‘I’m severely depressed.’
These were the words that Donesha*, a 35 year-old African American woman repeatedly uttered to me. I was a medical student in the psychiatric emergency room of a large County Hospital. She was my patient.
She told me she had felt like this for a week or so. I asked her if she had any other symptoms of depression. Did she feel more tired than usual? Did she experience joy out of life? Did she find it difficult to focus? Did she feel like going to sleep and never waking up? She had few symptoms of depression, was not suicidal, and was able to work and look after her 3 children. Still, she maintained, ‘I’m severely depressed’.
We talked further. She told me that she had turned 35, and thought she would be further along in life. But here she was, still single, still trapped in the same job. It made her unhappy. But this wasn’t the place for her. The psych ER was for the violently psychotic, the despairingly suicidal, the intoxicated aggressive. It was not a place for minor depression, and certainly not common unhappiness.
I discussed the case with the attending psychiatrist. I wanted to know how to fill out the paperwork, confident she had no psychiatric diagnosis.
‘Put mood NOS.’
Mood Disorder, Not Otherwise Specified, I mumbled. How could I diagnose her with a mood disorder when she had none? The answer was it was necessary for reimbursement. Here, in the County’s repository of madness, was a woman who was not mentally ill. Far away from the psychiatric emergency room, in the American community at large was an apparent epidemic of mental illness, unrecognized and untreated, that had been uncovered.
In 2005, amidst the devastation of Hurricane Katrina, the jubilation of the first free elections in Iraq, and the horror of Terrorist attacks in London, the results of a study in mental illness were quietly erupting. The National Comorbidity Survey-Replication, a large nationally representative household survey, including more than 9000 participants had found that Americans, in the course of their lifetime would be as likely as not to experience at least one mental illness. Fully 1 in 2 Americans, the study suggested would have a mental disorder at some point in their lives. This was not the first study of its kind, but it was the most up to date. In 1994, the same investigator, Dr. Ronald Kessler, a Professor of Health Care Policy at Harvard Medical School had published the results of a similar study with almost identical results. The 2005 paper had merely replicated the results using the most recent criteria in the latest edition of the American psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The story does not end there. Dr. Kessler and his group, in a re-analysis of the data from the National Comorbidity Survey Replication have upwardly estimated the prevalence of mental disorders in America – they estimate 57.4% of Americans can expect to meet the diagnostic threshold for at least one mental illness. Many, 27.7% to be more specific, will have 2 or more mental illnesses.
What do the results of this survey mean, and, does it even matter? To be sure, cancer and heart disease are also common. For a comparison, 1 in 3 Americans can expect to have cancer at least once in their lifetime, 1 in 4 will die of cancer. Similarly, roughly 1 in 3 will develop heart disease in the course of their life. Taken in this context, perhaps there should be nothing unsettling about viewing mental illness as common too. There should be nothing inherently suspicious about these numbers, and yet, the first reaction of many is one of incredulity.
Can mental illness really be that common? If we are more likely than not to experience mental illness, what value does the term even have? Has there really been a dramatic rise in mental illness in America? These are some of the questions that you might begin to ask. They are certainly pertinent questions. Criticisms abound: mental illness is over-diagnosed, we have become to quick to seek a pill for every ill, doctors have become too quick to acquiesce, pharmaceutical companies too greedy. These may all be true, but none of them apply to the results of this study, which looked at distribution of mental illness in the community, many of who had never been diagnosed by a mental health professional.
Others criticisms surface: we keep inventing new mental illnesses, we keep redefining the boundaries between mental health and mental illness, the supposed increase in mental illness represents what would have been seen as minor misery in the past. Those who believe there has been an increase in mental disorder retort that life is more stressful, diagnostic surveys reveal the hidden depths of the epidemic of mental illness, that we are aware of disorders we weren’t before, and minor mental health problems take their toll on the individual and society. These illnesses can and should be treated. These arguments get to the heart of the numbers. They address their significance in a country where more than 50% are believed to suffer from mental illness in their lifetime.
There have been many books that have looked at the creation of mental illness, how psychiatry and the pharmaceutical industry have medicalized and psychologized normal behavior, or problems that are moral, spiritual, even social in nature, for pecuniary gain. These texts tend to begin with the American psychiatric bible – the DSM. They note how the first edition in 1952 had only 106 diagnoses, a relatively slender volume at 130 pages. By the time of DSM-III in 1980, where there was major departure from the original format, the number of included diagnoses proliferated to 265, fleshing out the volume to 494 pages. DSM-5 is about to make its appearance, and with it, many diagnoses also make their debut. With new diagnoses comes new research funding, and new treatments, the most lucrative of which are almost always drugs. But the story doesn’t start there. Other books look at how the explosion of apparent mental illness coincided with the drugs revolution in psychiatry. But the story doesn’t start there either.
The belief that we’re all crazier than we like to think, that the boundaries between mental health and mental illness aren’t as clear cut as is often made out is not a recent phenomenon. Rather, it started over 100 years ago. In 1909 a neurologist by the name of Sigmund Freud stepped foot on American soil to deliver lectures on his theory of human mind and behavior and its associated talking cure, psychoanalysis. Freud’s views and those of his disciples were to dominate American Psychiatry for almost half a century. Among these views were the fluidity of the boundaries between mental health and illness; that we were less aware of our motivations than we realized, and importantly, as the title of one of Freud’s works put it, there is a psychopathology of everyday life. When psychodynamic psychiatry declined and biological psychiatry became the ascendant model in American psychiatry, because it was wedded to making diagnoses in the same way other medical specialties used diagnoses to assert expertise and moral authority, it became necessary to create new diagnoses and revise the threshold for the diagnosis of existing disorders. Biological Psychiatry was enabled by a symbiotic relationship with the pharmaceutical industry, which, from the 1950s onwards had profited handsomely from public interest in the new medicines for their psychic woes.
There is one actor that is frequently ignored, conveniently forgotten, accidentally exonerated. It is ironically the character that has the largest role, the most to answer for. It is American Society itself. Psychiatry, whether psychodynamic or biological, whether using psychotherapy or medication, whether in the 1950s or today, by focusing on the individual, provided deflection from the most difficult questions of all. Was it something about the structure of American Society itself that was causing so much unhappiness? Was psychiatry the solution to most of this unhappiness? What was it that made Americans so eager to turn to the mental health industry for help with their psychic angst, be it on the couch or on repeat prescription? Is our co-option of a psychiatric discourse to explain misery prevalent in America making us ill?
In a century of tremendous social, political, and economic upheaval that would leave American the only legitimate superpower on the world stage, it became more convenient to displace to the source of misery onto the individual than to question the structure of American Society itself. What no one quite imagined was that the mental health industry would become unstoppable, with seemingly no end to the situations that could make us mentally ill, no person too well to benefit from therapy. Eventually the mental health industry became a poisoned chalice, rather than deflecting from society’s failings, it added to them. America became paralyzed by an apparent epidemic of mental illness, an epidemic it had created, but could no longer control.
*Name and Identifying details changed to protect confidentiality.
Interesting piece.
This quote:
“Was it something about the structure of American Society itself that was causing so much unhappiness?”
Can lead to some interesting discussion I think. Yes, would be my short answer. Let me broaden your question this way and ask, “Is there something about the nature of human beings that was/is causing so much unhappiness?” Again, my short answer is “yes.”
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David Bates
on June 13, 2012 at 7:12 pm said:
Its what I meant about trying to understand the cultural history that has led our Western minds into a mechanical cause & effect logic. Can we really look at the history of psychiatry without paralleling a history of the culture in which it is “immersed?”
I agree Doctor Datta, its a brilliantly insightful essay.
It would have been even better if you’d added some explanations to the keen insight. Consider;
“The societal projection process: The family projection process is as vigorous in society as it is in the family. The essential ingredients are anxiety and three people. Two people get together and enhance their functioning at the expense of a third, the “scapegoated” one. Social scientists use the word scapegoat , I prefer the term “projection process,” to indicate a reciprocal process in which the twosome can force the third into submission, or the process is more mutual, or the third can force the other two to treat him as inferior.
The biggest group of societal scapegoats are the hundreds of thousands of mental patients in institutions. People can be held there against their wishes, or stay voluntarily, or they can force society to keep them there as objects of pity. All society gains something from the benevolent posture to this segment of people. A fair percentage of people are too impaired to ever exist outside the institution where they will remain for life as permanently impaired objects of the projection process.
The conventional steps in the examination, diagnosis, hospitalization, and treatment of “mental patients” are so fixed as a part of medicine, psychiatry, and all interlocking medical, legal, and social systems that change is difficult. There are other projection processes. Society is creating more ‘patients” of people with dysfunctions whose dysfunctions are a product of the projection process. Alcoholism is a good example. At the very time alcoholism was being understood as the product of family relationships, the concept of ‘alcoholism as a disease” finally came into general acceptance.
There might be some advantage to treating it as a disease rather than a social offense, but labeling with a diagnosis invokes the ills of the societal projection process, it helps fix the problem in the patient, and it absolves the family and society of their contribution. Other categories of functional dysfunctions are in the process of being called sickness. The total trend is seen as the product of a lower level of self in society. If, and when, society pulls up to a higher level of functioning such issues will be automatically modified to fit the new level of differentation. To debate such a specific issue in society, with the amount of intense emotion in the issue, would result in non-productive polarization and further fixation of current policy and procedures.
The most vulnerable new groups for objects of the projection process are probably welfare recipients and the poor. These groups fit the best criteria for long term, anxiety relieving projection. They are vulnerable to become the pitiful objects of the benevolent, over sympathetic segment of society that improves its functioning at the expense of the pitiful. Just as the least adequate child in a family can become more impaired when he becomes an object of pity and over sympathetic help from the family, so can the lowest segment of society be chronically impaired by the very attention designed to help. No matter how good the principle behind such programs, it is essentially impossible to implement them without the built-in complications of the projection process.”_Murray Bowen.
Consider more “fearless” thinking from the 1950’s and its reaction-formation to the enormous carnage and loss of two world wars?
“INNATE AFFECT/EMOTION & SOCIETY:
Because the free expression of innate affect is extremely contagious and because these are very powerful phenomena, all societies, in varying degrees, exercise substantial control over the free expression of the cry of affect. No societies encourage or permit each individual to cry out i.e, rage or excitement, or distress or terror wherever and whenever they wish. Very early on, strict control over affect expression is instituted and such control is exerted particularly over the voice, whether used in speech or in direct affect expression. (p, 93)
If all societies suppress the free vocalization of affect, what is it that is being experienced as affect? It is what I have called backed-up affect, it can be seen in children trying to suppress laughter by swallowing a snicker, or by a stiff upper lip when trying not to cry (anti affects?) or by tightening the jaw to suppress anger. In all these cases, one is holding one’s breathe as part of the technique of suppressing the vocalization of affect. (p, 93)
We do not know what are the biological and psychological prices of such suppression of the innate affective response. It seems at the very least that substantial psychosomatic disease might be one of the prices of such systemic suppression and transformation of the innate affective responses. Further there could be a permanent elevation of blood pressure as a consequence of suppressed rage, which would have a much longer duration than an innate momentary flash of expressed anger. (p, 94)
Even the least severe suppression of the vocalization of affect must result in some bleaching of the experience of affect and therefore impoverish the quality of life It must also produce some ambiguity about what affect feels like, since so much of the adult’s affective life represents at the very least, a transformation of the affective response, rather than the simpler, more direct, and briefer innate affect. (p, 94)
With anger the matter is further confused, because of the danger represented by this affect and enormous societal concern about the “socialization of anger,” what is typically seen and thought to be innate is actually backed-up. The appearance of the backed-up, the simulated, and the innate is by no means the same. (p, 94)
Details of the difference in socialization concern, differences in tolerance or intolerance of the several primary human affects – excitement, enjoyment, surprise, distress, contempt, shame, fear and anger – which in turn determine how positively or how negatively a human being learns to feel about themselves and about other human beings. Such learning will also determine their general posture towards the entire ideological domain. (p, 168)”
Exerts from “Exploring Affect,” (1995) by Sylvan Tomkins.
