.

      These laws DETER people from even setting foot in a ‘mental health professional’s’ office. They generate fear and distrust. They generate destroyed lives and traumatized people.

      You are advocating violence against that naked man on the highway. You’re advocating for more of his rights to be taken away than would be taken away if were charged with public lewdness.

      You are. It’s indefensible and counterproductive.

      A society that doesn’t even make eye contact with the homeless and passes them by, is not kidding anybody but themselves when it says forced drugging is humane. It’s not humane. It’s violence against the homeless.

      The defenders of forced drugging couldn’t care less if the homeless guy drinks or smokes himself to death over 30 years but if he dares try and take himself out in one night well that’s enough to sway you that there needs to be a law to have him tranquilized like an animal and you’re prepared to pay the cost in deterring other people who are horrified and terrified by these laws who don’t seek help because they are scared of being coerced.

      You’ve made the trade off. The people you see as acceptable targets for forced drugging will just have to deal with it.

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        • Wrong. You don’t get to declare a person who is aiming to use force against somebody a ‘caregiver’. It is not ‘caring’ to forcibly drug somebody.

          You don’t get it. And these people don’t ‘have’ to make these decisions. They chose to make those decisions.

          They chose to steal away somebody else’s right to make decisions.

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          • anonymous, exactly. The “dilemma” is an artificial construct brought about by the illusion (delusion) that psychiatry actually would be of help to anyone, and the need of “caregivers” to justify their human rights violations and receive absolution. There is no dilemma. There are only human rights violations.

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          • The dilemma exists only because the psychiatrist willingly accepts the situation and takes part in its actions. As long as she and others who claim to care are willing to inflict harm and presume to have the right to force their will on others, then they are part of the problem.

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      • ““With a pained expression, she said, “But what if it’s the middle of the night and someone is walking naked in the middle of the highway, screaming and cutting themselves?”” Try caring about them.

        Really, plenty of people will not want to read this. But it’s a true story – a real event – and it is what it is.

        Long, long story short – after midnight – I arrived at the emergency department. She was an intoxicated patient, under security custody. She was unruly and loud, but not hostile. She was restless – leaving the room, pacing the hall, returning back to her room. It was communicated to her that restraints were going to be used. That’s when I got involved.

        I spoke with her. It must’ve been something I said, and the way I said it – because she sat down quietly and calmly and she listened and interacted. When she spoke back, she was present, clear and in self-possession. It must’ve been something I SAID.

        So, how do you deal with or handle a person in crisis? CARE (what?) CARE about that person. An ARMY could not have dragged me away from that woman in that hospital that night. Do you understand?

        The “story” is actually quite detailed and very long but in short, you can call it a miracle if you wanna.

        EWW! A NAKED PERSON?? omg, what do I do? You don’t look, just like I did not see a “crazy drunk” woman that night. Do you understand?

        CARE * I S * THE TREATMENT.

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    • The issue is perfectly obvious — you folks have repeated it many, many times, as if it needed such repetition.

      What about these extreme situations? They do exist.

      Expressing outrage about the horrible state of treatment does not solve the problem.

      Should you leave the naked, screaming, bleeding person out on the highway? Would you volunteer your own home as a respite center?

      I don’t know much about the kind of treatment distressed people find in jail, if you truly believe that’s the alternative. I suspect it’s not tender loving care, and there’s quite a bit of coercion in it. Perhaps Sandra or Michael Cornwall will give more detail about that.

      I personally don’t have any answers. I wish everyone could be hugged by Michael Cornwall for a couple of weeks. It would do anyone good.

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        • Well we know that Sandy Steingard, the point is what qualifies you to force yourself on the law breaker who is doing an act of public nudity? You’re not a cop.

          I maintain that it is obvious that in jail you only lose your right not to be locked in a building. In psychiatry you get locked in the building and THEN SOME. It’s the ‘then some’ you should scared of.

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        • Correct. But I’d argue that everything that happens to people at a psych “hospital”, and which is beyond losing their physical freedom, is even less conductive to their recovery. Nothing is more damaging to traumatised people than being silenced — once again. The more thorough the silencing, the more intrusive the means used, the greater the damage will be. And you’ll know that you succeeded in taking the person’s voice away for good, when they come to you and thank you for having saved their life. “The Master doesn’t talk, he acts. When his work is done, the people say, ‘Amazing: we did it, all by ourselves!’ ” -Tao Te Ching. I will respect psychiatrists as true healers the day they reject the authority given to them by society, and stop intervening.

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          • There is something interesting going on in one of the units of the state hospital where I work. One of the staff is teaching patients how to speak up for themselves in treatment plan meetings. She teaches them about the meanings of the words the quacks, alias doctors, use and she teaches them how to go about asking effective questions. The expectation in our hospital is that you will go into your meeting and sit quietly while the team discusses you, you really aren’t supposed to speak up since your presence there is just a formality anyway to satisfy the law. The quacks couldn’t believe what is happening and have traced this new development down to the staff person doing the teaching. I fear that her job is on the line, simply for empowering people to stand up and speak for themselves. This is your right, but behind the locked doors your rights go right out the window and you’re expected to conform to whatever the quacks desire. So much for the wonderful forced treatment and human rights and all that other nice, pie in the sky stuff. People are being harmed right and left, forced to take dangerous, toxic drugs, and if you try to stop it, you will pay the price in more ways than one. Forced treatment and forced drugging, which are one and the same, are an abomination and the quacks who are doing it know it and yet they keep right on doing it because it’s within their power to do so!

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        • What’s interesting is that an asylum is listed as a place for recovery, although this actually is the opposite statistically, in comparison to places where recovery actually does occur. And calling it a place for recovery, regardless of outcome, allows people to separate cause and effect and suppress their conscience from emerging.

          Comparing jails to asylums is like comparing concentration camps to slavery.

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      • I agree. Being hugged by Michael Cornwall would do all of us a world of good, including our artificial constructs. I sense that Dr. Steingard reaches out to her clients with compassion and courage too. This discussion about human rights is of utmost importance, but it is painful to witness the verbal abuse that sometimes occurs on this website in its defense. Healing happens on a higher plane…

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      • “Would you volunteer your own home as a respite center?”

        To the extent it was possible I’ve done that. I do invite people in distress into my home, I do give out my private phone number. Why wouldn’t I? The fact that the mere thought of a “patient” getting to know their private phone number, not to mention their address, makes most “professionals” gasp speaks volumes. But hey, it’s called “professionalism”, isn’t it? Sorry, but, bullshit. Being scared to death of emotions isn’t being professional. It’s actually quite unprofessional of someone who wants to be a professional in the field of helping people in emotional crises.

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        • Exactly! I think that they’re scared of their patients and of everything that they represent so instead of dealing with their own stuff that is stirred up in dealing with the patients, they drug them into oblivion and call it good medical treatment. I think that many psychiatrists have issues that they don’t want to deal with and they take this unwillingness to know themselves and their motives better by taking it out on the people in their control. It’s pretty disgusting to me.

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          • Too bad we can’t “force” psychiatrists to deal with their personal issues or examine their motives for the way they treat people on the other side of the desk– you know the desk that separates the professional from the patient. The Safety Barrier.

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    • In the late 90’s when the drug companies were so aggressively couritng physicians, I wondered how a doctor could go to a drug dinner one night and then go into court to testify about forced treatment the next day. I knew that this would eventually undermine whatever credibility psychiatry had and this day has arrived. However, I do believe there is a role for medications but sorting through the available data is extremely challenging and I try not to supply answers when I do not have them.

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      • If you seriously think late 90s dinners paid for by drug companies is what is place is time that begins the problem that undermines the credibility of forced drugging, you’re neglected to consider psychiatry’s centuries long human rights abuses record.

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    • “With a pained expression, she said, “But what if it’s the middle of the night and someone is walking naked in the middle of the highway, screaming and cutting themselves?”
      Ask her politely if she want something to ease her pain? And if she refuses tell her that she can’t be hear because it’s disturbing for others and let her go?
      Victimising people because you don’t know how to help them… yeah.
      Psychiatry should for once admit that there are problems they won’t be able to solve and they can’t prevent every suicide and every act of violence. It’s like the NSA collecting data on the whole world because there are like 5 terrorists there.
      If you put everyone in jail there will be no one to commit crimes, right? The way to achieve world peace is to kill all the people first – that’s the philosophy by which current psychiatry works.

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  11. THANK YOU Dr. Steingard for being so honest and straightforward. Psychiatrists who manipulate, obfuscate and flat out lie seem to be the status quo, and it’s wonderful that you don’t. I have great respect for your honesty and hard work to help people.

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    • “Of all tyrannies, a tyranny sincerely exercised for the good of its victim may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience.” – C. S. Lewis

      Stop!

      Duane

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      • Sandra,

        This topic came up on a post by Robert Whitaker –

        http://www.madinamerica.com/2012/05/e-fuller-torreys-review-of-anatomy-of-an-epidemic-what-does-it-reveal-about-the-rationale-for-forced-treatment/

        I’d be lying if I said I was not disappointed to hear that you use force in your treatment. Those views are strongly expressed in the comment section on Bob’s post.

        What about those extreme cases?
        I think that those decisions need to take place in REAL courts; and that juries should hear the cases; and that attorneys representing the best legal interests of their clients should provide the counsel and advocacy, where alternative treatments could be found, by the local people in the community… Something as simple as a Salvation Army shelter with a doctor/nurse assigned to the case, with court orders that take into account the best interests of the person involved, not the subjective call by a psychiatrist (as one of many examples).

        Duane

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        • I understand your disappointment and I respect your point of view. As noted, I wanted to be honest. The laws vary from state to state and I encourage a vigorous advocacy from all. There are models that allow for a best interest model but there is always a values component and I can not think of any solution that will be satisfactory to all.

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          • Sandra,

            It took a lot of courage for you to come forward and admit to using forced treatment. I apprecite your honesty.

            And, believe it or not, I can appreciate your predicament, of wanting to help, but having a choice between seeing someone end up in jail or in a psychiatric hospital.

            All I’m trying to say is that it does NOT need to be a choice between two evils. Because neither jail nor being locked up is a choice that helps a person heal.

            If and WHEN we begin to give folks who end up in these “extreme states” or “spiritual crises” or “emotional distress” the opportunity to be heard in court – with counsel, with alternatives, with due process – we can THEN begin to see referrals to places that can help.

            And we can do that by INSISTING that they receive adequate representation, with juries of peers to hear all the facts, including history, trauma, adverse effects of past “treatments”… All of it! And we do NOT need to have Soterias in each of the fifty states to BEGIN to think outside the psychiatric box… We can start TODAY, with what we have.

            A referal to a Salvation Army shelter – with “three hots and a cot”… a court order NOT to prescribe meds, or to prescribe in the “smallest amount” for the “least amount of time” if a person begins to threaten someone (iminent threat, ,not “percieved” threat)… A doctor and nurse assigned to visit/monitor – full physical, regular vital signs, the basics… UNTIl a trial, at which time, their attorney can be adequately prepared to recommend some options – in the person’s best interest, not the mental health system’s… NOW we’ve opened up a HOST of options – with case law, as it develops, and NEW non-drug treatment facilities in each of the states.. saving taxpayer money and helping people heal.

            These items are addressed in this proposal for federal legilation –

            http://discoverandrecover.wordpress.com/mental-health-freedom-and-recovery-act/

            We can all work together on this, starting TODAY.

            In the meantime, psychiatrist, such as yourself can begin to INSIST to mental health courts, that a person in trauma be given adequate legal counsel and the “least restrictive” and “most therapeutic” environment pending trial, starting TODAY.

            Otherwise, we will all be having this same conversation ten years from now… In which case, you can count me OUT.

            Life is too short.

            Duane

            P.S.: Altostrata, thank you for holding back a few moments.. now, hammer away. But if it’s more of the same, about how integrative medicine is “snake oil” and how “we’re just stuck.. simply stuck”.. I’ll be the one who sits on my hands for a while.

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          • Everyone keeps saying how courageous you are for stating your beliefs and opinions and ownng up to your inhumane actions.

            You are a coward of the worst sort, and you seem so aloof and remote from the humans you are tormenting.

            A courageous person in a position of power such as yourself would at least try to see the world from the barefoot girl on an icy night’s perspective.

            Just ask “WHY?”. You might be surprised at the answers and not even consider forcing your idea of “help” on the person. But it seems you don’t consider them a “person”.

            I have the impression that you are ruining people’s lives by remote control, too. That you aren’t even present, but get a phone call at midnight and tell them, “shoot her up with Haldol and call me in the morning.”. Oh, you’re compassionate, all right.

            You don’t respond to any of the comments that confront you, only the ones that gush about how brave and honest you are.

