NY Times Invites Readers to a Dialogue on Forced Treatment

January 30, 2013

Chris Gordon, a Harvard psychiatrist writing in the New York Times, questions the “dangerously stigmatizing” linking of violence and mental illness. The Times invites readers to respond by tomorrow (Thursday, January 31) to be part of its “Sunday Dialogue”.

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18 thoughts on “NY Times Invites Readers to a Dialogue on Forced Treatment

  1. Sent to the NY Times Editor.

    Dear New York Times editor,

    I am writing to you concerning your invitation for comments regarding forced psychiatric treatment. I apologize for sharing my story anonymously but as you will see, this was a very humiliating experience. One of the many unfortunate effects of psychiatric misconduct is the continued stigma that exists in all things related to mental disorders so I am not ready yet to go public with this; maybe someday I’ll find the courage to discuss this openly but I am not there at this time.

    I begin by saying that I wholeheartedly agree with what Dr Gordon had to say. In my own case, as a result of the experience, I lost all contact with my parents and siblings. I don’t know what they are up to these days and frankly, I do not want to know. So in my case, my parents following the advise of a psychiatrist to commit me has resulted in them losing a son and in me losing my parents for all practical purposes.

    I am an American male, of European origin, in my late thirties. I only hold American citizenship and I only held American citizenship when this thing happened. I am highly educated with a scientific doctoral degree from one of America’s best schools. During most of my adult life I have struggled with a condition that was diagnosed as Obsessive Compulsive Disorder, OCD. The funny thing is that psychiatry dumps into this disorder all kinds of different types of mental distress. In my case it’s an exaggerated fear of contracting HIV through casual contact. Now, I don’t mean to say that this condition doesn’t cause me distress. However, it doesn’t warrant the type of abuse I am about to describe. When this episode happened I was married; my ex-wife was of great help, which probably avoided the ruin of my professional life.

    As the vast majority of people, I had a neutral position on the whole field of psychiatry. I assumed that it was just like any other branch of medicine, tested and confirmed by the scientific method to be 100% accurate both in diagnosis and prediction. All that changed a few years ago when I was involuntarily committed to a psychiatric institution and forcibly drugged in the European country where I was born for treatment of OCD.

    Unlike the laws of the United States (which are largely the result of the 1975 SCOTUS case O’Connor v. Donaldson), the laws of that country afford psychiatrists all-encompassing power to commit whomever they wish and to drug any individual against his/her will. The O’Connor v. Donaldson case was a victory for human rights and, as it usually happens in human rights issues, the US has been the leader on that area. In that country, any psychiatrist can order to involuntarily commit and drug forcibly any patient in cases in which a psychiatrist determines it to be necessary, regardless of whether a finding that the patient’s life or a third party’s life is in danger exists. I was forcibly detained; tied up for almost one day and then forced to stay in 2 different mental institutions for several months. The psychiatrists I worked with during that time are amongst the most arrogant people I have met in my entire life, which shows that, if you give anybody such power, they will become inevitably corrupt. The humiliation that I endured will stay with me for the rest of my life. My parents asked the psychiatrist to commit me. Out of respect to them, I did not invoke the protections afforded by international treaties, of which both the European country that detained me and the US are signatories, to citizens detained against their will in a host country. So I was pretty much on my own, with the help of my ex-wife to fight this. I was lucky that the company I was working for at the time here in the US was very patient with me; my ex-wife was able to manage the situation with them, but those psychiatrists who committed me couldn’t care less about my professional situation here in the US or whether I could be laid off for not showing up to work.

