Psychiatry Admits It’s Been Wrong in Big Ways, But Can It Change? A Chat with Robert Whitaker

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Since I interviewed Robert Whitaker for AlterNet in 2010, after the publication of Anatomy of an Epidemic, the psychiatry establishment has pivoted from first ignoring him, to then debating him and attempting to discredit him, to currently agreeing with many of his conclusions. I was curious about his take on the recent U-turns by major figures in the psychiatry establishment with respect to (1) antipsychotic drug treatment, (2) the validity of the “chemical imbalance” theory of mental illness, and (3) the validity of the DSM, psychiatry’s diagnostic bible. And I was curious about Whitaker’s sense of psychiatry’s future direction.

Bruce Levine: In 2013, the director of the National Institute of Mental Health (NIMH), Thomas Insel, announced—without mentioning you— that he agreed with your conclusion that psychiatry’s standard treatment for people diagnosed with schizophrenia and other psychoses needs to change so as to better reflect the diversity in this population. Citing long-term treatment studies that you had previously documented, Insel came to the same conclusion that you had: in the long-term, not all but many individuals who have been diagnosed with psychosis actually do better without antipsychotic medication. Was it gratifying for you to see the U.S. government’s highest ranking mental health official agreeing with you?

Robert Whitaker: Shortly before Thomas Insel wrote that blog, I had posted my own on madinamerica.com, related to a recent study by Lex Wunderink from the Netherlands. Wunderink had followed patients diagnosed with a psychotic disorder for seven years, and he reported that those randomized, at an early date, to a treatment protocol that involved tapering down to a very low dose or withdrawing from the medication altogether had much higher recovery rates than those maintained on a regular dose of an antipsychotic.

I wrote that in the wake of Wunderink’s randomized study, if psychiatry wanted to maintain its claim that its treatments were evidence-based, and thus maintain any sort of moral authority over this medical domain, then it needed to amend its treatment protocols for antipsychotics. I don’t know if Dr. Insel read my blog, but his post did nevertheless serve as a reply, and as you write, he did basically come to the same conclusion that I had been writing about for some time.

I suppose I took some measure of personal gratification from his blog, for it did provide a sense of a public acknowledgment that I had indeed been “right.” But more important, I felt a new sense of optimism, hopeful that maybe psychiatry would now really address this issue, which is so important to the lives of so many people. A short while ago, the New York Times published a feature story on Dr. Insel, noting that he had recently raised a question about the long-term use of antipsychotics, which had caused a stir in psychiatry because it contradicted conventional wisdom. That is a sign that perhaps a new discussion is really opening up.

Bruce Levine: In Anatomy of an Epidemic, you also discussed the pseudoscience behind the “chemical imbalance” theories of mental illness—theories that made it easy to sell psychiatric drugs. In the last few years, I’ve noticed establishment psychiatry figures doing some major backpedaling on these chemical imbalance theories. For example, Ronald Pies, editor-in-chief emeritus of the Psychiatric Times stated in 2011, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” What’s your take on this?

Robert Whitaker: This is quite interesting, and revealing I would say. In a sense, Ronald Pies is right. Those psychiatrists who were “well informed” about investigations into the chemical imbalance theory of mental disorders knew it hadn’t really panned out, with such findings dating back to the late 1970s and early 1980s. But why then did we as a society come to believe that mental disorders were due to chemical imbalances, which were then fixed by the drugs?

Dr. Pies puts the blame on the drug companies, but if you track the rise of this belief, it is easy to see that the American Psychiatric Association promoted it in some of their promotional materials to the public, and that “well-informed” psychiatrists often spoke of this metaphor in their interviews with the media. So what you find in this statement by Dr. Pies is a remarkable confession: psychiatry, all along, knew that the evidence wasn’t really there to support the chemical imbalance notion, that it was a hypothesis that hadn’t panned out, and yet psychiatry failed to inform the public of that crucial fact.

By doing so, psychiatry allowed a “little white lie” to take hold in the public mind, which helped sell drugs and of course made it seem that psychiatry had magic bullets for psychiatric disorders. That is an astonishing betrayal of the trust that the public puts in a medical discipline; we don’t expect to be misled in such a basic way.