            I don’t usually wish anything bad on anyone, and I don’t even on you. But I almost think if it took someone giving you a shot of Haldol for you to see how it feels it might be the answer.

            Why is the person behaving that way? Why is someone so out of control and how did it happen? And what on earth gives you the right to punish the person who down deep wants love and attention, which we all do, but just doesn’t know how to go about getting it?

            Because you don’t see them as human on the same level as you.

            This has nothing to do with “laws” and danger to self or others. It is nothing but a power trip for a sorry, scared psychiatrist who orders others to do her dirty work.

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        • Hi Duane,

          Courts, juries and assigned case workers? So in other words, absolutely nothing will change. Not really.

          Important to remember: these are paid jobs for people. Honestly, it’s an employment system, more than it is a “care and treatment” system.

          “Just doing my job. Just doing my job. Just doing my job. Just doing my job” ~ case workers, social workers, lawyers, attorneys, guardian ad litem, patient advocate, psychiatrists, nurses, receptionists … you get the idea.

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  13. Dear Dr. Steingard,

    You seem to be well intentioned in your attempts to listen to your patients’ concerns, so perhaps you can explain something that has been puzzling me for quite some time now: Why is treatment for a mental health condition such a horrible experience? I have never met a patient who speaks positively of their experience in a mental hospital (and have never encountered a resident or nurse who spoke positively of their rotation in a psych ward either!) Patients seem more traumatized by their hospital experiences than by their psychotic experiences (and if theirs are anything like mind – they are quite traumatic!)
    I went through extraordinary measures to be able to access treatment: After a couple years of very intense psychotic episodes, I gave up a career I loved and took a new job with health benefits that would allow me to utilize the hospitals and/or seek outpatient treatment. Yet after having read a few books including Whitaker’s, and talking to long term “consumers” in my city’s NAMI group, I believe I am better off today because I was not treated for my condition. At the same time, I know I am lucky to still be alive and that I did not seriously injure myself, and I do worry some days because I know I will have to face that challenge again. Yet I believe I have a higher chance of getting better on my own dealing with the voices directly, than by adding additional stress and trauma to my life by dealing with the system.
    Is there any other field of medicine where a patient would say this? What is going on with psychiatry? And what has to happen to make treatment more effective, or at least less distressing to the patient than the disorder from which they suffer?

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    • Your story is a case in point of the deterrent effect on getting ‘help’. You’re afraid and rightly so, that you’ll be coerced.

      To the supporters of forced drugging, their naked man on the highway avoiding some time in jail is worth the cost of YOU avoiding treatment. Is worth the cost to them, of the chilling effect on your speech and honesty about your states of mind if you ever talk to a psychiatrist.

      Most supporter of forced drugging ‘only want to help’. Ask them if they would feel safe living in a society where they were in constant legal jeopardy of being ‘helped’ themselves and they sing a different tune.

      People seem to think a system of laws enshrining forced drugging comes at no human cost. They seem to think all it costs is some taxpayer dollars.

      A system where due process is viewed as a barrier to the goal the government has, will always have a human cost.

      I’ve done a lot of highway driving, I’ve never seen a naked man on the highway. I find it deeply offensive that this world is full of ‘helping’ zealots who think the naked man on the highway should be forcibly drugged, and that his due process rights are a nuisance, and therefore my due process rights shall be stripped from me also.

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    • Although I do not doubt what you are saying, I would have to say that the term “never” may be a bit extreme. I truly believe that we need to think carefully about what we do and create trauma informed programs. I agree that hospitalization can re-traumatize people. At the same time, when our state hospital was decertified and subsequently closed after a flood, I knew of a number of former patients who were sad that it was closed because they had found it to be a safe place for them at times. I had others who found it to be a horror.
      Also, I work in an ER and there are people with a variety of ailments who seek hospitalization but are not admitted because – in all fields of medicine – we try to seek non-hospital care because hospitals are so expensive.

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      • “I knew of a number of former patients who were sad that it was closed because they had found it to be a safe place for them at times. ”
        Well, I guess they were not involuntary patients…
        A place like hospital is needed since many people need a safe haven in times of crisis. Psychiatric hospitals for most part are not that.

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    • Dear Alexa,
      May I suggest a book that helps understand “voices” for you.
      Agnes’s Jacket: A Psychologist’s Search for the Meaning of Madness by Gail A. Hornstein

      This doctor explores hearing voices in a way that really helped me, and is a completely different approach to “helping” than using drugs or force. She simply asks what the voices say and it starts from there.

      Sorry for interrupting the thread.
      M.

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  14. So much anger, legitimate but unnerving anger. So many people trying to tell others what they should or shouldn’t think, by proxy telling me what I should or shouldn’t think. Is it more psychiatry telling me that my thoughts are wrong? Or is it more people opposed to psychiatry telling me that my thoughts are wrong, are offensive? I’m not allowed to say out loud what I wish for. I’m not allowed to want what I want, which is probably alright because what I want, what I think hypothetically could help most in healing (and a few others have understood/agreed), doesn’t really exist anyway. But I’m not going to talk about my hypothetical healing here in the comments sections of MIA, because my wants are apparently offensive and shameful. Thomas Jefferson said the price of liberty is eternal vigilance. I can usually maintain my liberty, but I can’t escape my own incessant hypervigilance.

    And this comment isn’t about me, but about the notion of “safe exchange” of ideas. There’s probably no way for everyone to feel safe exchanging ideas.

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    • It’s true, philroy. Ironically, commenting on madinamerica is unusually risky, even by general Internet standards.

      So often, no matter what you say, some faction is going to come after you in the most passionately vicious way.

      Perhaps after a while, this community will mature, and see that attacking each other is going to get us nowhere.

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      • Philroy,

        I’ve read many of your comments, and always appreciate your input.

        Altostra,

        For whatever it’s worth, I find your comments to be quite dismissive, quite often. They often remind me of Nurse Ratched, trying to make the the boys are kept nice and quiet.

        Duane

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        • Please keep the Nurse Ratched comments out of this. I know you are not calling Altostrata Nurse Ratched here, but it feels uncomfortably close. Nurse Ratched has come up before here, and it turned out badly, so I’m asking you please to refrain.

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      • Bob has set as a priority that people feel free to express themselves. He does not want posts removed unless it involves a direct, personal attack. If we want people to show up for real here, talking about a subject about which they are rightly passionate, it is inevitable that people will get heated. Unfortunately that can also have the effect of silencing others, so it’s a tough balance to strike. So far, we have deleted very few comments, white-knuckled it through some others, and we have lost a few readers who did not appreciate the tone. It’s a hard balance to strike. Of course, we can hope that people, once knowing that the goal is for all comers here to feel respected, will feel enough comfort and safety to think carefully and respond to others rather than react. But on the way to them knowing that, what do we do? I prefer to try to make the space safer so that it will be respected, rather than to chastise or admonish.
        Please, everyone; please, keep it civil. A lot of people who come to this site have been hurt. Nobody here has a monopoly on that.

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        • I strongly believe that we should have a comment rating system. Also, maybe a system like Disqus that requires some form of public identity. The anonymous commenters can create an anonymous Twitter feed or something to link to, but people who hurt others without claiming their own ideas are part of what created the whole problem with psychiatry in the first place.

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          • I’m getting quite tired of this on this site! To begin with, there are VERY good reasons why many people would want to remain anonymous, and that’s EXACTLY because this site is open. Anyone openly and incisively expressing the truths about what psychiatric drugs have done, can be seen as being a danger to themselves or others by the people abusing them. And anyone can read these comments, and any fascist pro drugging psychiatrist or mental health worker who is allowed to assimilate erroneous diagnosis from how someone responds can do this here when people’s identities are clearly visible. And they could become EXTREMELY discriminatory in regards to lives they have control over, and whose comments they could read here, power they should never have been given such power.
            And MANY people have been hurt, and they deserve better than having to deal with some of the extremely insensitive self serving “political correctness” that abounds here and has conversations go around in circles fussing about things that might help for a certain small percentage although condoning seeing it as help still always hurts a greater percentage. These things should have never been considered help.
            This site shouldn’t be some karate exhibition defending political correctness. And it shouldn’t be a place where another touting completely uncivil barbaric healing methods can consistently defend these with saying highly offensive things while covering up their lack of logic, their unwillingness to take in another view point, and their inability to support true self initiative and true open thought. And they cover this up with “political correctness,” and they continue to hurt the people who aren’t given a voice and who they could denounce as being uncivil or “psychotic,” or “non compliant.”
            And these are just things that appear on a screen, words that have the meaning you give to them. No one is forcing anyone anywhere to read these words. Something which is quite different in the psychiatric profession, where you HAVE TO agree with the psychiatrist, or you are considered ill.
            I truly believe that some of the people pointing their fingers at others who they say are uncivil in their responses are simply sublimating their own aggression trying to inhibit people into confines that never will work.
            I don’t really see the people being “uncivil” as being such an enormous problem. What I see is a sort of political correctness that in essence always still pushes to the side enough of the truth that true incisive vital cognition is suppressed. If you didn’t have that problem, you would have the uncivil remarks. You would be left with what truly is the problem, and that’s the inability of those that wield the power have to listen to another viewpoint.
            People in anonymity throwing around personal attacks, has never been what caused the problems with psychiatry. It’s been people with self satisfying arrogance becoming the ikon to suppress others who don’t fit into the mold, and can’t inhibit themselves to getting rewards for being “politically correct.”

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          • correction in the last paragraph, left out a not

            “What I see is a sort of political correctness that in essence always still pushes to the side enough of the truth that true incisive vital cognition is suppressed. If you didn’t have that problem, you would have the uncivil remarks.”

            Should read:

            “What I see is a sort of political correctness that in essence always still pushes to the side enough of the truth that true incisive vital cognition is suppressed. If you didn’t have that problem, you would not have the uncivil remarks.”

            I truly believe that some of the people pointing their fingers at others who they say are uncivil in their responses are simply sublimating their own aggression trying to inhibit people into confines that never will work.
            I don’t really see the people being “uncivil” as being such an enormous problem. What I see is a sort of political correctness that in essence always still pushes to the side enough of the truth that true incisive vital cognition is suppressed. If you didn’t have that problem, you would not have the uncivil remarks. You would be left with what truly is the problem, and that’s the inability of those that wield the power have to listen to another viewpoint.
            People in anonymity throwing around personal attacks, has never been what caused the problems with psychiatry. It’s been people with self satisfying arrogance becoming the ikon to suppress others who don’t fit into the mold, and can’t inhibit themselves to getting rewards for being “politically correct.”

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          • And I have read from NUMEROUS highly intelligent sensitive people engaged with these issues, and highly active in an incisive way; people who all say that they either just don’t respond because of the state of things here, or they are disgusted and at loss to understand why certain people are blogging here and have no inclination to respond except saying a few words…

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          • And I strongly believe we shouldn’t. At most, a Like button. But ratings? That’s a sure way to suppress people expressing their views.

            People have a right to remain anonymous. They often have much to lose by expressing their opinions. Some could easily find that what they write here is used against them to force-feed drugs or toss them into psychiatric incarceration.

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          • I actually agree that one can get into the same anger-fear-attack-hate mode as those you are trying to criticize, if you don’t watch out. I actually remember daily, detach and realize that we are all in this together and that you can forgive people, you can bypass investing in fear based methods of control and make more difference than wielding all the “power” in the world. But to aggrandize a politically correct attitude and suppress people who just want to feel alive again and have the right to respond…

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          • As someone who identifies as a psychiatric victim, I would be unable to participate honestly here unless it was anonymously. A rating system would very bluntly rate some people’s voices as more valuable than others. I also can’t help but notice that some people have no problem using their real and even professional identities and posting things that I find offensive and uncivil… Having said that, I’ve looked back at some of the things I’ve posted and think I probably need to raise my level of civility. Can anyone recommend a resource for learning to communicate in a way that is confrontational yet civil? This isn’t something I’ve ever received any sort of education in…

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      • “commenting on madinamerica is unusually risky, even by general Internet standards.”
        Wow, I think I have access to a different internet there. Ever tried to comment on youtube? Or mainstream media article? Although if you’re offended here then I’d not recommend trying.

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    • Philroy,

      You seem like a very thoughtful person. I am interested in what you have to say. I’m against force and fraud, but I’m not anti-meds or anti-psychiatry. I’m pro-choice and pro-informed consent.

      I think your observation that there is no way for everyone to feel safe sharing is correct.

      I hope you share your hypothetical healing wishes somewhere soon. I’m always looking for new ideas myself.