Perhaps its “age” thing, because you were yet to be born when this fearless thinking came to fruition? Consider the above though and whether “enormous societal concern about the socialization of anger,” leads us into police training for those, “pitiful objects of the benevolent, over sympathetic segment of society that improves its functioning at the expense of the pitiful?”
Yet of coarse, we are self directed intelligent and insightful human beings.
Be well Doctor, be fearless in your thinking.
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The usual endless mantra from psychiatrists who are slightly critical of the profession, who steadfastly believe that when they throw around the word ‘psychotic’ they are referring to an objective and legitimately ‘medical’ ‘thing’, and then gives us some criticism of ‘over’ medicalizing sadness in others whom they deem not to be so ‘objectively’ deserving of medicalization.
All the while reminding us that the set of keys and violently injected syringes they wielded in the psych ward were there to lock up and forcibly drug the ‘legitimately’ medicalized people. People denied so much as a court hearing we need to remember, since he comes from Britain where those imprisoned and forcibly drugged and labeled by British psychiatrists are all denied their day in court.
The author is also a big government public healthist. In a recent blog, he absurdly claims that the smoking bans, salt bans, and sugar drink bans of the public health movement, are in fact ‘safeguarding our freedom’.
It’s also worth pointing out he wrote a completely insightless piece about ‘brief hospitalisations’ being the reason more people kill themselves. He makes absolutely no mention of the brutality and coercion that so decimates peoples’ lives during their time detained in forced psychiatry being a reason people kill themselves in the first week of release.
Another one he wrote on why choice in healthcare is a BAD thing…
http://canardtheduck.blogspot.com.au/2012/05/tyranny-of-choice-or-why-markets-do-not.html
A Harvard ‘public health’ graduate, the author has said this about ‘public health’:
“I had no illusions about the status about public health when I chose this path. I am sure my colleagues knew this too. My contention is that the marginalization of public health, by society, and by Harvard itself, is symptomatic of a world that does not appreciate what really matters. For public health offers nothing less than the possibility of freedom. Freedom not simply from infirmity or disease, not only from suffering and distress, but freedom from poverty, inequality, and social exclusion, freedom from intolerance, greed, and hate. Public Health provides the possibility of looking beyond the inevitability of death and focus on the experience of life. ”
He seems to believe banning sodas and forcing smokers out into the cold night, is the very definition of liberty itself. He seems to believe the uproar of over Mayor Bloomberg’s soda banning policy the other week was just a misguided response from people who don’t understand that ‘public health offers nothing less than the possibility of freedom.”
Biological psychiatry and public health, two specialties with a historical and contemporary contempt for individual liberty.
All blog quotes can be found at his blog. MIA only allows the posting of one html link.
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Yeah, as if the word “psychotic” in itself was proof of the concept’s validity, isn’t it.
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Medicalizing the human condition, has been increased due to the increase of pharmaceuticals availability brought to us by pharma’s heavy hitting marketing of psych meds in magazines (even Abilify was advert in the Rolling Stone,and on the side of a public phone booth)Americans in general want easy fixes for life problems and situations, and your example of the woman in the ER seeking help for her life situation and calling it “depressed” is my example of who buys into this entire marketing scheme and doctors beyond psychiatrists (PCPs) offering people anything from antidepressants, to benzos and antipsychotics such as Seroquel for off label sleep aid use. I feel it’s out of control, and now kids who are just toddlers are being medicated, our country has lost its way. It’s time to take it back and embrace the human condition for what it is, full of emotions that are and can be varied. Life happens, people grieve, and many suffer hardships. This is not new! many people have parents or grandparents that can describe living in the Great Depression. There weren’t Abilify ads offering them treatment as an add-on depression treatment! there weren’t ads with sad blobs offering them Zoloft!
There is NOT a mental health epidemic in America, instead America’s lifestyle and culture exhibit what we are: greed, gluttons, wanting east answers, promoting use of stims to get good grades, drugging children younger and younger, drugging the elderly in nursing homes with antipsychotics….. the alarming increase in childhood diabetes comes as no surprise to me, if the statistics were to include whether or not the child was on a prescription med, an antipsychotic at any time, I think we would see a pattern. What are we teaching our children? to take meds for any medical or emotional issue that comes up? there will be no baseline for that child any longer once on psych meds, no doctor will be able to tease out the child’s personality vs medication side effects which can be agitation and aggression.
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I am currently conducting a survey of sorts— checking out the books on the shelves of local libraries in the Boston area that have been written by the leading pediatric psychiatrists and their disciples for parents, teachers and caregivers. So, I am surveying ‘public education’ , which many would agree is the foundation for promoting public health. I am finding rather astounding evidence of the psychopathology of Associate Professors of Psychiatry at Harvard Medical School. Perhaps this is an area where an MD with a M.P.H. would find a challenge worthy of his credentials– to protect the public- mainly children and to put academic medicine on notice for its role in creating the most serious threat to the well being and the very lives of children.
Exhibit A : “Straight Talk about Psychiatric Medications for Kids” by Timothy E. Wilens MD- Assoc. Prof of Psychiatry. HMS – specializing in pediatric and adult psychopharmacology in his clinical work at Mass. General Hosp. Remember when psychiatrists were denying that they propagated the myth of biological causes for mental illness—after Robert Whitaker’s book “Anatomy of an Epidemic” drove home the point that there was no scientific evidence for “chemical imbalances” or ‘brain disorders’ that were supposedly ‘restored to normal’ via psychotropic drugs? Well, Dr. Wilens put the myth IN PRINT on page 14 of his book published in 2009. On page 15, Dr. Wilens continues his ‘public education’ to assist parents who must explain to their child that his/her ‘disorder’ is not due to a personal failing or weakness:
“Say that this problem is largely physical in the same way that Aunt Alice’s asthma is physical or Daddy’s high blood pressure is physical…. medication is a possibility, tell your child that it’s no different from the inhaler that helps Aunt Alice breathe or the pills that keep Daddy’s blood pressure under control.”
on page 25, Dr. Wilens lectures on specific psychotropics in the stimulant and antipsychotic classes that are , “indeed, FDA approved for use for behavioral problems in kids 3 years and older.” after letting it slip at the beginning of this paragraph that ; “There is no question that we are using medications that have not been extensively tested in preschoolers. however, for the most common problems identified among preschoolers, the field does have some data available, and more studies are currently underway.”
Guess what? there are no foot notes! No references to any ‘scientific studies, data, resources’ ON ANY OF THE 271 PAGES OF THIS BOOK. Evidently there are no longer interns and residents doing research for the eminent Harvard Psychiatric Professors who are publishing—- everything from outright falsehoods to seriously misleading information regarding the SAFE USE of psychotropic drugs for preschoolers—and up!!!
On page 94 Dr. Wilens puts the issue of FDA black box warnings for SSRI to rest. He asserts, on his own personal authority (recall—no foot notes in this book!);
” One ongoing issue you should be aware of concerns the finding that adolescents and children taking SSRIs for depression have shown a small increase in suicidal thoughts and behaviors (but no actual suicides), resulting in the addition of a “black box warning” on the package labels for these medications. since October 2004, when the warning first appeared, the suicide rate has actually risen substantially as SSRI use has decreased. This trend suggests, as many experts predicted, that the risk posed by the medication may have been lower than the risk posed by depression untreated by effective medications.”
Should we believe this because it is the WORD in PRINT of the eminent Dr. Wilens of HMS fame??? Or perhaps just take heart in his strict doctorly guidance, when he says; “Nevertheless, close observation of your child during the early phases of treatment (6 weeks) for problematic side effects such as fleeting suicidal thoughts is warranted on all medications for depression.”
but then…
How would a parent assess their young child for “FLEETING THOUGHTS OF SUICIDE” and what about the ACTUAL high risk side effects; like, mood lability, irritability, agitation…?? The side effects that are actually associated with actual suicides that have occurred in children and adolescents taking SSRIs?? What Dr. Wilens doesn’t KNOW has filled volumes written by psychiatrists who provide references for their ‘scholarly work’.
Who protects the public from the risks of believing Dr. Wilens “Straight Talk… What every parent should know” about psychiatric Medications for Kids” ???
If you are not interested in diagnosing the psychopathology of the brotherhood of Harvard Medical School’s Department of Psychiatry, you are missing the boat on WHERE THE STORY STARTS!
Guarding the health of children via exposing the dangerous propaganda that is poisoning the PUBLIC, should be top priority for anyone in the field of PUBLIC HEALTH.
If I had your credentials, I’d start by engaging Dr. Tim Wilens in a serious game of VERITAS or DARE!
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Timothy Wilens investigated by Senator Grassley along with his cronies Biederman and Spencer. They are paid pharma shills.
Researchers Fail to Reveal Full Drug Pay
http ://www.nytimes.com/2008/06/08/us/08conflict.html?pagewanted=all
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Thanks, stephany, for this information that had absolutely no impact on the well established and highly prized careers of this trio: Wilens, Biederman and Spencer. They were saluted and effusively embraced by Mass General Hospital throughout the investigation and very mildly admonished in 2011. Meanwhile they continue to teach, conduct ‘bogus’ research, see patients and WRITE— as renowned, highly respected professors of psychiatry at HMS and clinicians at MGH.
WHO amongst us is capable of challenging the dangerous falsehoods published in a book for parents, “Straight Talk about Psychiatric Medications for Kids” that reads like a pharmaceutical advertising manual? NOT one foot note, evidence base, or reference to anything ‘scientific’ in a book written by a professor in the most prestigious academic medical center in America. WHO amongst us should step up to the plate and view this as a serious threat to PUBLIC HEALTH?
When Harvard says: We are pleased to inform you that stimulants and antipsychotics have been approved to treat behavioral problems in preschoolers; that treating psychiatric disorders in young children with psychotropic drugs will spare them from suffering the sure to follow agonizing ordeals and abject failure ; when this is the ‘teaching’ of the world’s foremost University’s medical school— educating the leaders in child/adolescent psychiatry— shouldn’t the EXPERTS in Public Health prioritize with an interest in PROTECTING the public?
Thought experiment: How might the views and habits that have created the Psychopathology of American Life be altered by the TRUTH? That we are only as sick as we need to be in order to support the 1% who have been duping us in every conceivable way for the past 100+ years!!
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Dr. Datta, thank you for your contribution.
I agree, the very word “depression” has almost lost its meaning. Now whenever people suffer disappointment, frustration, sadness, loneliness, or existential angst, they might say they are “depressed.”
Patients’ self-diagnosis is embraced eagerly by doctors as long as the patients are claiming a psychiatric condition at which a prescription can be thrown.
On the other hand, post-industrial culture is disapproving of anything resembling self-doubt that might decrease “productivity,” so it might be understandable that individuals feel there’s something very wrong with them.
By the way, this is true of the UK as well as the US!
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in my experience, it is not psychiatrists who are trigger happy with prescribing antidepressants to patients with minor misery and self-diagnosed ‘depression’ as these patients rarely see a psychiatrist. instead it is family physicians and internists who have little time and little interest in exploring their patients’ problems and who find it difficult to rebuff demands for antidepressants from patients who have been convinced by direct to consumer advertising that there is a pill for every ill. by the time they realize the side-effects of the medications, or the withdrawal syndrome is far worse than difficulties that made them seek antidepressants in the first place it is too late.