But why now? Why are we hearing these admissions from Dr. Pies and others now? I am not sure, but I think there are two reasons.

One, the low-serotonin theory of depression has been so completely discredited by leading researchers that maintaining the story with the public has just become untenable. It is too easy for critics and the public to point to the scientific findings that contradict it.

Second, a number of pharmaceutical companies have shut down their research into psychiatric drugs [see Science, 2010], and they are doing so because, as they note, there is a lack of science providing good molecular targets for drug development. Even the drug companies are moving away from the chemical-imbalance story, and thus, what we are seeing now is the public collapse of a fabrication, which can no longer be maintained. In the statement by Dr. Pies, you see an effort by psychiatry to distance itself from that fabrication, putting the blame instead on the drug companies.

Bruce Levine: And recently, establishment psychiatrists have even been challenging the validity of psychiatry’s diagnostic bible, the DSM. Last year, NIMH director Insel, citing the DSM’s lack of scientific validity, stated that the “NIMH will be re-orienting its research away from DSM categories.” And psychiatrist Allen Frances, the former chair of the DSM-4 task force, has been talking about how the DSM is a money machine for drug companies (“Last Plea To DSM-5: Save Grief From the Drug Companies”), and Frances thoroughly trashed the DSM-5 in his 2013 book Saving Normal.

Robert Whitaker: I think this challenging of the validity of DSM is, in many ways, potentially much more of a paradigm-changer than are the scientific reports that detail how the medications may be causing long-term harm. Our current drug-based paradigm of care, which presents drugs as treatments for the symptoms of a “disease,” stems from DSM III. The APA [American Psychiatric Association] and its leaders boasted that when DSM III was published in 1980, that the field had now adopted a “medical model,” and thus its manual was now “scientific” in kind.

In fact, the APA had adopted a “disease model,” and if you carefully read the DSM III manual, you saw that the authors acknowledged that very few of the diagnoses had been “validated.” The APA’s hope and expectation was that future research would validate the disorders, but that hasn’t happened. Researchers haven’t identified a characteristic pathology for the major mental disorders; no specific genes for the disorders have been found; and there isn’t evidence that neatly separates one disorder from the next. The “disease model,” as a basis for making psychiatric diagnoses, has failed.

We are now witnessing, in Insel’s statements and those by Allen Frances, an acknowledgment of this failure. And here is why this is potentially such a paradigm-changer: The foundation of any medical specialty begins with its diagnostic manual, which should be both reliable and valid. If the disorders listed in a manual haven’t been validated, then you can’t conclude they are “real,” in the sense of the disorders being unique illnesses, and the diagnoses being useful for prescribing an appropriate treatment.

Thus, when Insel states that the disorders haven’t been validated, he is stating that the entire edifice that modern psychiatry is built upon is flawed, and unsupported by science. This is like the King of Psychiatry saying that the discipline has no clothes. If the public loses faith in the DSM, and comes to see it as unscientific, then psychiatry has a real credibility problem on its hands, and that could prove to be fertile ground for real change.

Bruce Levine: So do you feel you have accomplished your mission? And can dissident mental health professionals—who have for years been talking about invalid diagnoses, pseudoscientific theories of mental illness, and drug treatments that cause moderate and acute problems to become severe and chronic ones—now have reasons to be optimistic about their profession? Or are you pessimistic that the recent admissions of establishment psychiatry will result in substantive changes in treatment?

Robert Whitaker: This is a good question, and I vacillate in my personal response between guarded optimism and complete pessimism. From an intellectual, scientific standpoint, I think psychiatry is facing a deep crisis. There is an understanding, within psychiatric research circles, that the DSM diagnoses haven’t, in fact, been validated. And, at the very least, there is a recognition that psychiatry’s drug treatments are inadequate. In 2009, Insel wrote an article stating: “For too many people, antipsychotics and antidepressants are not effective, and even when they are helpful, they reduce symptoms without eliciting recovery.” And I do think that my book Anatomy of an Epidemic has contributed to an awareness of the limitations of the drugs, and at least a discussion, in some psychiatric circles, that the drugs may be worsening long-term outcomes.