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    • I don’t see how the fact that you’re ideas get criticised or ridiculed for what they are is the same as “I’m not allowed to say out loud what I wish for.”
      The point of discussion is to challenge others ideas and views not to politely nod your head and wait for your turn to speak so that others can do the same. No one is saying that MIA should censor this article or ban the author. But we have a right to express our opinions even if our opinions amount to stating “the author is a human rights abuser”.

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  15. Dear Dr. Steingard,

    Thank you so much for your honest concern about your patients, and I am sorry to hear about the struggles of your son. I believe that you voice the dilemma of many concerned psychiatrists who worry that they are struggling to assist people who need intervention.

    The problem is that the medical model of mental distress is wrong; mental distress is caused by real distressful experiences and is a natural expression (normal biology) of those experiences. A coercive response typically increases the distress and is therefore counterproductive. The Open Dialogue approach to mental distress is so successful because it understands this.

    “What do we do for the person who is wielding the knife or dismantling the electric wiring in his apartment or walking outside at night in a t-shirt and bare feet when the temperature is below freezing? If someone is screaming obscenities all night at his voices is it better that he get jailed for disorderly conduct or put into a psychiatric hospital? ” I absolutely believe that it is better to be jailed; this is societies response to those who are disorderly and causing social problems for the community. From there, an Open Dialogue can address causation and promote solutions. Consistently, someone who is hurting themselves is expressing extreme emotional pain; here again an Open Dialogue will address real problems and promote the best outcome. People struggle with real problems; solving real problems promotes mental health.

    Thanks again for expressing the position of concerned psychiatrists struggling with how to assist people in need.

    Best wishes, Steve Spiegel

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      • First of all the clause of “danger to self” should be done with once and for all. It’s my life and my body and I should be able to do with it the way I please. Ironic that I am not allowed to cut myself but the psychiatrist is allowed to physically and chemically assault me, which causes more damage. It’s so inherently authoritarian.
        So the only problem is “danger to others”. And that should always be the imminent danger. If someone’s yielding a knife or setting fire to buildings there are legal ways to deal with it. If someone is merely disruptive you can lock them up for 24h like you’d do to any “normal” person.
        But the best would be if psychiatry has actually done something useful for a change and employed non-coercive approaches to talk to this people. But then the intervention would likely take more than 10 minutes and a shot of drugs so it’s too much hassle.
        I was traumatised because the doctors didn’t “have time to deal with” me. I wasn’t a danger to self at the time or others (ever). Didn’t matter. I didn’t want to do exactly what they wanted (physical exam on a person who’s panicking – what emotional intelligence) so they had to “help” me.

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  17. Robert Whitaker’s right about psych drugs – they hurt people, they enable the worst impulses of those in power and they divert our attention from working on things that are humane and effective. People should not be drugged against their will. People should not have their freedom infringed unless they represent a clear and present danger to the safety or lives of others (and sometimes to themselves).

    Very occasionally people do become truly dangerous to themselves or others. Usually they are that way because they have been horribly and irrationally treated for years. And their immediate “dangerousness” could probably have been prevented if people around them had not acted out of fear and anger in ways that just make them feel less and less safe, more and more angry. The way we treat “out of control” people becomes a self-fulfilling prophesy; our reactions almost guarantee that their actions will become more and more extreme.

    But once it’s reached the boiling point, it is really boiling: a ten year old boy requiring three grown male police to subdue him; a 13 year old autistic girl with scars all over her body knocking me against a wall, throwing a shoe at a nurse and facing down a 300 pound security guard (AFTER 3 PRN”S of Ativan), spending three hours in isolation screaming, threatening and smearing feces. I’ve gone to a foster home on a Saturday when a foster mom reported her 200 pound foster child was ready to blow – the hair stood on my neck – we spent hours with the feeling that a puff of wind could send this child into uncontrollable assault – that day we all dodged the bullet, no hospitalization. Or the male teen who was found in the middle of the night standing over his foster parents’ bed with a carving knife in his hand.

    I would try to kill anyone who attempted to stick me with a PRN. But another writer said he’d choose jail over a mental hospital any day. I’m not so sure. NPR reported yesterday a national survey showing 10% of prison/jail inmates reported being sexually assaulted. I’d try to kill anyone who tried that on me too. Prisons, Jails and lockups are bad places too.

    Confining someone on the basis of their danger to themselves is not as easy a call for me as real danger to others. But that’s what I’d want if one of my children were truly suicidal.

    Confining someone in a safe place for a limited time, after TRUE due process with REAL representation (I used to represent people facing confinement) – I agree with that as a general proposition. My guess: maybe 15% of confinements are actually needed, and it would be even less if we didn’t act in ways that further agitated people.

    Confinement is one thing. DRUGGING is another – just don’t do it, unless it’s done as Open Dialogue does it. They hold off on it until a couple meetings with the patient and his/her family, allies (if any) and treatment team, and it is voluntary.

    Finland’s Open Dialogue for first time psychosis rarely hospitalizes anyone, makes minimum and voluntary use of drugs, and has 80 to 90% remission rates at 5 year follow up. Does anyone know any details of how they handle situations where people are brought to the ER with allegations that they are dangers to self or others? My impression is that their whole system is geared to respect the person, offer human contact and NOT provoke further escalation. Anyone know more about this?

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    • “Does anyone know any details of how they handle situations where people are brought to the ER with allegations that they are dangers to self or others?”

      To me it will seem that Open Dialogue has changed the culture of how people in Western Lapland respond to crisis profoundly. As far as I know, people mostly aren’t taken to any ER. They or their family/friends/whoever phone the crisis team, and a first meeting, preferably at the person in crisis’s home, is arranged for and held within 24 hours after the phone call.

      If you want to know more about the Open Dialogue approach I recommend Daniel Mackler’s film about it: http://www.iraresoul.com/dvd3.html , and/or read about it here: http://beyondmeds.com/2011/03/21/finnishopendialogue , and/or check out the link collection at Ron Unger’s blog: http://recoveryfromschizophrenia.org/2010/10/finding-out-more-about-the-open-dialog-approach-on-the-web/

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    • A great, thoughtful comment, especially:
      “Very occasionally people do become truly dangerous to themselves or others. Usually they are that way because they have been horribly and irrationally treated for years. And their immediate “dangerousness” could probably have been prevented if people around them had not acted out of fear and anger in ways that just make them feel less and less safe, more and more angry. The way we treat “out of control” people becomes a self-fulfilling prophesy; our reactions almost guarantee that their actions will become more and more extreme.”
      Unfortunately, people don’t understand that or don’t care. I wish Open Dialogue becomes a model for psychiatry everywhere.

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  18. Thank you. We are in agreement. My understanding of Open Dialogue coincides with yours. I am planning to get training in this next year. We are starting a home based program meant intended to avoid hsopitalization. We are hoping to integrate prniciples of Open Dialogue inot this program.

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    • WOW – That is great news. You are doing something that will benefit not only the people who come to you with problems; what you do can serve as an example to everyone in this country. We need demonstrations here that these programs work – bio-psychiatry manages to shrug off things done half a world away.

      I wish you and your program tons of success. This is the best news I have heard in a long time.

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      • Vermont is in the midst of a transformation in its mental health care system. It does not go far enough for some and it is too dependent on non-hospital care for others. This is the result of intense advocacy and a fluke hurricane that flooed our state hospital. I believe there will more written about this as it proceeds. However, I do not believe I have the answers. As of today, we are in a crisis situation and there are people who are, in my opnion, in need of hospitalization and we do not have enough beds. I would like to wait to see how things proceed before I try to convince others to do what we are doing.

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  19. For me, it was not so much an issue of fear of coercion as it was trying to avoid compounded stress. One thing I have learned about my condition is that avoiding stress is critical to keeping things under control. My psychosis is triggered by “compounded minor stress events” – and I can usually come out of it within a few weeks on my own.

    There is simply too much stress involved in the process of “seeking treatment” – from trying to get admitted, to “playing the game” with the hospital staff, to the process of getting discharged (usually AMA), to dealing with the behavior of the other patients (one girl in my support group witnessed a very messy suicide while in the hospital for depression and she now has serious PTSD), and then fighting with the insurance company and the doctors over what can and can’t be done, reimbursement, etc. – this is all seriously stressful and would cause me to go into a long term state of psychosis.

    The mental health system simply causes more stress than it provides benefit. I am often asked by “consumers” how I am so high functioning (despite having symptoms they seem to think are far more severe than theirs) and I tell them this: The amount of time and energy you have put into “fighting the system” I have put in to learning to live with my symptoms.

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  20. I’m a psychiatric survivor. I keep hearing my fellow survivors define psychiatry in black-and-white terms. The problem is not in psychiatry, it is in the definition. If psychiatrists were interested in the health and well-being of their patients, AS DEFINED BY THEIR PATIENTS, as this doctor appears to be, there would be no problem and we would be the healing we were looking for.

    There ARE grey areas. There are people who need help, and sometimes chemical or physical restraints are all that can be done. WE NEED TO SET THE BAR FOR THESE INTERVENTIONS AT A VERY HIGH LEVEL, but not one which is impossible to reach. We do not want care PREVENTED from being given.

    Robert Whitaker has said that perhaps as many as 30% of those given psychiatric drugs are helped by them (either short or long-term, he didn’t say). Obviously that is not because they fit the theory of chemical imbalance, so we need to scientifically look for a theory which fits the facts, not the drugs. We need to find which people could be helped by them, and find OBJECTIVE tests to identify those people. Without that, no psychiatric drug should be a first or second approach.

    Mr. Whitaker’s suggested level also implies that at least 70% of all psychiatric patients should NOT be on drugs. I’m obviously in that 70%. I have helped people find nutritional supplements, tools, practices, whatever it is that will help them, knowing that there is no One Size Fits All method of help.

    Please do not assassinate our allies. The author of this article clearly is one such.

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    • “There are people who need help, and sometimes chemical or physical restraints are all that can be done”

      Wrong. Forced drugging as restraint is never acceptable. Never. What are we? animals at the zoo? Physical restraint for self defense is a different story.

      A doctor who is petitioning a court to bring about a situation where the person’s express wishes are trampled is by definition not somebody at that moment who cares about that person’s definition of what constitutes ‘help’.

      You’re not hearing psychiatry described in ‘black and white terms’. You’re hearing violence and force described in black and white terms. There is either freedom, or violation.

      A psychiatrist is not my ally if they are my adversary in a courtroom. A psychiatrist is not my ally if I have to live in fear of that psychiatrist taking away my basic rights.

      This article is about coercion, not Whitaker’s statistics.

      Statistics shouldn’t come in to the matter. You could institute a scheme giving the government forced control over every citizen’s household budgets, or forcing every citizen to invest in the stockmarket, and then hit me with ‘statistics’ about the outcome. The issue is liberty. Sure, a lot of utopian schemes and do-gooding programs could be instituted if we start stripping freedoms from people who aren’t even criminals. The defenders of these schemes could hit us with statistics saying ‘since the government ordered SWAT teams to bust into everybody’s house and hide the butter nationwide cholesterol levels have gone down, ergo everyone should be violently deprived of their right to butter’.

      Freedom is what matters.

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      • You’re exactly right…
        “Freedom is what matters!”

        There are no “referendums” on Constitutional rights… Liberty is not up for a vote at an APA convention, or a hand-count a local NAMI office.

        And the fact that x-amount of people swear they were helped, while x-amouunt of people appear to be harmed.. Those statistics matter NOT.

        Because, at the end of the day, this is not about referendums or statitstics; science, or lack thereof; testimonials or medicine; black-and-white, or even shades of grey….

        This is about freedom!

        Duane

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        • And I say we fight for it.
          Tooth-and-nail.

          Ex-patients, consumers, survivors…
          Professional, non-professionals…
          Those in the system; those light-years away…

          Black, white, yellow, brown…
          Progressives, conservatives, libertarians…

          Because this is about the most vulnerable…
          And some of the strongest…

          This is about ALL OF US!

          Duane

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      • anonymous,

        We recently had a “situation” with a man who locked himself in his house and threatened to kill himself.

        He was despondent, already labeled depressed and mentally ill. His only crime was calling his girlfriend, who called 911 about him being suicidal. The SWAT team gassed the house and then shot him to death.

        He was a “danger to himself”.

        I just don’t get it. Nothing else has been in the news about this guy, and his tragic and unnecessary death. Collateral damage. A statistic. A non-person.

        Moral of the story: don’t call your girlfriend and tell her you’re suicidal.

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        • Happens all the time. Just another skull to add to the giant millions strong pyramid of skulls and dead bodies the idea of psychiatric coercion has created.

          Atop said pyramid of skulls, sit a psychiatrist with two happy ‘consumers’ ready to say forced psychiatry saved their life.