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Where might an Internist or GP get the notion that SSRIs are effective for treating mild bouts of depression, social anxiety, etc? Are there any articles in leading journals of psychiatry that support this notion? Any groundbreaking evidence from a fly by night RCT that is published by a group of psychiatrist researchers at a leading academic medical center that ‘advertises’ these claims ? How about articles on serious adverse effects of SSRIs? Any leading psychiatrist publishing articles to sound a warning that even a GP might hear about?
I think you might want to talk to GPs and Internists who are of the opinion that they are following the leaders in psychiatry to offer the best treatment for their patients. Other than citing a large number of patients who don’t seek out a psychiatrist, you aren’t addressing the root cause of the misinformation that leads to adverse consequences for the patients— And certainly you have not suggested any responsibility on the part of psychiatrists for either educating GPs or addressing the ‘bad science’ that has promoted SSRIs as a “safe and effective’ treatment for a variety of minor problems arising from difficult circumstances and environmental causes!
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I am not aware of any psychiatrists that recommend prescribing antidepressants for common unhappiness. But it is true that organized psychiatry has played its role in encouraging general practitioners to prescribe antidepressants. For example in the 1990s the Royal College of General Practitioners and Royal College of Psychiatrists had the pharma-sponsored “defeat depression campaign” that was designed to get GPs diagnosing depression and prescribing more antidepressants. And a success it was. However I don’t think anyone was really recommending prescribing antidepressants for those who weren’t depressed, even if that was the logical end-point we have got to today.
As an aside, I more often take people off antidepressants than start them. They do seem to do something of benefit in limited cases, but in the vast majority of patients who do not know they are on them (and thus cannot have a placebo effect), I have not found it made a bit of difference to their emotional state, and was not surprised, since they had very good reasons to be depressed (even if it was more ‘severe’) that had not disappeared.
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Doctor you are minimizing the deleterious effect of the practice parameters and treatment algorithms ‘peer-reviewed’ journal articles written by PSYCHIATRISTS, symposiums conducted by PSYCHIATRISTS; the information is/was relied upon; it was used and used by general practitioners to diagnose and treat psychiatric illnesses. General practitioners relied on experts in psychiatry erroneously and you are blaming them for doing so. Obviously, relying on information pedaled by psychiatry harmed patients.
How does minimizing the effect unethical psychiatrists have had on all of us mitigate this betrayal? Does abdicating individual and collective responsibility, and blaming others who believed the information was valid, ethically presented and based on actual SCIENCE help? General practitioners and patients relied on psychiatrists to be honest, ethical, and to conform to ethical scientific methods and ethical medical principles; they were betryed. Does it help psychiatrists sleep better to deny accountability, and abdicate responsibility for the harm done to patients?
It’s time to be REAL, we’re in this mess because psychiatrists went along with the marketing agendas of the pharmaceutical industry. Placing the blame elsewhere serves only to validate skepticism and deepen well-earned mistrust, psychiatry needs to take responsibility and make amends. Stop pointing the finger of blame and take some responsibility for correcting the grievous mistakes that have been made, that continue to harm patients.
Practice Parameters and treatment algorithms, that are based on a consensus of ‘professional opinions have no place in a medical specialty that is claiming to be Evidence Based. Consensus is a quasi-democratic process, not a scientific endeavor. Consensus is evidence of AGREEMENT, consensus is not evidence of scientific validity, therapeutic value, safety or efficacy. The recommendations contained in Practice Parameters and treatment algorithms are still in use, but instead of trying to undo the harm caused to patients by them, the corrupt work products are being defended, instead of thrown out. Why is that? They are not derived from the a Scientific Evidence Base. Indeed, most of the recommendations are not supported by the evidence, but are contradictory to the the evidence! The clinical trial evidence used to gain FDA approval, was incomplete and therefore biased and corrupt. It is only corrupt because unethical psychiatrists corrupted it.
“Whenever a doctor cannot do good, he must be kept from doing harm.”
Hippocrates
“Primum non nocere”
“Declare the past, diagnose the present, foretell the future; practice these acts.
As to diseases, make a habit of two things–to help, or at least to do no harm.” Hippocrates
Or, to paraphrase, Matthew 7:5:
Psychiatry needs to first take the beam out of it’s own eye, and then it will perhaps see clearly how to remove the splinter from another medical practitioner’s eye.
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In the US, patients may visit psychiatrists without going through a primary care doctor first.
From what I’ve seen from these cases http://tinyurl.com/3o4k3j5, psychiatrists are nearly as likely as GPs to overprescribe and are scarcely better at recognizing adverse effects or knowing how to taper off safely.
I agree with Sinead and yobluemama, psychiatrists are opinion leaders when it comes to psychiatric drugs. If the psychiatric profession was vocal in emphasizing the need for conservative prescribing and making patient safety a priority, other doctors would sure heed what they say.
At the very least, psychiatry long ago should have taken a strong stand against the widespread advertising of psychiatric drugs in the US. (Too late now, pharma’s cut the ad budgets as psychiatric drugs have gone off-patent.)
Instead, psychiatry has been unified in hyping the effectiveness of medication and obscuring the risks. Just the potential increase in diabetes alone should be enough to cut the frequency of prescribing! How often do we hear any psychiatrists warning about this?
And the garbage psychiatry’s main journals still publish as “research” — really, psychiatrists should be up in arms about that misinformation, which readily filters down to general practitioners.
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Altostrata said: ” And the garbage psychiatry’s main journals still publish as “research” — really, psychiatrists should be up in arms about that misinformation, which readily filters down to general practitioners.”
I wonder how many psychiatrists are aware of the actual situation with regard to research in academic medical centers; that pharmaceutical co. money is NOT aiding our leading medical schools by finding THEIR research projects; nor are the studies proposed by the private research division of PHARMA reviewed by an ethics committee within the medical school. PHARMA does not aid in the performance of academic research in medicine, IT USES ACADEMIC MEDICAL RESEARCHERS for its own purposes. Meanwhile controlling the outcomes of THEIR clinical trials by withholding the RAW DATA from EVERYONE who could determine the actual results of these “studies”.
ONE of the biggest threats to PUBLIC HEALTH is the misperception that there are gatekeepers anywhere in health care system. The fact that doctors themselves are either unaware or misinformed about the lack of “science” and “ethics” informing or establishing an evidence base for their practice, is a bitter pill we are all forced to swallow.
Even if psychiatrists who blog on this site are the very last to KNOW the facts that are destroying public trust in them; even if they are somewhat irritated by the steady stream of a well informed audience, who challenge their knowledge base and point to the dire consequences of ignorance; even if Dr. Datta believes he is “practicing by the rule of law of his profession” and is exempt from either scrutiny or liability— the FACT remains: DOCTORS are the official bottom line gatekeepers sworn by oath and their license to PROTECT the public from risks to health and life. It just so happens THEY have become the biggest threat — to their own careers.
Only those MDs who step up to the plate and begin to confront the corruption of the medical profession and the exploitation of the public for profit deserve the respect once given to them by a trusting public who took for granted THEY were the best educated, trained and most informed… AND, in my book, if you happen to have a M.P.H. behind your MD— your job description is quite clear.
Discounting what the PUBLIC has learned through diligent research is very foolish, tantamount to committing career suicide, as Dr. David Healy has so clearly demonstrated in his numerous warnings and wake up calls for DOCTORS!
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How dare a mere mundane layperson say they are severely depressed. I am the psychiatrist. I will decide who is severely depressed and what happens to them.
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Dr. Datta,
Are you aware that SSRIs have been linked to suicide in children and adolescents? In2004 the FDA issues a black box warning–SSRIs might trigger suicidality—and the FDA did NOT license Paxil, Zoloft or other antidepressants for use in children. BTW, in Great Britain, NICE issued a guideline on pediatric depression in 2004: they recommended against using SSRIs as treatment a treatment. Here in the U.S. journals continue to publish papers endorsing the use of SSRIs— and leading child/adolescent psychiatrist, Tim Wilens writes (for parents and caregivers):
“Although there are not a large number of studies in this area, children and adolescents with anxiety disorders appear to respond to the same pharmacological approaches as adult patients. We now have some controlled data on SSRIs (fluvoxamine) for anxiety disorders… hence SSRIs are first-line now for generalized anxiety, separation anxiety and panic disorder.” (“Straight Talk about Psychiatric Medications for Kids”- page 176, T. Wilens MD, Guilford Press- 2009)
Do you think you could get the “raw data” on the controlled trials Dr. Wilens mentions here, but doesn’t actually cite- for readers? Perhaps he would confide in a colleague?
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1boringoldman.com has published a series of articles on the sleight-of-hand hiding the dangers of antidepressant-induced suicidality in youth, the most recent is http://1boringoldman.com/index.php/2012/04/16/an-anatomy-of-a-deceit-6-anticipated-and-forestalled/
He points out all kinds of ways Gibbons et al have been playing with statistics, the shoddiness of the journal articles, and the lack of quality control at Archives of General Psychiatry.
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Could this be called, “willful deceit”— PROFIT DRIVEN willful deceit? Are there results that can be linked to harm, injury and death???
So much of what I have learned since reading and *fact checking* Pharmageddon causes me to pause and wonder:
WHEN do we address the CRIMINAL aspects of “shoddiness and lack of quality control” ???
Altostrata, you have been a strong influence on the evolution of my thinking and my strong feeling that it is time to say: “The gloves are off!”
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You should become a devoted reader of 1boringoldman.com, Sinead. He’s doing the dirty work re-analyzing these corrupt studies.
I believe he’s used the terms “willful deceit” and “criminal” and maybe “psychopathic” in connection with some of this research.
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Dear Dr. Datta, thanks for this thoughtful contribution. You emphasize that mental illness definition, and the level of mental health are defined as much (or even more) by our social structure than by the mental health professions. That case needs to be repeatedly made, in the convincing way you just did, as it is not obvious to everybody.
That said, while emphasizing the multi-factorial causes of mental illness is part of the job of psychiatrists, it is also their job and their responsibility to use the time and resources given to them to improve individual mental health in the current specific context. We live in the society we have, not the one we wish we have, and some mental conditions need urgent care (without waiting for society to change). So it is psychiatry responsibility to find how to lower the death count from mental illness not just in the future society of the XXII century, but also in the present society, next week, next month and next year, focusing mainly on the individual and its immediate family and friends. Even within those very restrictive conditions, it is hard for me to believe that psychiatry has reached a plateau, and is already doing the very best that can theoretically be achieved, and that nothing better can be done without changing the core structures of society (I know you are taking an interest in what psychiatric practices are actually making people’s mental health worse, that research field is vast, barely explored, and would lead to immediate benefits in today’s context. In addition identifying counter-productive treatments might also be a good intermediate step for discovering new positive treatments).
Thanks for your contribution, and I look forward to more of them.
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I work in the child welfare field, and I find doctors, including psychiatrists, recommending and prescribing antidepressants for common, situational depression all the time. I’ve seen them prescribed for normal grief and loss, for women in ongoing domestic abuse situations, for the aftermath of a rape of a 17-year-old developmentally delayed girl (she was diagnosed “bipolar” because of her “mood swings” following disclosing the incident), and many, many times for foster kids who have every reason to be depressed, anxious and angry about the way their lives have treated them.