But in terms of accomplishing my mission, well, I guess my “mission” would be to see that our society would actually build a system of care that was truly “science” based, particularly in its use of psychiatric drugs. I think this is such an important story for our society, and one of extraordinary moral importance when it comes to medicating children and adolescents, none of whom could be said to have really “consented” to such treatment. I turned madinamerica.com into a webzine with the hope that by providing a forum for a community of writers interested in “rethinking psychiatry,” and combining their voices with reports of research that provide a foundation for such rethinking, it could become a real force for change. We’ll see if that happens, but our readership is steadily increasing.

I should note, as you say, that dissident mental health professionals have been plugging away at promoting such change for a long time. I hope that madinamerica.com is providing that community a forum for voicing their criticisms, and making them known to a larger audience.

And now for why I can be so pessimistic. Even as the intellectual foundation for our drug-based paradigm of care is collapsing, starting with the diagnostics, our society’s use of these medications is increasing; the percentage of children and youth being medicated is increasing; and states are expanding their authority to forcibly treat people in outpatient settings with antipsychotics drugs. Disability numbers due to mental illness go up and up, and we don’t see that as reason to change either. History does show that paradigms of psychiatric care can change, but, in a big-picture sense, I don’t know how much is really changing here in the United States.

I think dissident mental health professionals also have to confront this question. Can they be hopeful that their professions will change their ways, and their teachings? I think so, but there is so much that needs to be done.

Bruce Levine: Is it really possible for psychiatry to reform in any meaningful way given their complete embrace of the “medical model of mental illness,” their idea that emotional and behavioral problems are caused by a bio-chemical defect of some type? Can they really reform when their profession as a financial enterprise rests on drug prescribing, electroshock, and other bio-chemical-electrical treatments? Can psychiatry do anything but pay lip service to a more holistic/integrative view that includes psychological, spiritual, social, cultural, and political realities?

Robert Whitaker: I think we have to appreciate this fact: any medical specialty has guild interests, meaning that it needs to protect the market value of its treatments. If it is going to abandon one form of treatment, it needs to be able to replace it with another. It can’t change if there is no replacement in the offing.

When the APA published DSM III, it basically ceded talk therapy to psychologists, counselors, social workers, and so forth. Psychiatry’s three domains, in the marketplace, were diagnostics, research, and the prescribing of drugs. Now, thirty-four years later, we see that its diagnostics are being dismissed as invalid; its research has failed to identify the biology of mental disorders to validate its diagnostics; and its drug treatments are increasingly being seen as not very effective or even harmful. That is the story of a profession that has reason to feel insecure about its place in the marketplace.

Yet, as you suggest, this is why it is going to be so hard for psychiatry to reform. Diagnosis and the prescribing of drugs constitute the main function of psychiatrists today in our society. From a guild perspective, the profession needs to maintain the public’s belief in the value of that function. So I don’t believe it will be possible for psychiatry to change unless it identifies a new function that would be marketable, so to speak. Psychiatry needs to identify a change that would be consistent with its interests as a guild.

The one faint possibility I see—and this may seem counterintuitive—is for psychiatry to become the profession that provides a critical view of psychiatric drugs. Family doctors do most of the prescribing of psychiatric drugs today, without any real sense of their risks and benefits, and so psychiatrists could stake out a role as being the experts who know how to use the drugs in a very selective, cautious manner, and the experts who know how to incorporate such drug treatment into a holistic, integrated form of care. If the public sees the drugs as quite problematic, as medications that can serve a purpose but only if prescribed in a very nuanced way, then it will want to turn to physicians who understand well the problems with the drugs and their limitations.

That is what I think must happen for psychiatry to change. Psychiatry must see a financial benefit from a proposed change, one consistent with guild interests.

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

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109 COMMENTS

  1. “Psychiatry’s three domains, in the marketplace, were diagnostics, research, and the prescribing of drugs. …. we see that its diagnostics are being dismissed as invalid; its research has failed to identify the biology of mental disorders to validate its diagnostics; and its drug treatments are increasingly being seen as not very effective or even harmful,” says Mr Whittiker.

    He says that one possible alternative for psychiatrists is for them to be the expert gatekeepers to psychiatric drugs.

    That sounds a bit like big profit driven bar managers being given the job of managing how alcohol is safely consumed.

    Maybe, “Psychiatrist,” as a job should go the way of, “Slave-driver?”