          They have a shaky foothold way up there on the pile of skulls. It’s a very high pyramid of skulls, way up there on their moral high ground.

          I smell an idea for a nice painting someone can make in ‘art therapy’.

          It’s a story of ‘don’t harm yourself because we’ve got that covered’.

          I wonder if someone autopsied the guy and sent his brain to some well known ‘researchers’.

          Let’s march for the cure.

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    • Nobody is going to assassinate anybody here. At least, I hope not. But if somebody who’s been victimised chooses to “ally” themselves with people who think victimising others is ok, they haven’t really recovered from being the victim. I for one am done with being the victim.

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      • Keeping someone safe is one thing, forcing toxic substances into there bodies is a whole different story. Prisons have for decades provided humane care to people without resorting to voilence or forced drugging, in many places in the world. How is it that you as psychiatrists are not able to keep a person safe without abusing them??

        A person had been forcibly detained in a psychiatric hospital and was being forcibly medicated. Clearly the medications were not working, as she was still hearing voices. The voices had to date always been about someone wanting to hurt her, someone coming to kill her. She started banging her head on the wall to get rid of them. Maybe on the best thing to do, but no one was offering her anything else and she was forbidden from talking about them – aparently it would make them stronger!!!

        On seeing the head banging a nurse and 8 security guards started running towards her, the nurse with a hyperdemic needle. She was pushed onto the ground and had 8 security guards on top of her, while her clothes were removed from her, ready for her to be placed in the seclusion room, totally naked, and the needle was placed in her buttom. She was stipped naked in the full view of the mixed gender ward. She was dragged to the seclusion room where they discovered that she was dead, she had had someone sitting on her head and had not been able to breathe??

        So much for keeping someone safe and treating them??

        What happened to sitting down and talking to someone and asking them WHAT was going on and WHY they were doing what they were doing.

        How can a person be supposedly so acutely unwell, that someone needs to force things onto them, and yet capable of giving directions to a lawyer??

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        • ” the medications were not working because she was still hearing voices”, News flash: medications don’t make voices go away.

          Why would someone have to DIE because medication “doesn’t work”? How is a death of a person in this circumstance ever justified? Why did they strip her clothes off, why did it take eight security guards to kill one person.

          Why couldn’t they have offered her a pillow and some comfort.
          The voices told her someone we coming to kill her, and they were right.

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      • “I would add that we need to provide adequate funds so that poor and disenfranchised people get good legal representation.”

        NEVER going to happen. It’s right to acknowledge that it’s a necessity, but it is a guaranteed non-reality.

        Adequate funds for poor people to purchase their rights, via “attorneys”. No.

        And we grow very accustomed to going without, and losing. It’s bankable, and if something is bankable – it is secured and maintained.

        There IS such a thing as modern day slavery.

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      • “we need to set the bar high”
        And you want to do it how exactly? Because I’ve seen a lot of awesome laws and protections that look nice on papers and I can list you all of them which were broken in my case and covered up by simple fixing of documents. Practice shows that when you give people power to abuse they will abuse (and cover it up). Just stop giving people this power and build alternatives. If you had Soteria and Open Dialogue like institutions everywhere instead of the status quo there is a chance that need to use coercion would go down to single digits. Which is as good as zero – you can’t prevent every instance of danger and suicide. There is no better example of it than the “war on terror” which in order to prevent a few attacks created more terror, deaths, destruction and horror on both sides. And btw was never really wielded to prevent terror but to make a few sociopaths rich and happy.

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  21. This is so out of proportion that one indeed needs multiple references to “I,” “I” and “I.”
    To begin with, do not ask questions about what would you do about several things, when there’s no honest appraisal of how much a person’s addiction to medications they were either forced, coerced or conned into taking has brought about such action.
    Propaganda is propaganda, no matter how “serious” you are about the propaganda that makes you believe you aren’t adding to an epidemic of chemical bondage, side effects and human rights abuses.

    Just two quotes:

    “I am a psychiatrist who believes some people can recover from psychosis without the use of medications.”

    “I am also a psychiatrist who sometimes forces people into hospitals against their will.  I have patients who are on court ordered outpatient treatment and this may include the requirement to take medications that I prescribe.”

    There’s in no point in the statistics that prove people who aren’t medicated do better (in Finland it’s 80% recovery) that would allow a sane reasonable person to think they have the right to decide when a system and method that statistically has been proven to make things worse should be forced on someone. To use psychiatric terms, and given the abundance of “non reality based thoughts,” only a person who is “psychotic” and “narcissistic” would think otherwise. You can delude yourself into think that “I”,”I”,”I” and ”I” have some cause and effect beyond statistics, morality, science, human rights and simple compassion, but this proves you’re a danger to yourself and others would anyone take all sides of your logic seriously, logic that defines people as being dangerous and then proceeds to make matters worse. It’s only thankful that you yourself haven’t had yourself committed into a hospital and forced on your own treatment, since it’s only been proven to make matters worse (and then take away your ability to see things are getting worse, by neurologically disabling your mind), given the powers you have over others and what the result might be, would it become even worse, which has been proven to happen when your method is followed, and which when taken logically would mean you should give yourself treatment and make things worse, and prevent yourself (with treatment) from finding out they are getting worse or that something might be wrong at all! And since your method is supposed to work, this would only logical to your strategy, to make yourself more of a danger to others.

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  22. I want to thank Anonymous, and Marian and everyone else on this thread who is saying that force medicating is harm.

    You’ve said things that I agree with and won’t repeat about coercion, human rights, and trauma, and silencing.

    I believe in kindness and understanding other people’s points of view in all dialogues, and at the same time, I want space for my point of view…and I’d like to point out that someone who wants to take away my basic human right to my mind, someone who threatens to take this away from me if I don’t act in a way that they are comfortable with, that this is not my ally.

    I am tired of being asked to treat this as a small issue.
    If we were discussing a different population than the “mentally ill”, I don’t think anyone would be asking them to be understanding of someone wishing to take away their liberty for no crime other than being different and in distress.

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  23. It’s also quite insane to believe that ANY psychiatrist can be objective, who has the right to have a person committed when they aren’t in agreement with the psychiatrist’s “assessment” of their condition; it’s also “psychotic” and “narcissistic” for ANY psychiatrist to believe that they are going to get any kind of an objective viewpoint from ANY of their patients from their interactions with them, given the coercion towards the patient in how he has to respond.

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  24. ultimately what we are all yelling about in outrage is that a person called a psychiatrist has the right to take over an other person’s life and ruin that person’s life and physical health witout that person having a say into it all. And why is that possible? Because of a far-fetched theory that a breakdown is a brain desease.
    The other sore point is that there usually is no choice available and even worse the person is not allowed a choice even if there is an alternative available. We are back to human rights.

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  25. This is addressed to Marianne and others who are critical of my blog-
    You point out that most of my replies are to those who are less critical of my blog. I don’t dispute that. It is not meant to be disrespectful. I just am not sure what to say to those of you who vehemently disagree. I believe we are at an impasse as “anonymous” wrote in response to another thread on this site. I just was not sure how to respond in a way that acknowledged these comments wihtout seeming to be partonizing. I do believe that this discussion is important and I welcome the comments from those who disagree.
    I am sorry that you find me aloof. It is not for me to say. I believe that the ones who are best able to make this determination are those with whom I directly interact. I would not presume to speak for them.

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    • “I believe that the ones who are best able to make this determination are those with whom I directly interact. I would not presume to speak for them.”

      “I am also a psychiatrist who sometimes forces people into hospitals against their will. I have patients who are on court ordered outpatient treatment and this may include the requirement to take medications that I prescribe.”

      Report comment

    • “I just am not sure what to say to those of you who vehemently disagree.”

      A pro forced drugging psychiatrist is lost for words in the face of opposition, this is why a psychiatrist says what they feel needs to be said to the judge, and not to the target of coercion, and the next ‘communication’ is the takedown and the needle.

      The takedown and the needle speak a million words, that will echo through the survivor’s life until their dying day. The takedown and the needle are the voice of society, the voice that will haunt the coerced throughout their lives. The voice that says I am not worthy of the same human rights those who assaulted me believe they are worthy of.

      The takedown and the needle and the perpetual threat to assault us again ‘if you deem it necessary’ allow the assaulted no respite from their attackers. The takedown and the needle is society telling the person they are a person no more.

      Maybe that’s why psychiatry chooses the buttocks for forced injections. Maybe it’s not that it’s just an anatomically ideal place for an intramuscular injection.

      Maybe it’s so they don’t have to look at us in our eyes. Maybe that’s why they hold us face down. Maybe the brain rapists would be haunted by all those pairs of eyes staring back at them. The eyes that screamed. The eyes that stream thorazine tears.

      Before psychiatry forced its way into my life, I never had a problem making eye contact. After I was labeled and assaulted and told how inferior I was, all of a sudden they’d always write down in the notes that I wasn’t making good eye contact.

      I was like that for many years. I felt worthless, subhuman.

      Now, I see right through you.

      Is it any wonder psychiatry can’t see eye to eye with survivors?

      “Hear now this, O foolish people, and without understanding; which have eyes, and see not; which have ears, and hear not:”

      Jeremiah 5:21

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      • Those of you who so violently attack Sandy, how do you feel about psychiatrists who honestly don’t give a cr*p? The ones who are cynical hacks? Is there any more room on the hate scale for them?

        Can you at least give Sandy credit for listening? How many psychiatrists have you known who don’t do that? I’ve met so many, my belief is this is a rarity.

        If they were all like Sandy, the profession might still have a lot wrong with it, but it would be very much improved.

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        • Again, we have to have a separate set of standards for psychiatrists and treat them differently from the rest of humanity, simply because the majority of them are so awful? No thanks. I’ll put them on the same scale I put everyone else on. Don’t arrogantly presume to speak for me if you don’t truly understand me, don’t do things to me without my consent if I consider them invasive and traumatizing. Too complicated for you?

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        • She listens yet she cannot hear, or at least it seems so for now – maybe this harsh criticism will change something in her self-justification for coercion.
          Stopping psychiatric coercion for most of psychiatric surviviours is not optional or debatable. We can discuss the use of drugs and benefit to risk ratio, we can discuss various studies on psychotherapy and Open Dialogue but we cannot discuss coercion. Like you can’t discuss how much slavery is OK, or how much genocide is acceptable. It’s not acceptable and as much as I am happy that Dr. Steingard is open to re-considering use of psychiatric drugs I am not prepared to give her a pass on being a human rights abuser.

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    • Thank you for your response. I am surprised.
      If there is an “impasse” it is the same one that I saw in your previous blogs, and that is that you are separate from other human beings, someone who is set above the rest of us, due to your label of psychiatrist.

      You come across as someone who has a superiority complex. That almost sounds like a diagnosis, doesn’t it. Stop quaking, it isn’t in the DSM.

      I do hope you will seek help in learning about human beings in your Open Dialogue training.
      I also hope that someday you will understand that we are not so different than you. In fact that is what I hope the most for you.

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    • “I just was not sure how to respond in a way that acknowledged these comments without seeming to be patronizing.”
      Well, tell me how would you then respond if a former patient would come up to you and tell you you’ve destroyed his life, traumatised him and needle-raped him? This is something you have to face and you have to respond to if you want to be honest with yourself. Do ends justify the means? How much collateral damage is OK? Do you even know how many people you have harmed? Have you even tried to discuss with them what you’ve done? Are you prepared to apologist to them? To admit that they were traumatised by you?
      People who are criticising you here are not doing it from an abstract place – we were harmed by people with your philosophy and your attitude, people who thought they know better when they didn’t know anything.
      Your not addressing our criticism is avoidance – because you can either agree with us and apologise and stop using force on people or you just have to ignore us and decide you’re somehow qualified to decide what’s best for us and all the people who’s life are ruined because of your and your peers are a meaningless statistic.
      “I just am not sure what to say to those of you who vehemently disagree.”
      Well, maybe there is a reason why you don’t know what to say…

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  26. I will take a somewhat different position on the issue of coercion and say that I do support involuntary holds, but not involuntary treatment. Current pharmacological treatments for mental health conditions are not effective and can cause long term harm (as the studies in Mr. Whitaker’s books demonstrated). However, there remains the issue of how to deal with someone in immediate short term crisis.

    I do believe that some sort of short term intervention is often necessary. The way I explain it to those without personal experience, is that the acute stage of psychosis is a bit like being in the middle of a very intense dream, where strange situations are unfolding around you, and just like a dream while sleeping, you have very little ability to make sense of what is happening or strategically adapt your own behavior to control the outcome. I would hate to have someday done something to seriously injure myself or found myself in legal trouble for something I did in response to something I was experiencing during one of my “dreams.” For that reason, I favour holds (although – I have never done one myself for reasons I explained in earlier posts).