I do agree that medical doctors are a huge part of the problem, but psychiatry has led the way by proposing and insisting on inane and subjective definitions of new “disorders,” by providing convenient “explanations” like “chemical imbalances” when they know these things not to be true, and by ignoring strong evidence of other effective approaches to assisting people with the moral, situational and spiritual crises that they encounter in the course of a normal or not-so-normal life.
That being said, I agree with your basic premise: modern life is inherently stressful, and a depressed reaction to it is very understandable. When we reach a point where over half of the members of a group manifest a certain response, it’s time to stop defining it as abnormal and to start looking at the structures that they are reacting to.
Take school as an example: it is axiomatic that the large majority of kids find the academic part of school dull, irrelevant, frightening, or depressing. If you doubt me, ask a hundred kids how they enjoy school. I’d bet 90 would say they’d avoid it if they possibly could (other than their enjoyment of their friends, and possibly a specific subject, usually PE, art or music classes). So are all of those kids mentally deranged? Or do we need to look at how we educate kids and stop forcing them to do things that are dull, irrelevant, frightening or depressing?
War, global warming, rampant consumerism, racism, sexism, dead-end jobs, poverty, domestic abuse – these are huge social issues that are overwhelming and depressing for most of us to confront. I don’t think there’s anything abnormal about feeling depressed or anxious or angry looking at the world we live in. Thanks for reminding us that “mental illness” as defined by the DSM can just as easily reside in the culture we’re a part of as in the individual responding to that culture.
—- Steve
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Steve said: “I agree with your basic premise: modern life is inherently stressful, and a depressed reaction to it is very understandable. When we reach a point where over half of the members of a group manifest a certain response, it’s time to stop defining it as abnormal and to start looking at the structures that they are reacting to.”
Yes, exactly. As long as each individual believes he or she has failed and needs chemical correction, issues in the larger culture will become more and more onerous, breaking more and more spirits.
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Altostrata said: ” Yes, exactly. As long as each individual believes he or she has failed and needs chemical correction,…”
BELIEFS ARE POWERFUL!
As are those who have propagated THIS ONE!
What does it mean, in a cultural context, when a BELIEF that has no basis in TRUTH, causes people to ingest toxic chemicals that cause them harm ?
What does it mean, in the context of humanistic culture, when a BELIEF enfeebles vulnerable people and then exploits them for profit?
What does it say about humanism as the root of any culture, when the POWERFUL are free to view “the people” as their means to their own personal ends?
If the individual is the microcosm of the culture and more and more individuals reflect an erroneous view of themselves as human beings, and a large degree of imbalance in their lifestyles— there just might be a powerful cultural influence fueling this mass destruction of individuals.
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It means, Sinead, that corporate forces are more and more turning people into fodder for profits (consumers) and deadening corporate jobs (employees). Unless the people themselves resist this, this is the trend in developed and developing societies that embrace the religion of the free market.
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Altostrata,
Corporations are the foundation of American culture, but not the product of consensus after public debate, so really the forces you refer to are the will of the wealthy, ruling class who took the reigns between the end of the Civil War, the influx of ‘non-Wasp’ immigrants and the start of the 20th century. The pseudo-science of eugenics, nurtured in our Ivy League colleges was the foundation for marginalizing both individual entrepreneurship and the influence of european cultures on our developing nation. The self-proclaimed *well born* legislated compulsory schooling based on the Prussian model and designed their idea of the *perfect hive*.
There are no forces outside of the minds and hearts of Americans who are either unwilling subjects or self appointed guardians of our country’s wealth and power. The best explanation I have read and studied for the rise in mental illness in America is John Taylor Gatto’s, “The Underground History of American Education”. Studying our young nation’s cultural history from Gatto’s perspective; a middle school teacher in NYC public schools for 30 years, demonstrates a clear connection between the subjugating of the masses for the purposes of the elite and the disintegration of the human psyche, or rather the breakdown of human wholeness.
Ironically, there is no ‘free market’ in the U.S. And as Dr. Healy points out, we could make major progress curtailing the advent of pharmageddon by abolishing the patent laws for *drugs*. Even more ironic is the reality of the disempowerment of the individual in the U.S. , while propagating the myth that here in America we enjoy a wide range of individual freedoms.
Anyone can develop a mental illness grappling with this stuff… BUT I happen to strongly believe that if we are going to resolve these crucial inequities–discrpeancies between what is *believed* and what is actually *true*, then we need to call a spade a spade.
It is the CULTURE of the well born, the elite and by proximity, psychiatry that is making Americans sick!
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Agree with you, there is no real free market, it’s a pseudo-religion that funnels money to the wealthy.
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Vivek Datta said: “the withdrawal syndrome is far worse than difficulties that made them seek antidepressants in the first place…”
So true, and so rarely heard from a doctor! Please write me at survivingads at comcast dot net regarding tapering and withdrawal syndrome.
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“Or do we need to look at how we educate kids and stop forcing them to do things that are dull, irrelevant, frightening or depressing?”
YES! Thank you, Steve! and in confronting this injustice , we cannot avoid scrutinizing the psychopathology of our compulsory education system and illuminating the idiocy that created a long list of *disorders* to capture a means for exploiting the suffering of our children for profit. Where, in our American culture, does THIS psychopathology reside?
Consider the obstacles that have been imposed for any parent to opt out of subjecting their children to compulsory public schooling– financial, circumstantial impediments to adhering to federal education laws—maybe cannot afford private school; cannot get into a Charter School; parents don’t have necessary *credentials* for home schooling or cannot afford to support their family on just one parent’s income. think about what happens when a teacher has decided your kid needs a psych evaluation an IEP; medication—
It isn’t like most of us don’t already know exactly what is wrong—BUT where is the freedom to act in our own best interest, or that of our children?
Forgive me for what I am about to say. I can’t help it. I am so-o-o-o deeply depressed! I am overwhelmed with feelings of hopelessness and helplessness… stuck, I am –here in a developed country, where all the super- educated folks just want to write books about the most ridiculous culture on the face of the earth— discovering new twists to the plot, expounding novel insights into the causes for our rapidly declining society. Forgive me. I know this may well be perceived as an uncivil comment …BUT…
None of this is very difficult to unravel, really. The problems facing those of us who care about the health and well being of the public, our kids, ourselves–THE PROBLEMS are as obvious as a dead bird on a windshield.
The Psychopathology of Everyday Life — has already been written—
We have fire and the Wheel… as well.
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American culture cultivates difficulty – not any form of ease.
American culture cultivates disease. It’s depressing.
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FYI:
Mass. General hospital, Boston, is currently recruiting “subjects” to study the benefits of psychotropic “medications* for *Complicated Grief Syndrome”.
Local radio stations ask: if YOU are suffering— beyond the 6 month period following the death of a loved one— a series of perfectly reasonable human reactions to deep loss; a very human picture of the term, GRIEVING…BUT, NO! these are actually ALREADY viewed as pathological and on the table for TREATMENT!
and the DSM V has not yet arrived!!!
WHY is this study being conducted??? Do you have the answer Dr. Datta???
Could it be a preemptive strike to get journal articles published from a study done at this prestigious hospital? Will the studies SHOW how beneficial psychotropic drugs can be for those suffering from *Complicated Grief Syndrome/Disorder*???
I predict YES to both of these questions. then, I wonder what you will conclude if a patient tells YOU; “Doctor, I am suffering from complicated grief….”
OR…
YOU could issue a preemptive strike to protect PUBLIC HEALTH— prevent medicalizing of normal human emotions and the countless prescriptions that will cause harm to vulnerable people.
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Mass General is the site of a research-for-hire paper mill run by Mauricio Fava. His customers are pharmaceutical companies.
If you get worked up over Mass General’s paper mill, you will wear yourself out, Sinead.
We can expect more garbage research to appear in a major psychiatric journal in a year or two, but that would be nothing new.
Unless Dr. Datta is involved in the study, I don’t think he can answer for it.
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I was thinking more in terms of the etiology of the phenomenon Dr. Datta presented as evidence of the psychopathology of our culture; that we are all falling into a mental illness category, seeking psychiatric treatment for failure to thrive issues in a society whose values have become woefully warped.
I wondered if Dr. Datta would consider it worthwhile to investigate this current example of how medical research has changed, from studying diseases to becoming a means for creating new diseases. I actually hoped Dr. Datta might realize that though he might not be aware of this trend that both enfeebles and exploits the public, remaining ignorant of the ramifications for public health and silent as his fellow doctors are selling out their shared profession will not protect him from complicity.
Thanks for the tip(s)! Your knowledge and investigative reporter skills energize me. Surrounding myself with the perpetual motion of youth also helps. These “kids” are always reminding me that paper mills are old hat and computer technology is in their blood… whatever that means 🙂
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Dr Datta says:
“I discussed the case with the attending psychiatrist. I wanted to know how to fill out the paperwork, confident she had no psychiatric diagnosis.
‘Put mood NOS.’
Mood Disorder, Not Otherwise Specified, I mumbled. How could I diagnose her with a mood disorder when she had none? The answer was it was necessary for reimbursement.”
Do we really need to look any further for the cause of a “mental illness epidemic” in this country?
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There are null diagnoses available: V71.09 No Diagnosis on Axis I and V71.09 No Diagnosis or Condition on Axis II
Perhaps Dr. Datta’s attending psychiatrist was unaware of them.
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you are right, DSM had V codes which include things like ‘no diagnosis’ and ‘malingering’. We are all aware of this, including the attending psychiatrist mentioned in the article. But a V code is not a diagnosis. Further, DSM-IV is not used for billing (though it can be), ICD (international classification of disease) codes are used for reimubursement and the ICD does not allow you to NOT make a diagnosis!! It is a ridiculous system, because in medicine you can code for say ‘cough’ without making a diagnosis and get reimbursed. But ‘low mood’ is not recognized, nor is ‘no diagnosis’! But this does not explain the apparent epidemic (which is questionable – the best studies do not show an increase in depression and other diagnoses over the past 50 years), as the National Comorbidity Survey was a community survey not a clinic one. Most of the so called cases of mental disorder were never diagnosed by a doctor.
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So, then, Dr. Datta, how many cases of– say, Mood D/O NOS do you think have been diagnosed by a doctor who was stuck with finding a mental disorder to ensure reimbursement?
I think I just figured out how it could be possible that, as you wrote:
>>they estimate 57.4% of Americans can expect to meet the diagnostic threshold for at least one mental illness.<<
Assuming that people flock to their doctors believing the market driven plethora of mental illnesses permeating every media outlet in our culture, and considering the importance of *reimbursement* for psychiatric services, the practice of making it up as you go should tally up to a mental disorder per visit.
Needless to say, the DSM V will be indispensable for pumping out a wider range of mental illnesses to support the *social and cultural* reasons that we all think we are mentally ill.
I have another theory about how we could reach 57.4% of Americans meeting the diagnostic threshold for at least one mental illness. We could create a whole new diagnostic criteria under the heading of mental illnesses that result from moral degeneracy. Under this category we could capture everyone from the doctor who makes a bogus diagnosis for money to the FDA, the APA, every practicing member of the PHARMA brigade, Health Insurance CEOs and their minions… editors of Psychiatric Journals , Mauricio Fava and so on and so on…
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The figure doesn’t include NOS categories, and indeed does not even include psychotic disorders. You can click on the link provided in the article for the breakdown. The DSM is important insofar as new diagnoses mean new research dollars and studies for drugs and psychological treatments for the new disorders and “educating” physicians in the form or CME etc to recognize and treat this “previously underrecognized” and “untreated” condition. In clinical practice, it is really not that important as it is quite easy to ignore. The best psychiatrists don’t really pay any attention to it. The problem is the worst psychiatrists also don’t pay much attention to it, and loosely use the DSM to make diagnoses where actually the diagnostic criteria do not support them. I have been horrified to discover patients with no mental illness who have somehow been admitted to a psychiatric unit for as long as reimbursable (usually a few days) and then thrown out on the street with a prescription of antipsychotics when they have nothing wrong with them! This sort of thing is not the rule, but is not the exception either.