    And then there is the forced drugging and the side effects. The American Psychiatric Association, APA, recommended pharmacological regime for OCD treatment involves the prescription of serotonin reuptake inhibitors, either modern SSRIs or older ones such as tricyclic antidepressants -like clomipramine-, at doses that are 2-3 times higher than what is prescribed for normal depression. It is normal practice to supplement the prescription of these antidepressants with antipsychotic medication to “strengthen the effect of the antidepressant drug”, whatever that means. I continued with the medication regime upon coming back to the US. Over the course of 12 months I was prescribed (though at different times) escitalopram, clomipramine, sertraline, risperidone, olanzapine and lorazepam. Even though the APA also says that Cognitive Behavioral Therapy, CBT, alone is more efficient than meds for the treatment of OCD, I was made very clear that unless I agreed to be put on a medication regime, I would not be released from my involuntary commitment. So I had no choice but to agree to be put on meds if I wanted to get out of there. After I refused to continue with the drug regime, I have not been back to that country out of fear that I could be committed again.

    Upon my return to the US, I started to be treated by a psychiatrist (meds) and a clinical psychologist (CBT). At the time of my admission to the European hospital, I was given comprehensive blood tests that showed all my biological markers within normal range, those of kidneys and liver in particular. Upon learning of my medication regime, my American psychiatrist ordered new blood tests that showed clear kidney impairment.Other markers looked normal. I was sent to a kidney specialist who, after all kinds of tests, couldn’t find the cause of kidney malfunction other than the meds I was taking which were “supposed” to be harmless. A few months later, I had new blood tests and this time not only the kidneys didn’t show any improvement, but it was the liver markers AST/ALT that were out of range. An ultrasound test showed also that I had began to develop fatty liver. After months that showed no improvement of these two conditions -in addition to the fact that I had been experiencing other side effects associated with antidepressant/antipsychotic such as increased cholesterol levels and weight gain-, and against the advice of my American psychiatrist, I made the decision of stopping all medications. One month and a half later, I had a new blood test performed on me and bingo!; the AST/ALT markers were back within normal range while the creatinine serum level went down to normal levels too. A few months after stopping all meds, my cholesterol levels went back to normal. I am not a medical doctor, but I have an excellent doctoral education in a scientific field. The data collected from my case shows very convincingly that in my case these medications were causing significant side effects that risked to cause long term damage to my kidneys, to my liver and to my overall health due to the elevated cholesterol levels.

    I learned several things from this ordeal,

    1- Psychiatrists in general love to prescribe drugs. They will use any excuse they can find to do it, even if, as it is widely admitted, the field of psychiatry has yet to find a single biological marker that can be reliably described as the cause of any mental disorder. As to why this is the case, originally I thought it had to do with psychiatrists desire to be considered as equals by doctors who practice other specialties of medicine, a reason that doesn’t speak very highly of psychiatrists’ inferiority complex but which is understandable. However, after the episode of my involuntary commitment was distant in time, I began to research on the topic and I am appalled at what I found. I was made aware of the work by US senator Chuck Grassley which exposed the undisclosed financial ties to big pharma of “prestigious” psychiatrists such as Joseph Biederman, Charles Nemeroff, Martin Keller or Alan Schatzberg -the latter served as president of the APA even after the extent of his misconduct was publicly known-, the APA, and its front groups such as NAMI; right now I am more of the opinion that it has to do with a more mundane reason: greed. All these people engaged at some point or another in ghost writing, a practice that consists in that somebody hired by a pharmaceutical company writes a book or an article promoting a drug or a given clinical practice. The article/book is then presented as authored by the psychiatrist in question. The end result is that few people question the findings of the work, regardless of its scientific quality, because it is promoted as authored by some “prestigious” doctor. Of course, the “prestigious” doctor is duly paid by the pharmaceutical company for the cooperation.

    2- The guides of the APA, such as the DSM, have far reaching effects beyond the American market. The DSM was used to give me the OCD diagnosis in the European country where I was involuntarily committed. If the DSM, as it seems to be the case for DSM5, begins to promote the over use of psychiatric drugs, its effects will be felt not only here in the US but worldwide, which takes me to the third point.