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      • Frankly I wouldn’t trust them with my precious hens!!!!! You’d be better off to let a fox among the chickens than to let psychiatrists tend the henhouse. They’d be caught trying to drug the poor hens to death! I don’t believe that you can teach an old dog new tricks when the dog is psychiatry. A few will be able and willing to change but the majority will have to be shown the door. What other profession would put up with these arrogant and puffed up individuals who are psychologically and emotionally abusive when they scream at people.

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        • I think if you look closely you’ll see the industry is trying to move to the developing countries like the tobacco industry did. The only problem is the developing countries cannot afford the drug disability and they know their mental health structure (as it is) delivers better than ours.
          In countries like India the industry targets the upper classes.

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  2. I may be a dreamer (one amongst many others by the way) but I think and hope that sooner or later it will turn out that human beings dealing with human dilemmas will be met in a different way. in a non-medical way. And IF people in psychiatry are willing to be part of that movement and change, they are more than welcome. If not, they will do better outside the coming contextual way of thinking and relating towards people in crisis.

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  3. This is a topic very close to my heart, and would like to thank you for the article/interview.

    Just a few peripheral points to add to the mix, if I may. I feel it is right to present a “dissident’s truth” whenever possible. I hope you will not mind my indulgence.

    1) Psychiatry from DSMIII till today has caused the deaths of too many countless innocent lives, and rarely has any justice been served for these victims or their families.

    2) AF= Paradigm-creator-editor-stakeholder-slayer. Nothing stopped AF from editing and supporting a DSM IV and then IV-tr despite having known (or should have known) that the authors of DSM III acknowledged that very few of the diagnoses had been “validated”. At the helm of DSM IV and IV-tr, it was business as usual and enormous profits to be had in the promotion of an unscientific and invalid bible for mental illness. One only needs to read this article from Gary Greenberg, author of “The Book of Woe” to see that AF knew exactly what the stinking truth about all “mental illness” was all along: http://www.garygreenbergonline.com/media/wired.pdf

    I want to know the truth here. Why is AF discrediting DSM V, challenging its validity now, when his editions promoted years of the same invalid and unscientific junk that lead to the deaths of innocent people and harm to many more?

    3) In my view, when the “challenging of the validity of the DSM V is more of a paradigm changer” than the “scientific reports that detail how the medications may be causing long-term harm”, suggests to me that the challenges to psychiatry’s tenure is more important to them than the long term harm they caused. I’d like to propose one step further than “may be causing long term harm” as RW suggests. These drugs (in keeping to a dissident’s truth here, these are drugs, not medications) are causally linked to a wide array of long term harm as Paula J. Caplan has demonstrated in her book “They Say You’re Crazy: How the worlds most powerful psychiatrists decide who’s normal”. Here’s a link to what I think are some pretty well constructed reviews on her book: http://www.amazon.co.uk/product-reviews/0201488329/ref=dp_top_cm_cr_acr_txt/276-0243637-6438362?ie=UTF8&showViewpoints=1

    4) In my view, any kind of re-medicalizing protocols will still cause more death and further harm. Its the “medicalizing” of emotions that is killing and harming! To “use the drugs in a very selective, cautious manner” seems to assure psychiatry the seat of judgment which has been a problem from the start. Unless “selective” includes the freedom of choice by the patient.

    5) Finally, I believe the only way people will be able to live productive and meaningful lives after having suffered serious emotional breakdown is if they are surrounded by love, support, non-judgment. Let’s face it, love, support, and non-judgment is free. I don’t see psychiatrists turning in the keys to the yacht just yet. At best they are reshuffling the chairs on the deck.

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    • So they’ve been relying on Foucault’s tactics during his Psychiatric Power stage. He referred to hid patients as subjects from the word subjugation. Including influencing the public and creating stigma and securing them more money.then you have the suicides and other drug related side effects. Tampering with research in order to use antipsychotics on children, and if you had just admitted you were wrong, people might still be alive today and I might have a future. I’m literally shaking. Oh, and Torrey could have had us all permanently locked up due to agnosia.