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Not to Dr. Datta.
Psychopathology of American Life.
The concept of psychopathology is a false one.
There can be no pathology of human thoughts and behavior, only quack doctors sitting back in smug judgment labeling a frowned upon feeling or behavior as ‘medical’ in nature. It is a social ritual hundreds of years old, reflects no real biological pathology that you or anyone else can demonstrate, and forms the basis for your entire career in psychiatry.
Do you really think pathologizing people’s psyches is a legitimate scientific endeavor?
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Perhaps the young, seemingly well educated Doctor is more interested in selling a book next year, than making a contribution to American Life?
The quiet readers may note that a conservative mind-set has great difficulty responding to anything outside the patently “obvious,” while feeling comfortably assured that educated letters after one’s name, hold something meaningful?
In human nature there has always been an issue of priesthood and dependent “under class?” We the “pitiful ones?”
Why does the survivor community have more meaningful knowledge than the so-called professionals? Perhaps because our need became more urgent, in the struggle for survival, while others can afford to remain, comfortably numb?
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David said: ” Perhaps the young, seemingly well educated Doctor…”
I would challenge any reference to well educated—even a seeming relationship to having an education as merely a strong display of having been schooled, or indoctrinated. The mark of education is revealed when one can accurately assess current phenomena and forecast a path for preventing worst case scenarios.
If you ask me: ” Why does the survivor community have more meaningful knowledge than the so-called professionals?”
I would say that studying that which has relevance to real life situations and personal investment in caring for and protecting others is a proven formula for acquiring knowledge that is meaningful. Unlike the so-called professionals, the survivor community is rarely ego based or self preservation bound in terms of their quest for an education in all matters pertaining to psychiatry today.
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I won’t introduce the scanning thing again, but do we notice a pattern in the lack of responses from those holding a “seemingly” superior position?
My fear for this webzine is a devolution into a clique of like minded “elites,” where the “appearance” of intellectual discussion and “something happening” is all that matters.
In the interests of addressing the topic of an “epidemic of mental illness,” it appears to be the less credentialed survivors who ask the most searching questions, or am I deluded, in that perception?
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You are spot on, David !
And by the grace of the bit of anonymity I can exercise on this webzine, and the power of first hand experience on the inside of the mental health system and all that is vested via my credentials, I AM WITH THE SURVIVORS 100%. I stand on the side of truth, justice and human rights.
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“Why does the survivor community have more meaningful knowledge than the so-called professionals? Perhaps because our need became more urgent, in the struggle for survival, while others can afford to remain, comfortably numb?”
It’s a matter of lives depending on it, versus mere livelihoods depending on it.
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Where’s* Nijinsky???
Here is exhibit B, in the civil suit against the medical school that indoctrinated this poor guy with little more than a formula for making a living on the ignorance of the masses. An accredited U.S. medical school turned a young man, impassioned to care for the sick, and alleviate their suffering, into an impotent whiner who is forced to LIE to put food on his table!
* credit for the idea of suing medical schools for *wrongful education*— removing the need to become an accomplice to the scourge of psychiatry in order to pay off the debt of medical school loans. 🙂
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“…a U.S. medical school turned a young man, impassioned to care for the sick, and alleviate their suffering, into an impotent whiner who is forced to LIE to put food on his table…”
Other than the “whiner” part, I think this pretty well captures how I feel on a daily basis.
(Ah, who am I kidding— I whine all the time.)
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Dr. Balt,
Sounds like you have a case for a civil suit against your medical school for: *wrongful education*
At the very least, you are entitled to a full refund for cost of your medical education!
You could start a new career with your settlement. Open a *remedial medical school* based on the tradition of academic medicine, teaching medical students the scientific and ethical basis for the practice of medicine.
Other doctors who follow *suit* can afford to be educated at your prestigious academic medical school!
Within the span of a single generation, the PUBLIC will have a choice between Sh– and shinola !
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From Dr. Datta’s blog article, I gather he believes there are social or cultural reasons why people believe they have psychiatric disorders and seek medical help.
I wouldn’t extrapolate from this any ulterior motives or bad doctoring. He seems to be questioning the reigning paradigm.
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Well then, how could someone who has immersed himself in the study of psychiatry be unaware of the source that is providing people with reasons for believing they have psychiatric disorders and should seek medical help? Depression is a classic example of a market driven psychiatric disorder and ascribing to the reigning paradigm is bad doctoring, by definition.
One’s motives are deeply personal matters, to be sure. BUT there is as much to be gleaned by what a person apparently does not know as there is by what he claims he knows. In any case, I would suggest to Dr. Datta that there are a good many books he should read cover to cover before writing one of his own–books written by psychiatrists who have been going well beyond questioning the paradigm to challenging any scientific claim to psychiatry as a practice of medicine.
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Dr. Datta is a skeptic. He wrote:
“What no one quite imagined was that the mental health industry would become unstoppable, with seemingly no end to the situations that could make us mentally ill, no person too well to benefit from therapy. Eventually the mental health industry became a poisoned chalice, rather than deflecting from society’s failings, it added to them.”
Personally, I can’t find any fault with those statements.
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I would say that Dr. Datta is misinformed, lacks a factual body of knowledge — is ignorant regarding the etiology of the *poisoned chalice* as well as HIS connection to it via ignorance— that I find, is a poor excuse for anyone who is in the medical profession to use; for who else, but DOCTORS SHOULD be tracking down the SCIENCE and the ETHICS of the *Mental Health Industry*—especially those who flock to the most prestigious academic medical centers for their degrees. (Yes, I know it was a M.P.H. that Dr. Datta earned at Harvard—but after his MD, which should have been something of an impetus to seek out SCIENCE in his own profession, and ETHICS in academic medical centers conducting research.)
WHO is Dr. Datta skeptical of?? Perhaps he is skeptical of Harvard’s , Joseph Glenmullen and ALL that have made their way to Harvard’s Hit List based upon publishing FACTS about the *poisoned chalice*?
There are serious flaws in Dr. Datta’s reasoning, ALL of which center on his own laxity in searching in the most obvious place for the source of the *poison*.
You quoted Dr. Datta: ” Eventually the mental health industry became a poisoned chalice, rather than deflecting from society’s failings, it added to them.”
SOCIETY’S failings? So, is there a separation between -“Doctors” and “Society”– are not DOCTORS a part of society? Are they not in a leadership role? And in this case, WHO has poisoned the mental health industry, by creating a business whose market depends on a *mentally ill society* for its profits?
Hint: There could be no business called the mental health industry without doctors. They are the key players. They wield the pen that placed dangerous drugs at the epicenter of the mental health industry.
Dr. Datta’s lead sentence–” “What no one quite imagined..”
Is that TRUE, Altostrata? NO ONE imagined how this scam could become a multi billion dollar industry? NO ONE saw it coming? NO ONE sounded warnings and continues to challenge this scam at its roots?
I think we also know how the public was duped. I think marketing strategies are no longer big mysteries. I think the dissemination of truth, facts and action plans NOW available on a global scale is the real story of what NO ONE in the mental health industry could have IMAGINED.
What does a totalitarian regime; a ruling class fear the most? The education of the masses…
The fault with the statements you shared above is that they redirect focus from the actual problem. A problem I heard identified from an 8 year old boy trying to fight his way out of the mental health system. With the beauty of innocence that children exude as their major strength, and unbridled audacity to match it, this youngster looked his psychiatrist straight in the eye and asked:
“Why [[do] you lie so much?”
Well? Who would like to step up to the plate and answer THAT question?
Paging– Dr. Datta !!!
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I suggest you have another read of the article above. What I’m exploring is how did we get to the position we are in today? This is not something that started with the the DSM, nor with the pharmaceutical industry. My point is if you go back over 100 years ago you can see how psychiatry changed and how psychiatrists came to occupy the role they did. It seems no accident that psychiatry would ascend so in the US (unlike in Europe) at the beginning of the 20th century when unfettered and unadulterated capitalism was transforming America for the worse. Psychiatrists were allowed to occupy such a position because they were agents of social control; the disaffected could be managed and labelled as sick, the source of distress could be located within the individual, and not in society itself. No one could have predicted at that time just how far the concept of mental disorder would expand, just how many people could come be have a mental illness. This was before there was even interest from pharmaceutical companies in psychiatry. The mental health industry is not just psychiatrists, psychologists and therapists have something to answer for as well as they have encouraged us to believe we are in need of help to manage our emotions, and created many more disorders than are even in the DSM.
For most of the 20th century the mental health market was controlled almost exclusively by psychiatrists. By the 1970s, this changed and psychologists, counselors, psychotherapists of various persuasions etc. found themselves vying for patients with psychiatrists. The result was the psychiatry remedicalized in order survive- what was it that psychiatrists could do that others couldn’t? They could prescribe meds, they could make medical diagnoses, they had the ‘moral authority’ of their medical training to justify their existence. In this way, psychiatry became more biomedical and drug-centered from the 1970s onwards, and more hostile to psychotherapies, treatments that were once their sustenance, could now be provided more cheaply by others.
You appear to think it is just psychiatry that is at fault. Of course psychiatry has alot to answer for. But the most overlooked question, is why did we allow psychiatry to have so large a role in repression and managing our subjectivity in the first place? Without answering this question, you would find that even if psychiatry disappeared overnight, the role would be filled by something else. American society maintains its need to displace the source of distress in individuals, and not look too closely at the structure of society itself. Until we do this, there can be no hope of ever being free of institutions which implicitly or explicitly seek to manage our subjectivity, and convince us that our distress is not the product of a sick society, but a sick mind.
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Sinead, I think the commercialization of mental health succeeded beyond pharma’s wildest dreams and not even their marketing people imagined the largest companies would be reaping the majority of their income from psychiatric medications.
I have a suspicion Dr. Datta is not entirely ignorant of the history of this cultural development and he will be sharing his perspective in installments here.
As near as I can tell from what he’s posted so far, his perspective is critical of this cultural trend.
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(Where the *heck* is the reply button to Dr. Datta’s post?)
Dr. Datta says: “why did we allow psychiatry to have so large a role in repression and managing our subjectivity in the first place? ….American society maintains its need to displace the source of distress in individuals, and not look too closely at the structure of society itself.”
This is the argument that places blame on a purported neoliberal movement, upon which psychiatrist-blogger Dr. Tad holds forth most amusingly here http://left-flank.org/category/psychiatry/ and elsewhere.
(I repeat, it’s not only America where these forces are in sway!)
Dr. Datta, getting away from the hypothetical forces of history, which may be discussed for decades without conclusion — despite patients abandoning responsibility for their lives and asking to be medicated, despite pharma propaganda, corrupt psychiatry thought leaders, subverted research, and the pressures of managed care, how can individual psychiatrists not perceive evidence of obvious adverse effects right in front of their faces?
This is a burning question among injured patients, who make up part of your readership here.
Where I would take issue with your perspective is that it, like the neoliberal movement, relieves the individual of responsibility — in this case, individual psychiatrists. In the one-to-one relationship with the patient, the psychiatrist is suffering some kind of cognitive block that negates perception of iatrogenic harm.
(And who told the DSM-5 committee to add and blur diagnoses? It wasn’t clamor from the general public that made them do it.)