    I think what needs to be done is to find a way to make holds a more pleasant (or at least more benign) experience for the patient. I believe we need to reinvestigate methods like Soteria and move holds out of cold, hostile institutional settings totally and more into a relaxing retreat type of setting. The holds should be something patients want to go to voluntarily and can see the value in them afterwards.

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    • That is something I can totally agree with. I don’t have a problem with the fact that I was not allowed to kill myself, I do have a problem with what was done to me, as a result of those feelings that were very real and very logical and grounded in very good reasons.

      I also do not believe that forced treatment is necessary. The simple fact is that people initially go searching for help and begging for help. When that help is not given in any real way then they end up being forced. I have NEVER EVER met a person who did not want help, having said that I have NEVER EVER met a person who wanted the help that was being given to them.

      I well remember a psychaitrist saying to me once that forced treatment was simply not necessary. A person who is that profoundly unwell would agree to anything at all, ask them to jump off a cliff and they would agree, offer ECT and they will agree. They are desperate and will agree with anything. There are massive issues with the fact that these are not informed decisions, but the fact is it does not need to be forced. No one wants to hear voices in there heads telling them to kill someone. But equally if the drugs you give them, make the voices stronger and also cause massive side effects as well, why would any sane person choose to take them. People choose not to take medications for very sane reasons.

      And yes, provide people with a real place of asylm and they would choose to be there.

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      • Great points Mary. “I have NEVER EVER met a person who did not want help, having said that I have NEVER EVER met a person who wanted the help that was being given to them” (because IT WAS NOT THE RIGHT KIND OF HELP). People need to stop repeating the same pop-psych b.s. talking points over and over and actually understand that this is at the crux of it.

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        • Exactly. I wanted help and I never got any. I told them I didn’t want drugs nor to go to a hospital (when I went to voluntarily seek help in outpatient clinic) and was forced to it anyway. No need to mention it didn’t make me better in the slightest – just the opposite. I tried to kill myslef and become violent (at least by their account – I was so drugged I don’t remember and I would think that was not aggression but defence knowing the reality of these places) thanks to their “treatment”. After this experience I will not only never ever go and seek help again but will strongly discourage anyone from it. Sorry, but that’s just the reality of current psychiatry – you’re better of dealing with whatever horrible sh*t you’re going through without them.

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      • So, with so many people having voices in their head that berate them, command them, tell them to kill … and this has been happening for … ever

        Hasn’t anybody figured out yet what these voices really are? Maybe we’re all too scared to know it. What if it’s not a disease or brain disorder? We all know voices are real. My heart really broke for the dead girl who was tortured and then killed when the inner voices became real people that actually attacked her.

        Here’s a hint: a psychiatrist is the least likely person to ever solve the “voices” mystery. I’d be surprised if even a single psychologist on this planet would profess to know and properly explain “voices”. And that goes to show what psychology & psychiatrist are NOT DOING. While they do harm with drugging, they do other harm by failing to understand so many of the core problems.

        “Voices”. Really? That’s interesting. I watch Andes cry out almost every day. He’s just telling and telling and telling and telling. All I want to do is HOLD HIM (in my arms, you asses – not in a quiet room or cell).

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        • mjk

          Please check out the hearing voices network for a completely new perspective on voices.

          Psychiatrists don’t have the time to understand voices and drugs are faster and easier, so they never will. They also don’t care.

          The psychologist who wrote Agnes’s Jacket does.

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    • While I disagree with the majority of what you’ve said there, if you want to talk about incarceration or ‘holds’ or whatever euphemism you want to use for stripping a non-criminal of their freedom of movement, fine, let that be a conversation society can have.

      To me, the most important thing is that society starts taking seriously how unacceptable it is to violate people’s bodies.

      There is a world of difference between kidnapping or incarcerating somebody, and violating their body. Violating someone’s body, entering somebody’s body against their will, is so unacceptable and contemptible it is just reprehensible.

      I don’t agree with locking people up who haven’t committed a crime. But I will admit, I’m not happy with the time I was locked up, or in solitary confinement, but I can live with that. It is a small fries compared to forced drugging.

      Society is society, it has boundaries and walls. Closing the walls in for a while is a big step for a society to take for a non-criminal. But the body is inviolable. It is the last thing the individual owns even when they are in locked up. To breach everything the human being has is the most vile indignity, to do something that invasive, is on a par with the most violent crimes in existence.

      If they had have just locked me up, even just tied me down, I could forgive, I mean that’s violence, but my brain isn’t being raped is it?

      This is what makes community commitment a manifold evil. It makes the assault constant and lasting. It’s egregious. Absolutely an atrocity.

      There are few things more degrading in this world to witness or experience, if you KNOW WHAT YOU ARE LOOKING AT, when you take the scenario of a poor person on community commitment coercively and powerlessly arriving at the clinic for their long acting injection. You’re not looking at a ‘client’. You’re not looking at a ‘consumer’. You’re looking at a human being, an innocent human being, who has been reduced by law to nothing but a receptacle for drugs. Someone condemned by the state to experience life through drugged eyes.

      It’s a horror. WE can bring this horror out into the open. And show the wider society how utterly demeaning to human dignity what psychiatry is doing is.

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      • “You’re looking at a human being, an innocent human being, who has been reduced by law to nothing but a receptacle for drugs. Someone condemned by the state to experience life through drugged eyes.”

        “It’s a horror. WE can bring this horror out into the open. And show the wider society how utterly demeaning to human dignity what psychiatry is doing is.”

        Yes WE can.

        Wow. Great post.

        (And, wow, again. I’ve read it through several times, before going on to write you this comment; and, it is truly perfectly inspiring.)

        Anonymous, I’ve followed your written thoughts, starting two days ago, at the point at which you first responded to Dr Steingard (May 17, 2012 at 7:17 am), and now I must say: At each new post of yours, in this particular conversation, on coercion, I’ve been genuinely awed at your ability to articulate yourself.

        And, by this point, you’ve come to the very heart of the matter.

        At least, from personal experience, I agree entirely with every letter, of what you’re saying here, in this post.

        Most especially, about the bodily violation, by psychiatry: it is truly a most incomparable horror (for me, by this point, beyond words, horrific); in fact, to be perfectly frank, I believe one can suffer no worse form of rape than this rape of ones own mind, with such brain-disabling drugs (e.g., Haldol), as psychiatry comes to forcing upon its subjects.

        (I mention Haldol, there, parenthetically – as, earlier, a mom posted her insistence, that forcing a couple of days of Haldol on people is not a particularly big deal; I gasped upon reading that post; for, in my experience, after a couple of days, Haldol was purely torture – no hyperbole whatsoever. It created a condition in me, of such rage, understandably, despite all my objections, I’d be viewed as ‘requiring further hospitalization’; not before, nor since, have I ever experienced such rage; it prolonged my “hospitalization” – and, thus, I sincerely believe, that had I not been drugged with it, I could never have been labeled by psychiatry, as a supposed sufferer a supposed, “severe mental illness.” Of course, that designation would forever change the course of my life. That diagnosis did not go away; no one would remove it; for, in the past 23 years I’ve deliberately shunned psychiatry and it’s meds – to save my life.)

        Given that I was raised to fully believe in what is, theoretically, the inviolable nature of the U.S. Bill of Rights, it’s an ever-increasing wonder to me, that such forced and coerced drugging continues unabated here in the U.S. – so many years after I endured it.

        In fact, the methods of coercion have multiplied.

        Therefore, I salute you for coming to this point, in your determination to speak the ‘rude’ truth, from beginning to end.

        Simultaneously, I convey how fully grateful I am to Robert Whitaker for the integrity of this work, that he’s been doing, as a journalist – and for his allowing for such discussions, as this one, here, on his site.

        I’ve been aware of this MIA site for some time – but have never before posted any comment. Before now, was always hesitant.

        At last, I’m compelled to post this – (hoping I have no regret afterward) – being urged on, by such and immense sense of gratitude for your uncompromising expressions of dissent, Anonymous!

        And, I say that, with all due respect to Dr. Steingard, who, in my estimation, seems – (far more than most psychiatrists ever would be) – a professional who’s genuinely interested in prompting straightforward conversation; though she expresses some self-contradiction, she is, I believe, by her own willingness, allowing her professional views and practices to be directly challenged.

        The average psychiatrist is far more guarded.

        (Also, I am grateful to the moderator for allow your expressions to remain posted.)

        Perhaps, I’d stop here – but will add…

        Anonymous: Reading your posts has been more than gratifying.

        In so many ways, in the course of this discussion, you’ve put into your own words my own deepest – and most seemingly ‘wordless’ – sense of having been ultimately disrespected and abused by countless well-meaning ‘believers’ in psychiatry.

        [Note: For me, it was quite long ago – well over two decades back – that I was a psychiatric slave; but, the memories of psychiatric force and coercion so frequently haunt me, despite any seeking to divert them from my mind – i.e., I was, in fact, so seriously affected, especially by the forced drugging, the restraints and the lies and B.S. which ostensibly ‘justified’ them – that, much as I’ve often aimed to ‘get over’ these memories, they invariably return, again and again and again – daily – so that: though I’m now 47 years old, not since I was 21 years old (prior to my being forcibly medicalized by psychiatry) have I ever felt safe or comfortable sleeping in a bed. (I’ve rarely slept in a bed all these years; it is largely from this point of view, that I believe I can well imagine why it is, that so many people come to prefer homelessness over any otherwise, would be, ‘suitable’ housing which required ongoing ‘care’ by ‘medical’ psychiatry.)]

        By the way, I am a certified hypnotherapist; and, from extrapolating the essence of so many interrelated concepts, from my training, I’ve come to presume, that it’s mainly because the medical abuse (of forced and coerced psychiatry) tends to involve such utterly debilitating drugs, the memories of such (‘medical’) violence *must* come to exist, for many who’ve suffered it, as though a portion of ones life trapped in amber – quite like that of traumatic ‘pre-verbal’ experience.

        But, what’s worse is that, if/when one ever attempted to verbalize certain objections to such abuse, as it occurred, s/he was typically called “ill” and drugged all the more; so, I’ve figured, even as an otherwise highly articulate person may yearn to ‘expel’ such experiences with psychiatry, through words, typically, to express the worst of them may seem a perfectly impossible task.

        I.e., it is largely the hypnotic conditioning of those ‘medical’ experiences themselves which thwarts later attempts at expression; so, necessarily, one reasonably wonders, years later: How many former and present, “compliant patients” (or, “consumers”) of psychiatry may seem ‘ok’ to casual observers – yet are actually terribly bottled up, haunted… as much as (or, more than) I have been?

        What becomes of so much suppressed feeling??

        I can only imagine based on my own experiences – which suggest to me, that there comes a time when one may need to ‘burst’ in ways.

        Hopefully, people can find creative ways to release…

        Very thankfully, in recent years, I have found ways of doing so, more or less anonymously, on the Internet; even more thankfully, I’ve encountered at least a few who would listen to me, thoughtfully, in person, when I’ve felt compelled to vent!

        How you have been able to break through to such a degree, of precision, with your words, here, in the past couple of days, I don’t know; but, in any case, I do thank you, Anonymous, from the bottom of my heart for your not holding back in this thread.

        If, perhaps, you may think you are just being yourself, please know: you are doing many a great service in the process…

        Sincerely,

        Jonah (@BeyondLabeling on Twitter)

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        • Hi Jonah,

          I share in your overwhelmed admiration and gratitude of anonymous. Truly captivating, “show stopping” and SO much more. A Star, like a guiding light, shining so so so bright. And it’s warming and endearing – not blinding.

          Thanks for making me feel “love”, anonymous. I rarely ever feel that anymore.

          And Jonah … I like the way you “speak” and I hope it felt wonderful for you to participate. *smiles*

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        • A wonderful response Jonah:))

          I liked the “trapped in amber” metaphor, although for me the amber is my body. Your reply prompts me to share a little of my own discoveries about the instinctual nature of mental distress.

          A few exerts from Peter Levine’s brilliant “In an Unspoken Voice.”

          The mental states associated with trauma are important, but they are secondary. The body initiates and the mind follows. Hence “talking cures” that engage the intellect or even the emotions, do not reach deep enough. Trauma is not a disease, but rather a human experience rooted in survival instincts.

          According to the polyvagal theory, being in shutdown (immobility/freezing/or collapse) or in sympathetic hyper-activation (fight/flight) greatly diminishes a person’s capacity to receive and incorporate empathy and support. To the degree that traumatized people are dominated by shutdown (the immobility system), they are physiologically unavailable for face to face contact and the calming sharing of feelings and attachment.