    3- The US is, as it has been in many other instances, a pioneer in the protection of individuals’ rights, in this particular case psychiatric patients’ rights. A series of opinions by the US supreme court in the seventies, O’Connor v Donaldson (1975) and Addington v Texas (1979) in particular, limited the ability of American psychiatrists to involuntarily commit patients to psychiatric institutions except in those cases where the life of the patient (or the life of a third party) is in imminent danger. Subsequent decisions also limited psychiatrists’ ability to drug patients against their will. All this is relevant because I was able to make the decision of stopping all medications without the fear of retaliation only because I am an American living in America. This decision might have meant a trip back to the psychiatric ward in that European country, despite the severe effects I was experiencing. That is not to say that psychiatrists do not abuse their power in the US, there is plenty of evidence to the contrary, however, their ability to abuse patients is severely limited.

    Ideally, we should have the current practice of psychiatry disbanded and the DSM abolished. That is unlikely to happen, at least in the short term, because there are so many special interests (the APA, big pharma, the FDA) interested in maintaining the status quo. However, we can all fight so that their negative effects are attenuated, not only for our fellow Americans but also for the sake of millions of innocent people who live in countries which are less protective of patients’ rights and who are likely to be abused by the psychiatric establishment of their countries with an expansive revision of the DSM.

    In the context of his article we should remind everybody Dr Gordon’s words “psychiatrists have limited capacity to reliably predict violence”. Lowering the standard for civil commitment will only result in abuses like the one I endured becoming more common place. We are all appalled for what happened in Sandy Hook. But giving psychiatry more power to commit whomever they wish is not the answer. I have to admit that I have had a very hard time in the last month when I began hearing people from the right calling for an easing of civil commitment standards as their easy answer to solve tragedies like Sandy Hook’s. As the Norwegian massacre shows, giving more power to psychiatry to commit people will not prevent these massacres. It will however make psychiatric abuse more common place in America.

    Sincerely yours

  2. I also wrote a letter to the editor, referencing the many shooters who had received psychiatric “help” BEFORE going on their shooting sprees. I encourage anyone with experiences to share or data to impart to write a letter. I’d love to see them bombarded with rational letters supporting the author’s viewpoint.

    —- Steve

  3. Thank you for the heads-up. Here was my go at it.

    To mandate psychiatric care in a system so manifestly broken seems a cruel and inhumane treatment for those suffering mental disorders. Those who argue that the system is not in crisis should be ignored, as they are not paying attention, or they are likely the ones who broke the system in the first place. The symptoms of Psychiatry’s dysfunction are overwhelming, and space constrains me to name only a few.

    The APA has a failing language– the new DSM-V offends everybody equally, and its diagnostic changes will be ignored by most practitioners.
    It has a broken disciplinary system — the government recently settled against GlaxoSmithKline for 3 billion for their criminal marketing behavior, but the ghost writing authors of “Study 329″ had no similar correction from the JAACP, and the Key Opinion Leaders who sought to make the whole world “happy, horny and skinny” with Wellbutrin are still writing prescriptions.
    Perhaps its worst injury is that Psychiatry does its greatest harm to those who are most weak — to those who are young and those who are minorities. Dr. Frances in his scathing critique of the DSM-V above, rightly rebukes Child Psychiatry for expanding its diagnostic dragnet with Disruptive Mood Dysregulation Disorder rather than repenting of its “sorry track record” and calls the field to “engage itself now in the crucial task of educating practitioners and the public about the difficulty of accurately diagnosing children and the risks of over- medicating them.” And when persons of color are given a stigmatizing diagnosis like schizophrenia at a higher rate, and given harsher treatments for their mental disorders –it is what this author calls Psychiatry’s “darker side of cultural variance, as not only does it affect the diagnosis, but it can also negatively effect the patient’s treatment.” There is a reason it is people of color who are largely the ones housed in the nations largest mental health facilities, that is, our county jails.

    I am a daughter and mother of those who have been treated by the psychiatric system. Twice I have had to place involuntary psychiatric holds on loved ones, so I know intimately the anguish of this decision, and the helplessness one feels when it feels little can be done to help a dear one spinning out of control. But I know equally well the futility of such mandated care — the bureaucratic nightmare Psychiatry’s inapt answers and broken delivery system forces upon the already suffering extended family. The crisis is especially acute in the care of adolescents at risk.