While it may be true that psychiatrists could disappear from the face of the earth tomorrow and other professions would quickly take over providing inept psychiatric treatment, while is it these specialists practice the way they do?
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“The DSM is important insofar as new diagnoses mean new research dollars and studies for drugs and psychological treatments. . . . In clinical practice, it is really not that important as it is quite easy to ignore. . . .
“I have been horrified to discover patients with no mental illness who have somehow been admitted to a psychiatric unit for as long as reimbursable (usually a few days) and then thrown out on the street with a prescription of antipsychotics when they have nothing wrong with them! This sort of thing is not the rule, but is not the exception either.”
———————-
I truly think professionals in the mental health industry have very little idea of the grim effects of the diagnoses they give and then so casually ignore. There is a remedy for this sad situation, but it’s a harsh one. Below is my response to Rossa Forbes’ story of her son who killed himself after diagnosis and “treatment.”
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Rossa’s story both saddens and angers me. If a young man drinks and drives, he and his family know he risks a heavy fine or jail, or both. If he joins the army, he risks getting injured or killed. If he starts a business with borrowed money, he risks bankruptcy. Everybody knows this. Sometimes the payoff is worth the risk, or the temptation is too great. But nobody is astonished or feels betrayed if matters turn out badly. We knew from the beginning it was a risky thing to do.
But what if a young man is brought to a psychiatrist? We have certain expectations of wearers of the honorable cloak of Hippocrates, primarily that they will do something to restore health. We don’t ordinarily think in terms of the risk the young man is incurring at this point: a terrifying diagnosis on the basis of a few questions, the degrading rituals of involuntary commitment, powerful drugs with disabling side effects, loss of friends and self esteem, stigma, helpless anger and hopelessness. And yet these are the risks he takes the moment he enters the door, unless he has considerable presence of mind and control of his emotions.
Some years ago I walked through a psychiatrist’s door and faced the same risks. I came for help, because the things going on in my mind frightened me and made me want advice from an expert. I felt I was in serious danger of losing control of my emotions and I would make a fool of myself and destroy what little credibility I had with my family. (Yes, I was the sensitive one that carried the generational burdens.) I tried to explain my predicament to the psychiatrist, but he kept interrupting me and disagreeing with what I was saying. I knew I was soon going to lose my cool in frustration. I was beginning to realize he had no idea of what was happening in the strange world behind my eyes, and that I was on my own in dealing with it.
Finally, in desperation, I asked the psychiatrist if he thought I was crazy. No, he said soothingly, not really. You haven’t come here with any wild theories or tell me people are out to get you, stuff like that. You’re not acting crazy.
A great light dawned on me. You mean I’m not crazy if I don’t act crazy? He hesitated. Well, yes, something like that, he said
I’m sure he went on to give me advice about not getting all upset about things, but all I remember is that. I wasn’t crazy if I didn’t act crazy. It was as simple as that. No matter what happened behind my eyes, I couldn’t let it make me act crazy. No matter what. Not unless I wanted to end up in the looney bin.
I thanked the psychiatrist politely and took the prescription he offered me, but never went back again. I did what he said: I didn’t act crazy, no matter what. And yes, it got bad, so bad that I finally had to go to the ER one night for a shot. I told them I had a terrible migraine, though the agony went much deeper than that and filled the whole world. But I had read enough about psychosis by then to suspect it would soon subside enough to be bearable, and it did.
The net result? My family relaxed after a few days of worry, and life went on – better than ever for me, because I went back to school, got an advanced degree, had a successful career, and retired a few years ago to enjoy my children, grandchildren and travel.
I’m afraid my story has a depressing moral: that we should teach our young men and women the risks of going to psychiatrists who deploy their dangerous potions and powers in such blissful ignorance. Consider the need for a psychiatrist with the same prudence needed in selecting a family doctor: don’t wait for an emergency. See if you can find one with a reputation for prescribing talk therapy and family communication before powerful drugs and institutionalization. Learn from Rossa’s story, and protect your children.
I dislike speaking so harshly, but sooner or later the emperor’s nakedness has to be recognized, along with the priests’ rape of alter boys and psychiatrists’ abuse of their patients’ trust. Otherwise the lie goes on and on.
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Dr Datta,
You said: “the DSM is important insofar as new diagnoses mean new research dollars and studies for drugs and psychological treatments for the new disorders and “educating” physicians in the form or CME etc to recognize and treat this “previously underrecognized” and “untreated” condition”
You are missing some key information regarding both *new diagnoses* and *research dollars*.
The KEY here is the absence of academic medicine in what only has the appearance of study, and practice of science based medicine. All aspects of this process we have come to believe is the main thrust of medical advancements is the handiwork of pharmaceutical companies: the private research companies that design studies, the ghostwriters who publish the spin on the data that no one in academic medicine has access to.
Academic medical researchers receive payment for doing the work that markets the products of the wealthiest industry in this country.
Doctors are little more than whores for the pharmacuetical industry. Crass and base language is the best medicine these days, because sadly enough, doctors, themselves are in the worst possible position in terms of their careers, their livelihood– their once respect worthy identity!
Excuse me, for pointing out the obvious, but there is no scientific basis for biological causes of ANY diagnosis in the DSM . Actually, childhood bipolar is an example of a disorder that has been created by psychotropic drugs–and meets criteria for biological causes–CAUSED by drug treatment prescribed by leading psychiatrists at HMS!! The only known biological causes for symptoms of mental illness are IATROGENIC! Therefore, research should be focused on discovery of TRUE causes–IF it is true medical research. And we all know that is not the case. WE all know that medical, scientific- based research to discover the causes of mental illness is not happening.
Can you name a single clinical trial that is not testing the effects of a psychotropic drug on a *new diagnosis* ? Can you put your hands on the raw data of any clinical trial? Can you PROVE there is science behind the DSM, the new diagnosis, the research and the actual practice of psychiatry?
IF you fail at answering these questions in a manner that supports psychiatry in America as a medical practice, you might want to consider the value of your M.P.H. in terms of a career that honors a commitment to the health and well being of the public. The greatest threat to us these days is the delusion that has created the wealthiest industry on the planet; that the current practice of psychiatry has anything whatsoever to to with either science or medicine as it is DEFINED.
You are fortunate to have this encounter with the well informed educated health care consumers that have the most at stake in bringing forth the truth. You are fortunate in having this opportunity to prevent your own career suicide!
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Sinead – whatever the problems at Harvard Medical School, the Harvard School of Public Health is rather more enlightened and teaches its students to think critically and ask challenging questions. Indeed it was at Harvard that I was required to read An Anatomy of an Epidemic and met Bob Whitaker, when he guest lectured on one of my courses.
You will also find that in schools of public health across the country the most interesting work in mental health is being done – looking at the social factors that appear to cause mental distress, improving wellbeing on a population level, developing mental health policy, how we can give our children the best start in life, the social and determinants of dementia and so on.
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Sans **, here goes:
You claim:
“… the Harvard School of Public Health is rather more enlightened and teaches its students to think critically and ask challenging questions,”
I wonder: WHO are you questioning? Have any names connected with HMS popped up on your critically thinking radar as possible targets for probing questions that are directly related to public health? How do you think unethical market -driven research happening at a leading academic medical center impacts public health? How about manuals published for care givers of children teaching the merits of drugs that have been proven dangerous and life threatening?
“Straight Talk about Psychiatric Mediation for Kids”, by Timothy E. Wilens, MD
I’d like to see your book report on this public health document!
Could you formulate a few critical questions to ask the leaders who are propagating the dangerous myths about mental illness (biological/brain disorders) in preschoolers and even more dangerous propaganda regarding the SAFETY of psychotropic drugs for children 3 years old and up? This could be a relevant application for your comprehensive studies of Robert Whitaker’s work.
Are you really looking at “social factors that appear to cause mental distress?” How so? you are viewing them in a vacuum where the real forces of public health influence don’t exist. You are totally discounting the most distressing aspect of our social structure; badly misleading information from leading medical experts and the lack of any true academic medicine influence — a much needed gate keeper for the public.
Extra credit assignment: Employ critical reasoning to explain the fraudulent claims that gave rise to psychiatry’s claim to having a biomedical paradigm. And then look at how this myth is used to fund and fuel new diagnoses —- new uses for psychotropic drugs? As the adverse effects, serious risks of these drugs are kept out of public view.
How can we give our children the best start in life?
Keep them out of public Kindergarten thru- third grade— (ideallyl)—but definitely say NO to public Kindergarten.
Refuse to submit to teachers who label, them, request psych evals, etc.—much less insist upon medicating them.
Band together with parents in your community—co-op parenting strategies, mutual educational experiences and involvement in the arts- in addition to community activities in general.
QUESTION AUTHORITY!!
STEER CLEAR of the MENTAL HEALTH SYSTEM.
Listen to your child.
Life saving advice from a *medical professional*; mother , grandmother and all around concerned member of American Society,
Sinead
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In fact, I place my hopes for correction of psychiatric overmedication and the epidemic of iatrogenic conditions caused by it on public health studies.
While they’re not devoid of politics (with representation of the long arm of entrenched interests), public health studies at least have the explicit objective of improving public health and protecting the patient, as opposed to that of the medical-industrial complex now running mental health treatment.
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Altostrata,
I don’t want to dash your hopes… but, some things that are a matter of grave and urgent importance do not require any more *new* studies! When the current crisis that is threatening our children is left unchecked by any bureaucracy in the mental health system– even public health, I have to wonder if their studies are more about protecting their own interest in remaining employed.
Here’s a thought experiment worth pondering: For starters– Let’s say that the brilliant minds in our best schools of Public Health undertake studies to determine if the currently accepted RCT’s and proclamations of HMS big shots have actually established the safety of psychiatric drugs for children. How might these findings impact current trends in psychiatric overmedication and the epidemic of iatrogenic conditions caused by it?
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p.s. your asterixes are a bit distracting. if you (b) (/b) (but use < instead of ( ) then you can bold points you want to emphasize – hope that helps
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Point taken
🙂
Thanks!
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According to Altostrata the * is used for emphasis. Well established internet practice. I apologize for the distraction.
There is so much I feel the need to emphasize when addressing your commentaries. Maybe you could read the * with that in mind. ??
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Dr. Datta,
Based upon the history of this relatively new nation, there are answers to questions. such as these:
“” But the most overlooked question, is why did we allow psychiatry to have so large a role in repression and managing our subjectivity in the first place?””
I want to correct the use of WE; to emphasize that the rendering of our budding democracy into a society that was governed on ancient philosophies, like : *parens patriae*, where the people are the property of the state DID NOT occur after public debate; laws passed that opened the door for psychiatrists to become *protective guardians* were proposed and passed by the THEN, *ruling class*—many of whom resided in prestigious Ivy League colleges as the EXPERTS of the time. In other words : WE, as in US, the public, the masses, the bulk of society, DID NOT ALLOW psychiatrists to assume their role in society…IT WAS IMOSED upon us.
As was the Prussian compulsory *schooling* system that has dumbed down *society* to our current level of immature, consumers and disempowered dependents on *the state* and foolish sense of trust in *authority*as our protective guardians.
We have NOT developed as promised in the Declaration of Independence. A far cry from it! The PEOPLE, have not been the protagonists in creating America Culture for well over 100 years. SO, please, stop talking about what you and yours are coming up with next to help us *get over* whatever new malady you think you have a cure for!
I am quite upset by your position on this, because you seem to believe that an empowered, educated society could evolve into a mass of self debasing misfits. This is absurd reasoning on your part. If you want to determine causation, you have to did deeper than you seem willing to go. This lends itself to a superior vs inferior mindset; that so long as there are erudite, elites, ( like yourself) society can rest assured it will be properly diagnosed, cared for and kept at bay!