          And while immobilization is rarely complete (as it is in catatonic schizophrenia), its ability to suppress life and one’s capacity for social engagement is extreme. Traumatized clients are stuck in the primitive root of immobility with its greatly reduced capability for reading faces, bodies and emotions, they become cut-off from the human race. As highly dissociated and shut-down clients “involuntarily” retreat, they experience additional self-recrimination and shame.

          A TRAUMA SURVIVOR:
          “I feel all alone in the universe, dissociated from the human race …. I am not sure that I even exist …. Everyone is part of the flower; I am still part of the root” Indeed the brain stem’s immobilization system is the “root” of a default hierarchy” (p, 111)

          Researchers read a traumatic story to a group of clients and compared two brain regions in each (measured with fMRI). The researchers found that the amygdala, the so-called fear or “smoke detector,” lit up with electrical activity; at the same time, a region in the left cerebral cortex, called Boroca’s area went dim. The latter is the primary language center-the part of the brain which takes what we feel and expresses it with words. That trauma is about wordless terror is also demonstrated in these brain scans.

          Frequently when traumatized people try to put there feelings into words, they speak about it as though it had happened to someone else. Or clients try to speak about their horror, and become frustrated and flooded, incurring more shutdown in Boroca’s area and thus enter into a retraumatizing feedback loop of frustration, shutdown and dissociation.

          This language barrier in traumatized individuals makes it especially important to work with sensations, the only language the reptilian brain speaks. (p, 113)

          For ten minutes or so (a few times a week), take a gentle, pulsating shower in the following way; at a comfortable temperature, expose your body to the pulsating water. Direct your awareness into the region of your body where the rhythmical stimulation is focused. Let your consciousness move to each part of your body. For example, hold the backs of your hands to the shower head, then the palms and wrists, then head, shoulders, underarms, both sides of your neck, etc. Try to include each part of your body and pay attention to the “sensation” in each area, even if it feels blank, numb, or uncomfortable. While you are doing this, say, “this is my arm, head, neck,” etc. “I welcome you back.” You can also do this exercise by gently tapping those same parts of your body with your fingertips. When done regularly over time, this will help reestablish awareness of your body boundary through awakening skin sensations. (p, 115)

          Generally, tight, constricted muscles are associated with the alarm and hyper vigilance of the sympathetic arousal system. Flaccid muscles, belie how the body collapses when dominated by the immobilization system. (p, 116)

          Be well,
          David.

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          • Thank you, David. Great excerpts, much appreciated.

            And, I certainly agree: toward resolving trauma, “talking cures” do tend to be limited – especially if/when there’s little or no simultaneous activity, of tending-to-the-body (e.g., attention to breathing).

            Nevertheless, talking is key (as is listening); much healing occurs when one is genuinely listened to (heard); and, of course, typically, one needs to speak, to be heard.

            Also, there can be immeasurable good that comes from telling ones story (as long as the telling is done in a relatively safe space).

            Ones recounting of trauma (in a safe space) can be good for oneself and for others who are present.

            By the way, it is only in recent years, that I’ve begun to realize how deeply traumatized I am.

            I mean: Yes, I knew all along that I was traumatized by the psychiatric ‘care’ I received in various so-called “hospitals”; but, I was also traumatized (and, many are) in the course of having well-meaning friends and family literally hounding me to return to psychiatry whilst I was in the midst of withdrawing from psych-meds.

            I.e., that well-intentioned meddling, too, is a part of the trauma I suffered (which is not unusual): I came feeling as though a ‘witch’ literally persecuted by my own community – in having virtually everyone in my entire social system unrelentingly insist that, supposedly, I “must take psych-meds” to survive – when, in fact, I felt increasingly certain that such meds were anything but necessary; they were actually, gradually destroying my life from within.

            At times, I felt persecuted by such misguided ‘love’ – as it meant these people (‘my people’) wanted me back in a “hospital” (and, those “hospital” experiences had been ultimately traumatic).

            It is important to speak, of such matters, I feel – not least of all, because: many (countless) well-meaning families and friends of so-called “patients” of psychiatry are being, today, convinced by fear-mongering psychiatrists, that their loved ones literally could not survive without psych-meds.

            In truth, the meds are habit-forming; so, coming off of them, without support, can be somewhat hazardous (and, coming off of them too quickly can be literally disastrous for some people); but, psych meds are seldom proven to be vitally needed.

            What people can’t survive long without, is some (at least minimal) social support; and, unfortunately, most psychiatrists are so deeply caught up, in forwarding their medical model of what is actually, in most instances, ‘just’ the effects of mental and emotional distress (typically caused by unresolved trauma and/or neglect), that they place that social need of their “patients” below their own professional passion to pathologize, label and then drug all prospective “patients” whose behaviors may seem to fit ‘perfectly’ into their official (DSM or ICD-10) descriptions of “mental illness” and “disorder”.

            I Know Why The Caged Bird Sings by Maya Angelou

            The free bird leaps
            on the back of the wind
            and floats downstream
            till the current ends
            and dips his wings
            in the orange sun rays
            and dares to claim the sky.

            But a bird that stalks
            down his narrow cage
            can seldom see through
            his bars of rage
            his wings are clipped and
            his feet are tied
            so he opens his throat to sing.

            The caged bird sings
            with fearful trill
            of the things unknown
            but longed for still
            and his tune is heard
            on the distant hill for the caged bird
            sings of freedom

            The free bird thinks of another breeze
            and the trade winds soft through the sighing trees
            and the fat worms waiting on a dawn-bright lawn
            and he names the sky his own.

            But a caged bird stands on the grave of dreams
            his shadow shouts on a nightmare scream
            his wings are clipped and his feet are tied
            so he opens his throat to sing

            The caged bird sings
            with a fearful trill
            of things unknown
            but longed for still
            and his tune is heard
            on the distant hill
            for the caged bird
            sings of freedom.

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      • “Violating someone’s body, entering somebody’s body against their will, is so unacceptable and contemptible it is just reprehensible. ”
        There is a term for it, the term which many surviviours use: RAPE. Rape is in essence not sexual as much as a way to exert power over someone and subdue them and this is exactly what coercive psychiatry does. You don’t own you body anymore – you can be touched and injected with chemicals and force fed and stripped naked. It’s torture and it’s subjugation and it needs to stop.

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  27. I am fully in support of developing programs in which people can be safe and not forced to take medications. I also think that there needs to be a legal separation between involuntary hospitalization and involuntary medications. I also agree that this is an extreme intrusion on an individual.
    I mean it with utmost sincerity that your voice is important and I have been following what you and others write both here and elsewhere on this site.
    I do try to taper people off medications even if they are on an outpatient commitment. I say this not to win your approval or respect but just to further the conversation.

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  28. Since this will be off the main page soon, and into the abyss that as go all posts that are no longer on the main page, a coda:

    I’ve just read all 130 (approximately) comments here.

    First, I want to say to Sandra Steingard. You never forcibly drugged me. While you might stand ready, willing, and armed to be deployed by the state, and into my life or anyone’s life in your town, know that I do understand you are well meaning, and that this isn’t ‘why’ you got into this line of work in the first place. I hope you don’t take the ‘vibe’ of this entire vast comments response, mine, and that of dozens of others, to be personally hurtful to you.

    You’re a real person, and the internet is depersonalizing. I’m a real person too, we all are. This site, this article, this giant comments response, is not so much a response to your article as it is a function of this site being a public square or village pump, for people to speak freely on their feelings on whatever issue is covered in an article.

    The simple one word title of this article, ‘coercion’, is a red rag to a bull, in a heated ‘politics of the personal’ debate.

    As I say, I’ve just perused every comment again, and most of them are ‘generally’ talking about this issue, not for instance, what you had to say about your state being one of the most positive states in the union in regards to this problem. I mention this because I want to point out that ANY of the bloggers on madinamerica.com could have written an article titled ‘coercion’ and had the exact same 130 comments appear. I hope this hasn’t been too rough personally for you. It’s rough for me every time I even see the concept mentioned.

    I like all of these comments, all 130 of them. Cumulatively, they are ugly, vexing, desperate, reckless, pleading, arguing, harrowing, complicated (in both directions). This is the natural response one can expect to such an ugly and messy issue. And that’s good, it’s better than the stone silence of previous eras.

    Abortion, as a political issue, is where the phrase ‘the politics of the personal’ was coined. Women wanted the ‘rosaries off their ovaries’. Coercion in psychiatry unleashed an unstoppable fireball of pain and painful impasses on society from the moment your profession was handed the legal power to coerce. It’s a story society needs to see, that WILL be told now that the internet has finally given voice to the long hidden results and the free and open weighing of them. Unlike in previous generations, there is no stopping this, a development I relish, white knuckled as it may be.

    Kermit Cole, our long suffering blog comment moderator, said he ‘white knuckled through’ many of these 130 comments. He chose apt words. Coercion is a white knuckle ride.

    When the psychiatrists who write on this site trained as psychiatrists, there was no internet. All you had was the mass media. You aren’t likely to hear about books like Robert Whitaker’s on the Today show in front of millions.

    The internet is a mere 15 years old. People lose their freedom at the hands of psychiatry behind closed doors mostly, and suffer the ultimate power imbalance, unarguably one of the most powerful power imbalances in the history of modernity, a minority group, robbed of credibility due to myriad factors that I need not rehash here.

    The internet is the most hopeful thing to ever happen to us as a group. We finally have a voice. When a ‘red flag to a bull’ one word title like ‘coercion’ comes up on the main page, everyone knows it’s going to be packing the explosive power of a nuke, given the readership of this site, and given the issue generally, or at least they should.

    This site is nascent. It’s six months old in its current format. The issues covered are gargantuan in scope, and society shaking. I know of no site on the internet where other ‘politics of the personal’ hot button issues can be debated so inclusively where people have at least a modicum of shared goals. Everyone here deserves credit for that. Robert Whitaker deserves credit for that first and foremost, Kermit Cole deserves credit for that just be sheer acknowledgement of the time he is putting in, people who stick it out deserve credit for that, other survivors deserve credit for that, the psychiatrists who write here deserve credit for that, even Steve Moffic could go and disappear behind his Psychiatry Times curtain if he chose. He sticks around. I think he deserves credit for that.

    There is no site on the internet where pro-life and pro-choice people in the abortion debate regularly congregate and spar, for example/comparison.

    Sandra Steingard is brave to step into this sparring ring. You don’t see most shrinks doing that. That counts for something. If I were being coerced by her personally, sure, I’d fight tooth and nail in the courts to neutralize her designs on my life. But she’s not, she’s here, on madinamerica.com engaging, to a lesser or greater extent, with the readership here.

    That the survivors are brave goes without saying, and the pro-force parents and well meaning pro-force advocates only recently grappling with the enormity of these issues and the effect on others beyond their own children, are admirable in many respects too. (those that are willing to listen) (I exclude intentionally any Torrey acolytes, they’ll never listen).

    I hope everyone can give deep thought to the deep debate going on on this site.

    It is clear to many that psychiatry is kneecapping the chance millions of people have of recovery from their personal distress. It is clear to many coercion in psychiatry is kneecapping the chance many people have for recovery too. Not even active coercion, the threat of coercion is beginning hopefully to be considered a hindrance to recovery too.

    To some, it is from their perspective clear the only thing wrong in the world of “mental health” is the ‘drugs aren’t safe’. They believe that that personal distress is a problem for the ‘medical realm’, and they are entitled to this belief. The fact remains it is the law of the land that people be handed over by legal force, to this ‘medicalized’ camp. Expect a push-back from the government forcing your beliefs on the many.

    To others, it is clear to them that it is ludicrous to entrust the problem of personal distress to a profession who has not come up with single objective proof that any form of personal distress is a ‘brain disease’.

    There is deep division. Division is a fact of this situation, this here and now, for all people concerned with this issue in 2012.

    We can agree there are many problems going on in this profession which society has dictated shall be the go-to profession for personal distress.

    ‘Society’ as an entity, is bigger than any one man or woman, bigger than any psychiatrist who chose to write the above article, or who chose to enter this profession. We were all born into this pre-existing belief system.

    Robert Whitaker is patient man, and a deeply, profoundly good man. He has saved lives (using persuasion not coercion) and he has made resources available. Not just years of his life in painstakingly piecing together disparate leads on this mess that is modern ‘mental health’, but this forum.

    The freedom to ‘comment’ without any blowback from the less powerful is what psychiatry has enjoyed for hundreds of years. They could write op-eds in the press, publish articles, and be insulated from any opposition by sheer factor of their professional prestige and unquestioningly respected credentials.