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      • I got to thinking about the way this was written , and it was never meant as an accusation against Robert. I just got a bit overwhelmed and angry. I’m up to my neck in surviving my birthday which is now accompanied by the first anniversary of my first love’s suicide which was loosely tied to anti depressants, and I just wanted to shake the whole dsm5 board. I do want to thank you, Robert, because it was your book that motivated me to stop taking my med, and if I can just survive this week, you’ll be able to tell the good it did me.

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  4. I know I often sound too critical, and I have tremendous respect for Bob Whitaker. But I think he left out a couple of important areas.

    One is the incredible, and increasing, amount of state power that has been turned over to psychiatry. Why would they change when all they have to do is force people to take their drugs? I think the end of this power would do far more to make psychiatry change than any amount of research and discussion. If you can’t force people to “buy your product,” then you will have to offer something that people see as useful or else go out of business.

    Also, although I do believe that some dysfunctional behavior (trying to avoid the phrase “mental illness” here) may have a physical cause and might have to be dealt with by physically-based treatments, in most cases what are labeled as “disorders” by the DSM are problems in living.

    The diagnosis that I find most disgusting is psychiatry’s proclamation that you have fourteen days to grieve, and after that you suffer from clinical depression. (Again, I do think there is such a thing as endogenous depression, but in my experience it is very rare.)

    In fact, the whole concept of “depression” as a “disorder” I think is completely inhuman.

    Of course, what I’ve just said is hardly news to MIA readers. But my point is that human conditions like this are real problems for people, and all that is offered is drugs.

    A real helping profession would help people deal with these real problems, but not through “science.” (Myself, I think “science” is quite overrated in our culture, especially when it is applied to activities that have nothing to do with real science at all.)

    People change through their life experiences, if they’re lucky. People change through being nurtured, which is a completely foreign concept to present-day psychiatry, with its inhuman view of human nature.

    Recently, I have been participating (as somewhat of an outsider) in a group for people getting off psychiatric drugs. The remarkable woman who runs it puts huge amounts of energy into supporting people emotionally, being very open about her own problems and struggles. She is one of the most nurturing people I have ever met, and engages people as equals, because they are.

    I hope that if she goes on to professional training, she doesn’t lose that openness, that relationship between “I and Thou,” that exchange among human beings that to me is something that in most cases is what people need to heal themselves.

    This isn’t scientific. This is what all people owe to one another, respect, caring, love. And this is what most people need to change and grow.

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      • I think the genuine evidence is now showing that the psychiatric approach guarantees the psychiatric diagnosis. Tranquillizers are not treatment, they disable and they keep people sick. But that it is possible to make full recovery with a suitable non chemical approach – I can substantiate this.

        I think the psychiatric approach is now being accepted as defective. But if they back down they’re in trouble. Because of the harm that’s been done.

        Do you remember the yellow book I’m ‘Okay, You’re Okay’, by Thomas Harris MD. On pg 107 he mentions the use of psychoactive drugs, but to get through, to then talk about the underlying problems.

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    • Yes Ted I agree with everything you say, thanks for saying it.

      I remember hearing and reading Prof Phil Barker’s Tidal Model of Recovery where he, with wife Poppy, talks of problems in or of living, of patients as people, and that we are all Jock Tamsin’s bairns. As you describe the woman who leads the “coming off psych drugs” group. Which I take to mean that mental health difficulties are no respecter of persons. It could and does happen to any one us. Therefore mental illness is a psychiatric construct and only exists in the mind of psychiatry.

      Like you I don’t believe that science is the answer and I’m concerned that as the drugs are seen to not have power (the emperor is naked) there will be more brain stuff going on eg the fruitless search for biomarkers for mental illness, sacrificing transgenic mice and people resorting to NMD or brain surgery to dispel their depression by zapping brain tissue. Dr Insel mentioned neuroscience, if I remember correctly, as a new focus which he would, being a neuroscientist and psychiatrist.

      It is all about relationship, I’ve found, in supporting family members in and through the psychiatric system, helping them recover from traumatic treatment, picking up the pieces. I never did believe the scientific reasoning behind mental illness despite being given a lifelong label in efforts to pin me down. When I saw what they did to my mother in a locked psychiatric ward in 1970, and the other women with her, it was no advert for “best practice”. And I’m not seeing much better going on nowadays for people in mental distress.