You said :
” Without answering this question, you would find that even if psychiatry disappeared overnight, the role would be filled by something else. American society maintains its need to displace the source of distress in individuals, and not look too closely at the structure of society itself . ”
I think I have answered the question. SOCIETY by definition, did NOT create the hierarchy of elite protective, now malevolent, guardians. And in the current wake of an education movement that is overpowering the best efforts of our public school system to keep us dumb and obedient, I’d like to point to the problem with the error in your premise, which you restate as :
” American society maintains its need to displace the source of distress in individuals, and not look too closely at the structure of society itself .”
We have no inherent need to displace our source of distress, but an urgent need to confront IT. IT, being power structures that exploit the masses for profit and have no foundation of credibility for the authority they wield. WE are looking closely at the structure of our society, Dr. Datta— measuring and weighing those *protective guardians*, of which psychiatrists comprise one of the most destructive positions, and WE are finding them wanting…
YOUR erroneous premise has lea you to this erroneous conclusion:
“… if psychiatry disappeared overnight, the role would be filled by something else…”
you seem infer that the *something else* will be equally destructive to the well being/health of our society.. No?
What IS happening is actually a nuance of a tried and true healthy cultural tradition; community building and self reliance– a return to the healthy concept of human wholeness that has been badly eroded by an unchecked, unchallenged small minority of erudite elites who have controlled society, our government via their wealth!
To summarize, you have misdiagnosed the *illness*. You have not discovered the root cause, the necessary information for finding a cure for *American Society’s illnesses*.
Before you write your book, or publish anything more of what you have written, you should read: “The Underground History of American Education” by John Taylor Gatto and “Pharmageddon”, by David Healy.
If you are truly of the academia ilk, then you are somewhat under obligation to research the thesis that presents the greatest opposition to your own. Otherwise, you are only a self professed expert who will publish your own ideas on the merits of the letters after your name. A terrible waste of paper!
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Dr Datta isn’t part of the Big Delusion created by psychiatry and its marketeers.
This self-diagnosed person came in wanting drugs, or inpatient care, or a crazy card.
He turned her down. He didn’t buy into the big delusion that anyone who thinks they may be depressed needs chemical help.
I think we forget just how new the non-chemical imbalance theory is, or at least how short the time is that it has been in public awareness.
Most people I know still believe the chemical imbalance Delusion.
I know a psychiatric professional who diagnoses everyone– everyone– even herself. She is one of many who are deeply caught up in the Big Delusion that make it so difficult to fight. I know I will never convince her that her world view is warped. She has too much invested (and I don’t mean financially) in the status quo.
Every question has an answer, and to her it’s in the diagnosis. She sees everyone as bipolar, epileptic, or borderline personality disorder for the most part, with some OCD and dementia also in her wide, wide net.
Even anchor persons on TV, or sit-com characters have a Dx from her point of view, and all they need is meds.
In reading MIA over the last couple of months, I have come to realize that we will always have a voice of authority in our society. Whatever the motives are behind that voice, whether money, power or political gain, it will be there and people will listen to it and mold their world view to it.
Dr Biederman decided, from his position of authority, that little kids who have temper tantrums are bipolar. I didn’t think so when I read that, but people with little kids having temper tantrums did because it fit their situation and gave them an answer to their problem, one that was easy to fix with a pill, or a lot of pills as it turns out.
As long as an authority figure says, “Medication does help SOME people” and “there are extreme cases which need medical intervention”, there will always be some psychiatric chemical to fill the “need”.
Who decides where to draw that line between “extreme cases” and not so extreme?
Who decides if someone falls into the category of the SOME people who can be helped?
And the problem remains that these decisions are made very quickly and without any input from the extreme case or the patronized SOME. The person is in the ER, or is outside threatening suicide– there’s no time to talk to them and get their perspective on their situation, or ask them if they want the shot in the butt, because it is more important to control the person at the time– and the reasoning is, “they’re OUT OF CONTROL!!!”
So there is no such thing as a chemical imbalance in the brain.
Unless the person is acting wild and out of control, then there is such a thing.
Or if the doctor thinks a sad person “may” be helped by a psychiatric chemical.
Are we back at square one?
The creation of more diagnoses and expanding the diagnosed, increasing the numbers to what we now see as epidemic in order to sell drugs will be difficult to reverse. There is too much to lose for too many.
All the people who spent years learning about it in medical school, all the para-psychiatric professionals, all the drug company employees, all the parents with screaming bipolar toddlers, all the sad people, all the financial investors, all the people who have been made ill by taking brain damaging chemicals…why, these people must add up to more than half of our citizens.
I just made up that statistic, but my point is that we are in very deep.
Dr Datta IS smart, young and well educated. And not delusional.
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pencilect,
Curious way you have of explaining our relationship as a society to authority. For example, you said :
“Dr Biederman decided, from his position of authority, that little kids who have temper tantrums are bipolar.”
Now, how is it that Dr. Biederman has a position of authority? Are there any expectations that we, as a society, have reason to hold regarding the statements made by a full professor at Harvard Medical School? Do we have any reason to believe that something as serious as a labeling our young children with a serious mental illness would be the product of sound scientific evidence? Do we have any reason to expect that a psychiatrist affiliated with,and held up as a leader by HMS would prescribe drugs for young children that alter their developing brains in a number of dangerous ways? or encourage parents to view these drugs as safe even though studies are sketchy, and the FDA is out to lunch when it comes to regulating these drugs for use in children?
Maybe you just haven’t given much serious thought to how morally degenerate it is to create a disease category that opens a new market for GSK, Eli Lilly, etc. by lying to the public. Or perhaps since this has not yet been fully exposed and confronted, you may not realize the impact Harvard’s best and brightest psychiatrists’ fall from grace will have on public opinion of public health! And on our current view of the concept of a position of authority.
As much as you prize the attributes you have assigned to Dr. Datta. I’ll lay odds that it won’t be anyone from Harvard’s School of public health that paves the way for long overdue and critically needed reform of the mental health system. My best guess is that the story will break; the documentary will air and the you- know -what will start hitting the fan!
When you have an hour to spare, google Shelly Jofre BBC. She is a pioneer in the movement that looks like it will put an end to worshipping false idols.
Thank you, David Bates for another amazing essay. My favorite quote :
“Has the young, smart, well educated mind become so embalmed in a split off sense of self, it can’t see reality, right in front of its eyes? ”
I remembered the story you share about the natives of Tierra Del Fuego who could not see Magellan’s ships. It was a scene in “What the Bleep Do We Know?” Excellent documentary… Very stunning use of analogy on your part.
Cheers!
Sinead
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Thanks Sinead:))
I actually used a clip from “what the bleep do we know,” in my analysis of another full term, six week psychosis last November. My nature “acting out,” not a disease process.
Its an essay about psychosis and its species function, as a visionary re-interpretation of where we are, at this point in our evolution.
Beneath our learned social rituals of meet and greet civil discourse, our conversations about this, that and the other, lies a hidden stimulation of electro-chemical activity, within our body/brain. Is there a microcosmically intertwined nature lying beneath our surface and socialized sense of normality, that false self competently adjusted to our alienated social reality, as R. D. Laing puts it?
In going through a psychosis episode that can be seen as illness or existential crisis, depending on your point of reference, am I and others like me experiencing a misunderstood process of metamorphosis?
Metaphor and Meaning within a Personal & Cosmic Metamorphosis?
In early November, 2011 I wrote about my sense of an eternal now, using Franz Kafka’s famous novella to communicate my ideas to others. At least that is the assumption of a rationalizing mind, or was I acting out an unconscious need to unfold my own inner process? Looking back in analysis I’m reminded of the old therapist maxim, “its always about you!” The many times I’ve offered an interpretation or advice to a client, only to have that familiar feeling later, “was that about them or me?”
Metamorphosis: Evolution & The Eternal Now? Posted: TUESDAY, 8 NOVEMBER 2011.
The Metamorphosis is a novella by Franz Kafka, first published in 1915. It is often cited as one of the seminal works of short fiction of the 20th century and is widely studied in colleges and universities across the western world.
Metamorphosis is a biological process by which an animal physically develops after birth or hatching, involving a conspicuous and relatively abrupt change in the animal’s body structure through cell growth and differentiation. References to “metamorphosis” in mammals are imprecise and only colloquial, but historically idealist ideas of transformation and monadology, as in Goethe’s Metamorphosis of Plants, influenced the development of ideas of evolution.
Chaos Theory Chaos theory studies the behavior of dynamical systems that are highly sensitive to initial conditions, an effect which is popularly referred to as the butterfly effect. Can the nature of chaos and the butterfly effect be understood by the thinking mind alone? And what is the TRUTH about Nature, about Metamorphosis & Evolution?
As the world descends into apparent chaos, are we witnessing a shift in the dynamic systems of an underlying reality, including our own? Will we emerge from this current period of apparent crisis (chaos) into a new systemic view, a new awareness of dynamic balance, a new stability of order in our evolving social systems? Are we in Metamorphosis – In Transition?
Does a Thinking non Feeling mind get Lost in Translation?
In Self Interpretation?
From: Mad Visions or Mental Illness? Part 2
http://www.bipolarbatesy.blogspot.com/2012/06/mad-visions-or-mental-illness-part-2.html
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David,-with appreciation for the link you posted.
First view of your presentation is tempting me to spend the day with your thoughts and deeply resonating insights. I thought immediately of this Murphy’s Law axiom:
“When something requires your undivided attention, it will occur simultaneously with a compelling distraction.”
Today I must fulfill my promise to start a few flower beds with my grand children, so will return to your site much later– before I sleep.
I am always drawn into your musings as they are such a delightful synthesis of my favorite topics: neuroscience, spirituality, and the potential we innately possess to grasp the eternal in a single life moment. While some may want or need to given a meaning to madness, putting it in the context of rational *thought* explanations, I find such rationalizations rather mundane — or perhaps cowardly is a better description? The belief that madness is the missing link to our ability to grasp an essence we all share; a pulse of life that permeates all life ,gives madness the higher purpose vibrations that communicate IT is vital to the evolutions of our species.
Reflecting on the tragic history humans have written with regard to the interpretation and the disposition of *madness* amongst our fellow human beings, I am reminded of an analogy Kurt Vonnegut, Jr. employed to illuminate a very seriously self- limiting problem in our species; the selective attention syndrome–only being able to hear the message that is conveyed in a manner that is familiar, soothing to us.
So it goes: Kurt tells us about altruistic , benevolent Martians who have worked out making themselves appear in a non-threatening human form for the purpose of informing Earthlings of the precise and vital information we need in order to avoid destroying ourselves and our planet. Yes, their physical form was completely human, but not having the time to work out spoken language, they arrived with just two means for communicating their urgent message, two entirely human endeavors that most interested and entertained them: farting and tap dancing!
Needless to say, the Martians failed to persuade! But, perhaps a small minority in their audience were able to decode their message? Our biggest threat to survival as a species is that too many of us sell ourselves short—fail to recognize our true potential and worse, medicate and label so many messengers before someone has the chance to decode their urgent message—meant for all of us!
Wonder if you are familiar with “Waking the Tiger – healing trauma” by Peter A. Levine . His approach to mitigating the autonomic nervous system response to trauma triggers has its origins in understanding why animals don’t suffer from PTSD– so it is not the enlightened version of discovering deeper meaning, but it can help to explain what is happening to many in the mental health field who are traumatized by their own fears/insecurities and need our reassurance that recovery (*theirs*) is indeed possible.