    That era is over. The internet has smashed the egg. Powerful earth shaking repercussions await this unfortunate profession in the coming era of open mass communications technology.

    There is a thing called ‘the bubble’ that President Obama spoke of when he was elected. It is a widely acknowledged concept. The President of the United States is surrounded by secret service guards. Every word he says has an effect on millions of lives. Freewheeling press conferences are rare in this office these days.

    The president cannot go out for ice cream, it would cost hundreds of thousands of dollars in coordination. He is trapped in what is colloquially known as ‘the bubble’. The main thrust of the debate in the press in 2008/09 when he was first elected was that Obama was supposedly cognizant of this ‘bubble’ and that he wanted to keep in touch with the ‘real word on the street’. Something seemingly impossible from up on so high and insulated.

    Psychiatry has been living in a ‘bubble’ of its own making for some time. On the internet the bubble gets burst. In semi-mainstream books, like Whitaker’s, the ‘bubble’ gets burst.

    The almost impermeable machinery of establishment psychiatric journals, professional prestige, drug company influence, and professional hubris, and mainstream media unquestioning access, have insulated psychiatrists from facing the discontent growing in society about their profession. The internet smashes that.

    The internet smashes lots of illusions in society.

    When I re-read every 130+ comments here, this is what I thought.

    I’m sharing my thoughts. Others are sharing theirs. In this particular ‘politics is personal’ debate, bubbles are going to be burst. Don’t get too upset. Madinaerica.com will continue bursting bubbles.

    You don’t want to be inside a bubble, so that’s why you’re here. When I saw the title ‘coercion’ of this article, I clicked on it. I clicked on it because I wanted to hear what the author had to say. That’s common ground right there. I wanted to at least hear the author had to say. So did all of you who clicked on this. You read the comments, because you wanted to hear each person’s take. That is what draws us together. You are reading this, because you are choosing something fresh and new, something outside the ‘bubble’.

    Sometimes it is a fine, fine string that draws us together indeed. But you and I are all clicking on this, so it must be natural, it must be human, our shared minimum desire to come together.

    Clicking on madinamerica.com stories is not a symptom of a brain disease.

    I don’t see why any other human choice, behavior or thought that leads to clashes needs to be seen as one, or worse, forcibly defined as one by government force.

    But I’ll let the battle of interpretations continue, it will anyway.

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    • Thank you for this deeply thoughtful comment. I will admit to rushing through it (girlfriend and weather await) but I look forward to taking it in more deeply tonight. It is yet more evidence that we are creating something meaningful here. Thank you again.

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    • I agree with Kermit. This is deeply moving. Perhaps it could be posted as a blog so that others see it. To be clear, I have not felt personally attacked. I know that I chose a provocative title. You are right – I do not know you and neither of us knows what would have been the outcome if I had had the privilege to meet you in your time of distress. I think it is my obligation to listen to you and others who have had your experience precisely because of what I do.

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  30. ‘That era is over. The internet has smashed the egg. Powerful earth shaking repercussions await this unfortunate profession in the coming era of open mass communications technology.’
    …
    ‘Since this will be off the main page soon, and into the abyss that as go all posts that are no longer on the main page’
    ——–
    The egg is not smashed. The second comment is closer to the truth – just extend it. This site is a disposable memory hole as everything on the net is. It can all disappear with a single mouse click or all the effort of thousands of experts can be obviated by a single 30 second clip on MSM TV. The media is all powerful and a cartel of economic fascists still control the media and the political process. The mainstream media is one big organized lying machine (as Orwell said) and firmly pulls the stings of the thoughts of the public in a 24/7 assault on their rationality.

    I’m afraid the DSM-5 needs a new category “Political-Economic Sockpuppet Disorder’ – then they cold dope 98 percent of the population – but that is one that the APA definitely doesn’t want to cure, it’s the disorder they thrive on.

    The people here , even if they represent 50-90 percent of the population , don’t have power. If they ever in any way became a threat to established doctrine, as a group their voice if not their actual lives will be crushed like ants.

    About 95 percent of the people are totally oblivious to the fact that they live in a country run by economic fascists that own the democracy, own the wealth own the media and won the person and everything they have – including their thoughts and opinions.

    The point is that the psychiatric kool-aid is a subset of the political kool-aid which is a subset of the entire media kool-aid. The country that most people think they are living in doesn’t exist, it’s an illusion. How can they help ‘psychiatric people’ when they cna’t help themselves? The ordinary people the 99.5 percent are under the jackboot, they have no idea of what has been taken from them, they have been dis-inherited from their historical birthright and entitlement to wealth, prosperity and freedom.

    In light of this: deceits with in deceit, illusions withing illusions, lies within lies, fascism within fascism – the psychiatric victims are the lowest of the low. The whole system needs to be toppled before they can be free.
    …
    Myself, I would never want to fight against the power of overwhelming fascism – it’s a waste of time especially not in country where the majority of it’s citizens through propaganda a indoctrination are actively participating in their own repression. When they own the propaganda system, they own the country.
    However, there are many other things that can be done like sharing information building a ‘cure methodology’ data base , saving individuals – maybe creating an underground railway to get people out of the state or country or keep them in ‘safe houses’ where they can be cured or at least live free and un-violated etc etc.

    —>
    ‘But she’s not, she’s here, on madinamerica.com engaging, to a lesser or greater extent, with the readership here.’
    …
    Nope. That’s not the article I just read. She’s an apologist for the system. She’s saying there is nothing else she can do and she presents herself as a ‘hero of the people’ struggle for wonderfulness’ however her article is totally oblivious to everything she could do on a human level for others, like actually contacting people in their inner world. Oops ! I forgot they have no inner world (The brain disease model say so)- that’s what she is saying in her article -that is the premise behind everything she wrote – she has deliberately missed the key piece of the situation – the inner world of the afflicted. It’s strange, because everyone else that wants to can seem to contact that inner world. How did she miss it?

    —>
    ‘Keeping someone safe is one thing, forcing toxic substances into there bodies is a whole different story. Prisons have for decades provided humane care to people without resorting to violence or forced drugging, in many places in the world. How is it that you as psychiatrists are not able to keep a person safe without abusing them?? ‘
    —>
    Yeah that says it. Furthermore it’ not just toxic substances,it’s chemical lobotomies.

    Can the medicated person ever:
    Be angry, furious, depressed, happy, joyous, extremely relaxed. sorrowful , sad unhappy etc. and feel these things intensely and express them well.
    No.
    Do they ever have a chance of getting there?.
    NO.
    Did they ever feel these things before medication.
    Quite possibly yes. And even more likely in states of psychosis – they just weren’t working well – false starting,blocked.
    That’s not theory. That’s from my experience.
    And that’s my experience of medication as well.
    (Wow! What an idea actually asking people who have been there about their experience.)
    …
    BTW, I was cured before forced medication.
    I can tell you from my current POV as a real person – I rather have been killed than be forced to live medicated for the rest of my life. To live an entire life medicated as a confused non-human you have merely sent the psychosis from the outer world, frozen it and internalized it inside the person. The only reason for not euthanizing medicated people is they still have hope to be free , they can still go off their medications.

    So a medicated person is a murdered person.
    …
    “Sorry , that’s the best we can do for you right now is murder you, and you DO have to be murdered because no one has any time to speak to you or give you therapy besides we know your brain is empty so it’s no point anyone trying to interact with you. Maybe someday science will invent a drug cure to make you into the perfect well behaved ‘Spock-like Vulcanite’ with no side effects (but if if was a real cure the inventor will be buried in a freeway).

    —->
    ‘No one wants to hear voices in there heads telling them to kill someone.’

    Silly. I liked my voices. ‘Everyone’ was so interested in me – it made my day- they alway let me know how I was doing and they were never violent – why should they be? I wasn’t. You people should watch your assumptions. Also, making voices go away has nothing do with curing SZ, voices are a person’s own thoughts, accepting them is useful – voices are not a problem – dissociation is and whatever it was that generated the fear the caused the dissociation is the bigger problem.
    Symptoms are driven by deep seated fear and anxiety, its an error to think that the fear all comes from having the symptoms. Accepting and understanding the process changes the process – that’s certainly something that people can do for others.

    …
    For that matter for all you brilliant professionals out there, you must have tried bioenergetic therapy to help schizophrenic generate anger.
    Right?
    Right?
    It seems a good forward anger rush could really kick start an emotional system. And of course I know you brave self-sacrificing peeps are not scared of rolling up your sleeves, being fiercely confrontative with emotional armour or getting all dirty with the anger or even letting yourselves be emotionally involved so that the other person can have an example and have something ‘real’ to react off.

    Right?
    Makes sense?
    No? there’s a rationalization coming?

    Wait,Wait…
    Don”t tell me! You didn’t try it yourself?????
    What! You have not been tested in a process of critical self-inspection and had your ego and emotions stripped to the bone and laid bare in a group confrontative process?
    Holy boom bats!
    And yet you people ‘treat’ others for illness?
    ..
    I’d like to know more about that bioenergetics thing failed, it seem such an obvious shortcut. It worked for me. Did I get it all wrong? Does it only work on .001 percent of the population. Maybe so.
    But it was all thoroughly tried right?
    Point me to the case studies please. Show me the efforts. Where is the documentation? (heh… probably buried under the freeway with the inventor of the med cure for Axis I)

    –>

    “Would you volunteer your own home as a respite center?”
    ….
    wow! Hey That is my idea I was about to post. But this way – take that high salary buy a split house – in the other half of it host 1–20 schizophrenics or other Axis I patients – donate 4- 5 sessions a week of group psychotherapy 1.45 hrs long each. Just spend five years at it and you will have learned how to start curing people – whatever works use it – follow no limits in methodology. . When you finally learn to accomplish something – have 2 – 4 groups going on simultaneously 3 times a day as a teaching center where others can learn you new technique.
    OK , Then you will be a hero, and you can have the peoples award for self-sacrificing service to humanity.

    The psychotherapist-psychiatrist that cured me, the Holocaust survivor, he did pretty much what I just described, except patents didn’t live at his house. His house , half of it was separated with office , waiting room and two therapy rooms – he could run two groups simultaneously three times a day and weekend marathons with the help of trainee and senior therapists.
    And he cured me without ever using the word ‘cure’ or ‘diagnosis’ and probably cured many others but he died and the torch was lost.
    I’m looking now to see if there are any other torches out there and I am quite disappointed.
    If he could do it , why can’t anyone else do it now.
    (answer- insurance companies , the DSM, the APA, government collusion and a behemoth propaganda machine).

    …

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  31. You say ‘force people into hospitals’. Why would you do that? Ever tried the arts of persuasion and dissuasion,and if they fail, getting the police involved?

    If dangerousness is to be used as a criterion for involuntary nominal hospitalization in one of your nominal hospitals, then it must be applied equitably. There is one problem for you in this line of argumentation, and that is that all the psychiatrists would have to be locked up with us. I’ve known a lot of ‘schizos’ in my time, I’m supposedly one of them, none of them pose the same kind of threat the average psychiatric rapist does. We are in the presence of an enormous double standard. No matter how you try, you cannot consign to oblivion the obviously discriminatory nature of mental health laws.

    As for the comment about some of the individuals ending up in jail if they weren’t committed, psychiatric hospitals are carceral institutions as well. When I was in hospital, in the UK mind, I couldn’t leave for months, stuck in that cesspit with lights. We couldn’t even watch films rated eighteen, which is symptomatic of the kind of the systematic infantilisation of the patients that goes on these wards. Being something of an aesthetic epicurean, I used to put foreign films by directors like Bergman, Mizoguchi and Tarkovsky on, and they banned me from watching them in the lounge in the end, before this sometimes coming into the room in groups and boorishly guffawing at how much more tasteful I am than the stupid, degenerate, spiritless non-entities.

    When they told you get up and wash, you had to do it, even though you were quasi-lobotomised by the drugs. They could even put you in ‘intensive care’ wards, which is psychiatric newspeak which roughly translated means intensive control, punishment and surveillance ward. Even in jail they don’t regiment your life to that degree, and if you broke the rules, such as taking illicit drugs, you had to have pee-test and they would treat you like a wicked child, saying ‘aren’t you ashamed of yourself’, the gits.

    The ability to predict dangerousness of all people is low. Either psychiatrists infer way too much from what patients say, or they make the fundamental attribution error, blaming a person’s threats or wildness on some internal problem when a lot of the time people are just metaphorical foxes surrounded by hounds. Human beings are like foxes; when surroundeded by hounds, or individuals seeking to deprive them of their freedom or sovereignty over their own bodies, they bare their teeth, though this is rarely if ever factored into the equation by psychiatrists, their lackeys and family members.