    When my own daughters began showing symptoms, we went through psychiatrist after psychiatrist. I found out again that the system is so, so broken. The meds prescribed off-label made things so much worse, adding paranoia, weight gain and tardive dyskinesia into the volatile mix of symptoms . My brave daughters have defied the system and their psychiatric labels. They did the research, cheeked the meds and tapered themselves off psychotropics completely, and in the process they educated me. Their days are not without struggle, but they hold a narrative of hope and recovery now that emboldens them to persevere in the fight for a dignified life. They refuse the psychiatric establishment’s story that they have a crippling chemical imbalance in their brains that dooms them to a lifetime of substandard living.

    I wish I had never bankrupted our family with that first 5150 years ago, depleting our resources , financially and emotionally. I found out too late that forcing treatment does more harm than good.

    • When my parents triggered my commitment they lost a son. For the next year or so I agreed to follow with the psychiatric scam. When my marriage fell apart, something that happened largely as a result of the continuous blackmail psychiatrists submitted my ex wife to, I decided enough is enough. I stopped talking to my parents and never looked back. Even though this happened a long time ago, the experience of having been forcibly drugged and detained has stayed with me all this time. It has been particularly tough to watch TV during the last few weeks because of the insistence I hear from some right nutcases that the safeguards against psychiatric abuse that exist in the US be lowered. The damage psychiatry does to people’s lives cannot be understated.

  4. sent to the nytimes editor:

    The practice of psychiatry has no scientific reliability or validity. There are many court cases involving psych drug induced murder/suicide and the surviving family’s were awarded millions of dollars. In fact, Psychiatric drugs kill an estimated 3,000 people every month. If every victims family got justice, the drug companies would be out of business.
    I propose an alternative solution. Outlaw psychiatry and psychiatric drugs.

    sincerely, survivor030406

  5. The practice of the NYT, when they deal with psychiatric issues, has been to completely ignore our viewpoint and our voices. I will be extremely surprised if their policy changes for this “dialogue,” which I expect will mostly feature various mental health professionals, all in agreement that they should have much more power over us, with the disagreements limited to just how many of our rights we should have taken away.

    In trying to comment on a recent Times article that was NOT about “mental health,” I discovered that the Times’ censor was VERY heavy-handed. I modified my post to suit, or so I thought, but apparently I was now on the censor’s list of subversives.

    The Times is in a bad way financially, as are a lot of print publications, and I can’t wait till they go out of business.

    Please wake me up when this alleged dialogue is over.

    • All this talk about lowering the standard for civil commitment in the US as a result of the Sandy Hook massacre has caused me a lot of distress. I thought I had moved on from the whole thing, since it is distant in the past, but suddenly it’s like the whole episode had come to life again, causing me even nightmares. It’s the same feeling a woman that was raped might feel if TV suddenly started to publicly praise her rapist. Sicking to the stomach. This psychiatric abuse has to stop.

    • You were absolutely right,

      http://www.nytimes.com/2013/02/03/opinion/sunday/sunday-dialogue-treating-the-mentally-ill.html?pagewanted=all

      It’s pathetic that they have chosen to emphasize the responses from the crowd that favors forced treatment.
      This is an utterly unfair situation in which the bullies and tormentors like Dr Jaffe or his pal E Fuller Torrey are free to market their recipe of “civil commitment for all” openly while us on the receiving end of their ill policies are forced to go into hiding for our own well being.

      • My comments were included, if somewhat reduced in detail. I think mine was the only one to connect the shootings to actually RECEIVING psychiatric care. The original author chose not to comment on that particular point.

        — Steve

        • Thanks,

          Yes, I was surprised that they published it (I didn’t make the connection that you were this “Steve”). The response selection was very biased though. Not only because of the number of responses dedicated to each side of the argument (the forced drugging crowd had more) but because they gave more space to those who were in great lengths to reason by anecdote (like that Gary guy talking about his mother) for forcibly drugging people against their will. They didn’t give a voice to Fuller Torrey but they did the next egregious thing, giving lots of space to Mr Jaffe. While I understand they didn’t publish mine (it was an anonymous story that I send so that I could push them to be more balanced), they could have published the story of Karen Butler above but they didn’t. They did however bring in the usual suspects for defending forced drugging (the aforementioned Jaffe, some random prosecutor that speaks of the “drama” of people “untreated” and so forth). Very deceiving.