Sorry, for the brevity—no trivializing intended. Going out now to fee-e-eeel the day. will respond on your site in more detail!
Smooth sailing…
Sinead
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Levine is my savior:))
No body understands the human condition, like the truly wonderful Peter Levine.
If we want to heal our mental anguish, we should “get thee to a, http://www.somaticexperiencing.com/news-and-updates/a-primer-of-somatic-experiencing.html trained therapist, to miss quote the Bard.
It is only our unconscious “hard wired” dependency and the nature of hierarchical structure, in all things (chaos theory) that keeps us dwelling in ignorance.
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“Dr Datta IS smart, young and well educated. And not delusional.”
I think it was Moses who advised against worshiping false idols/ideals?
Is there an assumption in the value placed on “smart, young and well educated,” which does not resonate with our actual lived experience? Like those private 3am moments of dissonance when all the cognitive “should’s and should not be’s” of public discourse don’t quiet match our “embodied” experience of life.
“Loss is the pivotal human experience.” Monica McGoldrick.
We tend to need a few miles on the clock and quiet a few experiences of loss, before this great teacher of wisdom begins to sweep aside all that we “thought” we knew.
Western culture is beginning to question the degree to which we have been led up the garden path by our “mind” based sense of self, and our dissociation from nature. Consider;
“Without access to the feeling sense, through bodily sensations, our lives would be one-dimensional, black and white. Both our physical life and feeling life, from our most primal cravings to the loftiest creations, depend upon embodiment, engaging the body‘s innate capacity to feel, to heal and to know. (p, 273)
Our tendency is to identify with our thoughts to such an extent that we confuse them with reality, we believe that we are our thoughts. Body awareness exercises can help you detect the fundamental difference between your minds visual image of your body and your actual “introceptive” experience. In discovering that we are not just our thoughts and images, we begin a journey to fullness as living, participating, sentient, embodied creatures. (we come home to the “instinctual self“)(p, 274)
Instincts, at their archaic roots, are compelled actions. They are movements that the body does or postural adjustments that prepare us for these actions. For this reason, physical sensations that guide these actions are the vehicle for direct knowledge of our instinctual selves.
Of our ancestors, cave paintings and other archaeological evidence record the saga of the evolution of embodied human consciousness as it blossomed in self-knowledge, in abstract symbols and finally a written language. As individuals congregated in populated communities, their survival need for constant environmental vigilance waned. Their awareness of bodily sensation took on more of a social function – what is now termed social and emotional intelligence.
As society became more and more complex, the need for greater mental capacity to navigate our position in the group increased. Nuanced body language – the reading of facial and postural cues, gave way to establishing impulse control, and an increasingly mental framework. By the so-called age of reason, the importance of rationality ascended to new heights. Disembodiment, in the service of rationality had become the norm. Finally, the supremacy of rationality congealed in Descartes “I think therefore I am,” iconic statement for modernity. (p, 275)” Peter Levine PhD, “In an Unspoken Voice.”
“Our greatest blessings come to us by way of madness,
provided the madness is given us by divine gift.” _Plato.
In Europe at the moment we see the “talk fests” of the educated priesthood and just how impotent it is, in affecting a reality that our “disembodied” sense of self has created. It seems we may be falling into a well laid trap, set by our mind/body split and Descartes, Le Superior clockwork dictum? Have we become, “mechanical man?” A simplistic, cause and effect, D’head? The smart and well educated who speak thought/words as some “split off” parts of an organismic self? Is the body/brain really put together like an elaborate French Clock, with millions of separate parts? Consider;
“Descartes was a great dualist. He thought not only that there were two types of substance, mind and matter, but that there were two types of thinking, two types of bodily movement, even two types of loving; and, sure enough, he believed there were two types of people: ‘the world is largely composed of two types of minds . . .’ It has been said that the world is divided into two types of people, those who divide the world into two types of people, and those who don’t. I am with the second group. The others are too Cartesian in their categorisation, and therefore already too much of the party of the left hemisphere. Nature gave us the dichotomy when she split the brain. Working out what it means is not in itself to dichotomise: it only becomes so in the hands of those who interpret the results with Cartesian rigidity.” _Iain McGilchrist. “The Master and His Emissary.”
Has the young, smart, well educated mind become so embalmed in a split off sense of self, it can’t see reality, right in front of its eyes?
Example: When Magellan’s fleet sailed around the tip of South America he stopped at a placed called Tierra del Fuego. Coming ashore he met some local natives who had come out to see the strange visitors. The ship’s historian documented that when Magellan came ashore the natives asked him how he had arrived. Magellan pointed out to his fully rigged sailing ships at anchor off the coast. None of the natives could see the ships. Because they had never seen ships before they had no reference point for them in their brains, and could literally not see them with their eyes. Therefore, it is to our advantage to expose our brains to varied stimulus so that the proper neuronal connections are forged. In this way we expand and enrich our ability to experience more of our environment in a meaningful way.
Do these smart young minds pause to “catch the gap between the spark and flame?”
The Brains Motor Cortex & Unconscious Premovement: The brains activity began about 500 milliseconds before the person was aware of deciding to act. The conscious decision came far too late to be the cause of the action. It was as though consciousness was a mere afterthought – a way of ‘explaining to ourselves’ an action not evoked by consciousness. Peter Levine “In an Unspoken Voice”
“Curse the mind that mounts the clouds in search of mythical kings and only mystical things, mystical things cry for the soul that will not face the body as an equal place, and I never learned to touch for real down, down where the iguanas feel” _Dory Previn.
Is it an ancient “felt sense,” which has been lost to denial, in our need to ensure group harmony, through this pale imitation of life, we call cognition? A cognitive capacity which is essentially about “modulating” the metabolic energies, of the fire within? The heart stimulated cerebral tone, set by the orienting motor reflex. Our postural attitude to life and each other.
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Given that I’m an American, I agree with Dr. Datta’s suggestion that there’s something very wrong with American life (as an example of what’s wrong with many post-industrial states).
People should not have to take drugs to tolerate their jobs, yet that’s what people do when they’re stuck in tedious, pressured corporate work that keeps them sedentary and isolated all day.
People should not be taking drugs to deal with unhappy marital relationships, they should be dealing with their relationships.
People should not be taking drugs to bear the privations of poverty, yet they do.
I agree with Dr. Datta the existence of these anesthetizing agents, much of which is prescribed by doctors, keeps the general public from looking at what’s wrong with society, the blame for failure being shifted to the individual.
However, I do not agree that all the above has absolved the individual physician of his or her responsibility to at the very least do no harm to patients. That is a societal contract that has not yet been dissolved.
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Did we need a Harvard elite to tell us that?
Or a journalist to tell us that Capitalism has a “predatory” nature? What makes “the system” work is our unconscious motivation.
Like watching American debate swing in true bipolar fashion between vitriolic attack of “otherness” or sycophantic support of we-ness?
The ingrained nature & history of a culture, which is one of the most violent on the planet. No wonder Americans are “stuck” in “us & them.” The Psychopathology of American Life?
“We have a built in Arousal cycle that we have inherited from our animal ancestors to protect us from danger. Most people are aware of this Flight or Fight response to danger yet many people are not aware of the Freeze or Appease response.” http://www.thesanctuarylanecove.com/resources_arousal_cycle.php
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Sinead,
I am not worshipping a false idol.
Doctors such as Vivek Datta are not delusional in that he didn’t handle this incident in the way most psychiatric residents would.
The psych residents I know have all bought into the whole drug scheme. If a woman came into the ER and had already diagnosed herself, that would just make their job even easier.
Skip step 1, diagnosing, and go right to the prescription pad! Pat her on the head and send her on her way.
My point about Dr Biederman went right past you. There are too many situations in which ONE doctor or institutional following, manages to convince everyone of their brilliance and then goes forth and destroys millions of lives. Dr. Biederman is one. Dr Robert O. Wilson is another. Max Fink and Harold Sackheim are two other “authorities” who continue to wreak havoc on brains through ECT, indirectly, but with financial ties to the industry and no CONSCIENCE to stop them.
Dr Philip Coons spread the myth that between one and ten percent of the population has MPD, back in the 1980’s. His statistics proved it, because when it comes to iatrogenic illness, MPD is on top of the list.
Probably the only reason that died out is because there is no DRUG to “treat” it, and all the lawsuits during the Recovered Memories heyday. But he convinced a lot of people and had a large following of believers.
Worshipping these quacks is the furthest thing from the truth. It makes me angry when I discover that an individual with professional status has abused their position of authority.
This is why I call them delusional. They have bought their own false beliefs.
I usually tend to think they are not brilliant at all, except in their ability to fool people, and I’m always amazed how easily the public is swayed by them. But just look at the diet industry to see how easy it is to make money selling false hope.
The story of how Prozac was “discovered” was written up in a popular magazine with an interview of the two scientists responsible for it. Their tone was very casual. They considered it an accident, a fluke, and a eureka moment.
Thiat was in 1989. The two chemists were scratching their heads in wonder at what they had done. Wow we just discovered how to make everyone happy and make a lot of money, too. Little did they know what kind of monster they had unleashed from their lab in Greenfield.
I wish you had chosen to respond to this part of my reply, “Are we back to square one?”
More than powerful doctors and authority, money, and societal and personal responsibility, the fact that there is no such thing as a chemical imbalance in the brain of a distressed person needs to be settled once and for all.
There is no biological basis to mood changes, distraction in classrooms, having a temper tantrum, being fearful for no “apparent” reason, or even hearing voices, and psychiatry needs to admit that it doesn’t have any business meddling in an area that is beyond their expertise.
Recent reports that we are undergoing too many diagnostic scans and that we need to be more cautious before just having a CT scan, dental X-Ray, or mammogram have made us aware that even though imaging is helpful, it isn’t always necessary.
This will result in less scanning and less money to be made by promoters of scans. If the tide can be turned on how radiology is used, what will it take for this psychiatric monstrosity to be brought down?
Not more research. There is plenty of research already, although it is full of holes and biased on the side of where the money comes from.
But we do need intelligent doctors who are willing to see the monster from a fresh viewpoint and not toe the line. I see Dr Datta as having potential in that regard, and I am not worshipping him or any false idol.
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pencilect, as you suggest. I will respond to:
“I wish you had chosen to respond to this part of my reply, “Are we back to square one?”
“More than powerful doctors and authority, money, and societal and personal responsibility, the fact that there is no such thing as a chemical imbalance in the brain of a distressed person needs to be settled once and for all.
There is no biological basis to mood changes, distraction in classrooms, having a temper tantrum, being fearful for no “apparent” reason, or even hearing voices, and psychiatry needs to admit that it doesn’t have any business meddling in an area that is beyond their expertise.”
PRECISELY!! THIS is NUMERO UNO on my hit parade. THE WORK I WOULD STRONGLY URGE THOSE IN THE FIELD OF PUBLIC HEALTH TO UNDERTAKE… SOONER RATHER THAN LATER… CREATE A LARGE SCALE PUBLIC EDUCATION INITIATIVE TO DISPEL THE MYTH OF BIOCHEMICAL IMBALANCES CAUSING THE SYMPTOMS OF MENTAL ILLNESS…. AN EDUCATION CAMPAIGN ON THE SCALE OF HIV AIDS EDUCAITON!!
AND: T’would be nice to see some public health docs confront the bottom feeding crooks who have absolutely no right to still have a license to practice medicine!
ALL in the interest of PUB:IC HEALRH—relevant to our lives NOW.
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PUB:IC HEALRH> should read:
*PUBLIC HEALTH*
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pencilect – thank you for your comments. you have given me some food for thought which I will address in my next post!
V
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