    If you are circumspect about the risk of medications, then why do you administer to people against their will, or don’t you realize the moral implications of your actions? If I was to force someone to smoke marijuana, I would be demonised and treated as the lowest of the low, but the far more dangerous drugs of which the average psychiatrist’s drug-basket is made up of are suitable to be administered to some people in a procedure that is phenomenally consubstantial with literal rape, only the psychiatric rape victim is raped repeatedly with substances taht can damage your brain, turn you into a fat masochist, take decades off your life span perhaps, give you neuroleptic malignant syndrome, which I experienced with stelazine, and it was frickin terrifying. Yet this is only beginning to enumerate the multifarious ways in which the drugs can screw you up, one of the worst being akathisia, which makes you want to tie your head to a tree, get in a fast car, and accelerate!

    There can be no justification for such a monstrous iniquity. The coercive psychiatric force-druggist is the worst kind of drug-dealer, a dealer that rapes you with the drugs they have, whilst trying to convince you that they are the supreme arbiters of your best interests, which only compounds the indignation, because the psychiatrist is incapable of being honest with his/her conscience, so they create their own lexicon of self-legitimating self-deceptions, that sometimes contaminates the patients’ thinking on the matter.

    You say ‘it came with the job’. Then maybe your choice of career was an injudicious one. No one forces the hangman to be the executioner, he chooses. You have chosen, and must live with this moral compromise and live with the criticism it engenders or quit.

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  32. You tell them ‘A Howells’. Give ’em Heck.

    ‘of the kind of the systematic infantilisation of the patients’

    Oh yeah, I could tell stories, even as a volunteer citizen dropping off sweet cakes , I got seriously reprimanded for making jokes – saying ‘weird things’.
    Offensive beyond offensive both for me and for the others.
    …
    “They will make sure that we will not think weird things, we will have weird things flat-ironed from our skulls, we will be zapped no mercy, flat-lined zombified, staked out in the hot sun, wet-sheeted to our beds, electrozogrefried, de-metabolized til no more weird things exist in our brains even if it kills us.”
    ..
    Merciless intolerance.
    We will not suffer even if it kills us.
    Intolerance
    Intolerance to let us suffer.
    Intolerance to let us suffer living.
    ….
    These are my people, Me psychobat shaman medicine man, psychedelic seer of the Schizophrenic Tribe. I ghost dance on the freeway. We invented weird. Weird is ours! You don’t like weird, GTFO! Get out of town, “We will, we will, weird you!”
    ————
    I’m twigging on now. It’s the inner world. Madness is a door to the inner world, one door of many. Not a door anyone wants to go through but it’s the one we went through – drop kicked down the rabbit hole. There is a segment of the human race that keeps the doors to the inner world shut and locked. They don’t understand it, they are frightened of it, they have no empathy for it, they deny it exists. Everything in the inner world is garbage – get the torches and pitchforks – snuff it out.
    ————–
    I am terrified I will dissolve through the floor beneath my feet and plunge fourteen stories to my death , I can see myself falling. Yet I am standing, yet what can stop me from falling through the floor? I am terrified of my own imagination Everything in my imagination is real and everything real is in my imagination.
    ….
    What if I just blink out? I mean I’m here, I’m not , I’m not , I’m here.. and gone again.
    What if I blink out?…. I’m afraid.
    Blink.
    Blink.
    Did you see it? Can you see it? Was i here? Where did I go?
    Will I come back?
    ..
    I wake up. I woke up an hour ago. I didn’t wake up an hour ago. I am sitting in a chair, I am not asleep and I am dreaming. I can’t wake up and I can’t sleep.
    Everything is fragmented, a nightmare hours and hours, dreams without images,seeing without waking, awake-asleep.
    I stand up .
    On the dresser is a Valium.
    ‘Eat me!”
    ‘No, I won’t eat you. I want to wake up’.
    I scream.
    ——-

    It’s a BEOTCH to find out that reality is not real. I’m no talking about hallucinations or delusions. The mind makes everything. Whatever the mind understands is real.
    They got it all wrong. the reptiles got it reverso.
    Hallucinations and delusions are easy – they mean nothing. It’s reality itself that is terrifying, the essence that isn’t.
    Reality and nothingness. We live it in, but we never see it and never touch it.
    …
    Is that what the reptiles are afraid of? the slavering brain-jacketed crocodiles? The ones that hate us for where we’ve been and what we’ve seen? Is that why they want to slice out our brains?

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    • Hi skyblue,

      You’re Wired Weird?
      Me Too

      “Hallucinations and delusions are easy – they mean nothing. It’s reality itself that is terrifying, the essence that isn’t. Reality and nothingness. We live it in, but we never see it and never touch it.”

      Sky Blue: Peter Gabriel
      http://youtu.be/B7Jdo8e3erE

      So Tired, I’m Always Traveling
      So Many Miles Away From Home
      I Keep Moving To Be Stable
      Free To Wander, Free To Roam

      ((( What A Cry It’s Going To Be )))
      ((( If I Can Stop To Let It Out, Oh )))

      Would Ken’s Bureau of Bears be as wonderful as it was, if he didn’t have .verbal talent. to convey his life to the rest of us? I cried when I read his story. I loved him, in an instant. I Did Not see a “sick” man. Immediately, I thought of Birdy: http://www.imdb.com/title/tt0086969/

      When it’s “Art” … it’s okay. When we claim it’s our “Real” life … it’s not okay.

      Art is a shield. We’re able to say and do things, under the protection of “Art”. It’s so much more acceptable this way. When I want to read a True Story, I visit the “Fiction” section. How about any of you?

      I worship the Law of Gravity. I wake up and everything is, amazingly, still in it’s place. The kitchen table stays exactly where it’s supposed to. But sometimes, things happen. Weird things. Most humans won’t accept weird things, unless they’re categorized in the “Fiction” section of life. THOSE people are devout worshipers of the Non-Fiction section, and all I can do is giggle at them.

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  33. I am a veteran with at I history of severe depression and suicidal ideation, but I always ask for help when I start having these problems. Once the VA refused to admit me and so I cut my wrist in their bathroom. After stiching up my wrist they still refused to admit me and I swallowed a bottle of antidepressants in the ER right after they handed me my belongings. On May 13 I was hospitalized for SI. I have been the victime of a brutal crime in which I was lured to a remote area and strangled followed by captivity for. Several days by an aquaintance. I am also transgender and suffer from anxiety after being assaulted by a police officer in Feb. Once I reach inpatient status my thoughts of suicide go away because I know I am safe. That Sunday I wasn’t safe though from the staff. At the VA patients have the right to wear their own clothing unles the treating physician and the chief of staff agree that should be restricted on an individual basis by law. My VA has been violating this policy requiring all psych patients to be in Pajamas provided by the VA. Well, that day I was done submitting that policy. I said they could search my cloths for controband or dangerous cords but I wanted them back. They demmanded that I change and when I again refused they had me placed in lawenforcement handcuffs then they cut my clothing off in front of all the staff! Men and Women! In minnesota it is only legal to use restraint when a person is an immediate threat to themselves or others. I was calmly sitting on my bed in my single room. I filed a complaint with the OIG and tomorrow I will be getting in touch with the Minnesota Disability Law Center. Psychiatrist have a huge amount of power! Sometimes that power destroys lives!!!

    Emily

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  34. In a 2003 study, Karen Cusack et al. surveyed people with histories of psychiatric hospitalization and found that 47% of them reported having a DSM-IV-defined traumatic experience while in hospital. There has been some attention paid in recent years to making hospitalization more “trauma informed,” in some quarters, but I am not aware of any formalized effort to quantify the risk of trauma in the hospital setting and incorporate that information into a risk-benefit analysis of involuntary commitment decisions. As far as I’m aware, every other branch of medicine explicitly considers the risk of an adverse outcome vs. the potential benefit for a given intervention, except involuntary commitment decisions.

    Karen J. Cusack, B. Christopher Frueh, Thom Hiers, Samantha Suffoletta-Maierle, and Sandy Bennett. TRAUMA WITHIN THE PSYCHIATRIC SETTING: A PRELIMINARY EMPIRICAL REPORT. Administration and Policy in Mental Health, Vol. 30, No. 5, May 2003.

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    • Thanks for that info. It’s very hard to find any studies on this subject, apparently psychiatrists are not interested in verifying if their coercive measures really “save” lives and improve people’s outcomes.

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  35. All statisticians and suicidologists agree that we cannot predict any individual person’s likelihood of completing suicide with any degree of accuracy. Yet the common perception of most mental health care workers, judges, and the general public is that a person deemed a danger to themselves under the law is at least more likely than not (>50% chance) to die if not hospitalized against their will. The statistics tell another story.

    NIMH reports that about 1% of the adult U.S. population made suicide plans in 2008. There were 228 million adults in the U.S. in 2008, resulting in an estimate of roughly 2.3 million adults who made suicide plans that year. Under most state laws, making a suicide plan (even if never attempted) is sufficient evidence of dangerousness to justify involuntary commitment. In some states, the mere act of writing a suicide note within the past 30 days – including one that was never followed by an actual suicide attempt of any sort – is considered sufficient justification by the courts for a finding of imminent dangerousness (see for example http://www.pacode.com/secure/data/055/chapter5100/s5100.84.html).

    Compare this with the fact that there were about 36,000 completed suicides in 2008 (for all ages, not just adults). Compare 36,000 to 2.3 million, and you will see that the probability of an adult who attempted suicide in a given year actually completing the act is less than 1 in 63. This means that if you randomly pick an adult who attempted suicide in 2008, there’s less than a 2% chance that the person is actually going to be one of the ones who die from suicide – in the entire year, not just in the timeframe of an involuntary commitment. If you calculate out the risk of suicide on a daily rather than yearly basis, either on the basis of equal odds per day, or some kind of hazard function that models a cumulative risk over time, you can end up with statistics showing a 1 in 1000 or lower probability of any given recent suicide attempter truly having their life temporarily saved by a coercive psychiatric intervention on that particular day.

    So basically, when an involuntary commitment decision is made on the basis of a person having made a suicide attempt, the psychiatrist making the decision can be much more than 98% sure that the person is not actually going to succeed in killing themselves no matter what they do. This risk profile is completely at odds with the perception (voiced by many psychiatrists and the general public) that involuntary commitment decisions “usually” get it right and that the coercion is therefore justified for the benefits it brings to society, even if “a minority” of people actually suffer more than they benefit from the process.

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    • Not mentioning that the trauma of coercion can cause suicidality (speaking from experience here) so it’s likely at least cancel out any potential benefit if not actually turn it into net loss of life.

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    • Exactly. Steingard makes the error of separately personifying ‘his voices’ here. Part and parecel of being an ‘expert on states of mind you’ve never experienced yourself’. If someone is talking to himself, he doesn’t forfeit his right to own his own body.

      In the criminal justice system they reserve the needle for serious crimes like murder.

      In the forced psychiatry system the needle is the first resort of the STFU and stop thinking, saying, doing, things we don’t like brigade. It’s inhumane. Torture.

      The key giveaway in the phrase ‘screaming obscenities’, is that the speaker is actually proposing a human rights obscenity in response. What is more obscene? The domination of the stranger’s biology by the forced psychiatrist? Or curse words?

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  37. “I am also a psychiatrist who sometimes forces people into hospitals against their will. I have patients who are on court ordered outpatient treatment and this may include the requirement to take medications that I prescribe.”
    In other words you’re abusing people and violating their human rights (forced psychiatric “treatment” is torture – even UN has recognised that).
    Have you ever experienced rape? Have you ever gone through the nightmare of physical assault, kidnapping and incarceration? Any of these awesome “treatments” on their own are enough to inflict life-long trauma and PTSD and you’re doing it to people who are already in deep problems.
    What would you tell a person who told you they feel victimised by you and raped and tortured? Are you going to excuse yourself and say “I did it for your own good”? Why do you think you have a right to these decisions? Are you prepared to take the responsibility for ruining someone’s life and maybe causing them to kill themselves (I am not over dramatising – I tried to kill myself because of the “treatment” you’re defending). Do you have any proof that what you’re doing has any benefit to anyone (as far as I know there is no research showing that coercion helps people recover or prevents suicide and violence)?
    “If someone is screaming obscenities all night at his voices is it better that he get jailed for disorderly conduct or put into a psychiatric hospital?”
    I’ll take prison anytime. For every “crazy schizophrenic with a knife” there are plenty of people who never did anything wrong and the worst they did was hurting themselves. And even for the “crazy schizophrenic with a knife” there are better ways to persuade him to accept help without the need of coercion. I was served better by a policewoman who took an hour of her time to sit down with me and talk sitting at the curb than any of the psychiatrists I’ve met.

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