          • Thank you, cannotsay2013, for thinking my piece was worth hearing. I thought in your reaction– saying that your parents had lost a son– that you were angry at me for the 5150, as well. When I read your comment to my daughter, she said “yes, you nearly lost me too!”

            She was able to stay in the process, was able to recognize our motives, however misguided, were from love and concern, and we all benefited as she educated us about psychiatry. I think that is one of the great damages of forced commitment, that it can rupture already strained relationships.

            And that is one of the great benefits of Open Dialog — that it sees the family as a whole, and is not just carting off the ‘identified patient’.

          • Karen,

            Sure I think your piece was worth publishing. My parents lost a son yes, but my anger can only be directed at them, not you, you didn’t do anything to me :D. You at least have recognized the damaged you caused, something that my parents never did. They were brainwashed by the psychiatrist that committed me and they never thought they did any thing wrong. In fact, the last time I talked to them, they thought they had done me “a favor”. Needless to say not only I stopped talking to them but I haven’t been back to that country since I broke my ties with them. Fool me once, shame on you, fool me twice, shame on me.

            To this day, this experience haunts me. Every time I hear about the so called “mentally ill” and how “civil commitment” standards should be lowered, I get reminded of the experience. And I have heard a lot about that, especially from the right in their search for an easy answer, in the aftermath of Sandy Hook tragedy.

            Basically, my parents destroyed my life on many levels. Because of the commitment, I cannot apply to jobs that require important background checks. I cannot legally own guns either, because federal law forbids those who have been civilly committed from owning them. Not that I ever wanted to own guns, but it is one thing not wanting to own them, quite another to have that constitutional right taken away from you because of the evilness of some psychiatrist. When people make jokes about being “crazy” it’s like being stabbed in the back.

            I condemn civil commitment under all circumstances. It’s incarceration, plain and simple. We already have a criminal justice system to take care of those who commit crimes. This idea that somebody is “helped” when they are “incarcerated”, as I was, without having committed any crime whatsoever is preposterous. The person is stigmatized for the rest of his/her life. I have yet to meet anybody who is happy to have been involuntarily committed. If there are any, I haven’t met them.

            Thanks for sharing your experience.

  6. I was 15 years old 1966/67 when I was committed to a State Hospital. Before that I was a member of the Girl Scouts for 7 years, a member of my high school concert, marching, and pep band, I was a member of the Girls Athletic Association and earned awards in track and field, I was a member of the high school hiking club, and a member of the choir. Once committed, all these things were lost.
    I was 19 years old when two psychiatric technicians drove me for hours until we were in the middle of a big city where they stopped the car and told me to get out. I had no money and no idea of how to get any money, so I remained homeless and without any family for years.
    I have worked in the mental health field for over 20 years in administration and it is the administrators of the system that abuse people. I attended an administrative meeting of a mental health outpatient clinic where I worked and found them discussing how they were going to facilitate an emotional breakdown of a consumer. When I stood up against this premeditated psychological warfare toward the destruction, I was fired from my position and they did just as they had planned and broke many of the consumers intentionally. There are many cruel people working in the administration of mental health facilities and there are many more that stand by and allow it.
    I am 61 years old now and still struggle from the abuse of the psychiatric system. I thought that self-help and working in the consumer movement at a consumer run statewide organization would be safe, but they too were abusive. Therefore, I do not think it wise to force this abuse on anyone. Honestly, I am a living example of the non-violence of those labeled mentally ill, because I surely have had reason to be enraged.

    • What a horrible tale! I admire your gumption in trying to turn your own trauma into a benefit for others who are similarly at the mercy of these “professionals” who often lack mercy and empathy altogether, at least toward their “patients.” Thanks for sharing your story. I’m glad you’re still fighting – we’re with you!

      —- Steve

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