      When a person or system resorts to force then the game’s a bogey, it just doesn’t work, whether you dress it up in scientific terms or not. Yes it does require more respect, caring, love, I’m with you on that also. And it will require a whole lot of patience, listening to the pain and the voices, and not silencing them or trying to change what they are saying.

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    • Ted, I worked in the death business in one capacity or another for years, and the first thing you learn is that everyone grieves differently. As long as they aren’t burdened by misplaced guilt or considering self harm, their grief is it’s own coping mechanism and it will continue until they are prepared to cope with the future… without the person they have lost… It’s not a disease, and dumbing down the natural process of mourning does not alleviate the need for it. Do you know what happens when people lack coping mechanisms? The Hemingways. Generation after generation of people who have no idea how to cope and generations of lives that were thrown away. Sometimes you have to be sad. It’s the reality of the human condition, and without enduring the sadness, there’s no way to gauge our happiness.

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    • Interestingly Ted, the patients in the Johnstone `Northwick Park’ ECT placebo trial (1980), who were diagnosed with `endogenous depression’ did better with the `sham’ than anyone else. (Read & Bentall 2010). Here in Victoria, Australia, re just amended the Mental Health Act and the psychiatrists managed to get the existing age restrictions, (under 14), for ECT removed, along with pre-existing penalties for misuse, poor outcomes, of `psychosurgery’, removed.
      I despair at times because despite ALL of the evidence, ALL of the science, ECT use is rising exponentially in my country. They are now targeting children & the very old, with it, as well as prescribing anti-depressants as preventative medicine for the elderly. Our Therapeutic Goods Admin (TGA `Aust FDA), have classified ECT machines as equivalent in safety to a condom. Our supposedly protective govt regulating bodies, `the Chief Psychiatrists Office’ refuses to police breaches of the Mental Health Act involving `consent’ for ECT legislation in private hospitals who, commonly, are more `insistent’ & use threats, confinement and sometimes physical force to make people have `voluntary’ ECT than the public ones. If the public guys behave badly, and they do, they are more likely to have consequences. It is far more likely that lawyers, advocates, `Official Visitors’ roaming around there than in private hospitals. Complaints can go to the Chief Pscych Office, the Ombudsman, Mental Health Legal Centre. None of these are available to private patients. Few people can afford to sue even if the law will take an un-winnable case and face public humiliation from the docs’ mates. I believe there is only one way to stop ECT and that is to remove the MONEY. And the only way to do that is to shout from the rafters and even then, the shouts of a madman are the shouts of a madman. But exposing the rorts, the lies, the frauds, telling people that their taxes are paying for brain damage, permanent disability via repeated treatments, and young lives spent on Welfare for 50 years, when alternatives exist. The info now is telling. Schizophrenia sufferers do better in Nigeria & India when they get NO meds or ECT. Did someone forget the old and well known fact that depression will almost always be self-limiting. Unless they take anti-depressants. That refractive, treatment resistant depression is CAUSED by the drugs, tricyclics, SSRIs, SNRIs, Lithium & anti-psychotics. My recommendations to the psychiatric profession is `It’s OVER – learn new skills or go under. Mind you, what sort of person is it that could electroshock a 3 year old. Do the expectations of doing ECT brutalise the doctor, or does the opportunity to be brutal (see History of psychiatry), attract a certain kind of person? Perhaps it’s that they are able to reduce their patients to a sub-human level so they can do anything they like, as has happened so often in human history? Nazi Germany, Rwanda, Cambodia, et al?

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  5. Bob I am not convinced that psychiatrists should become “the profession that provides a critical view of psychiatric drugs”. Why? Because I just don’t think it is possible or doable, bearing in mind their relationship with Big Pharma where they are under the illusion/delusion that they are calling the shots when it’s really “he who pays the piper calls the tune”.

    Rather I think psychiatrists should develop their communication and listening skills, widen their therapeutic knowledge and practice, get qualified in psychotherapy and trauma informed studies. The psychiatrist we have in Fife, Scotland, is trained in psychotherapy and he supported me in helping my son taper and come off psychiatric drugs within 6 months in 2012. He revoked the CTO in response to our request at the time and since then has been a support when we had no other.

    I think that close relationships with big pharma are fraught with difficulty if a person is a doctor of any kind. Pharma drugs can be powerful chemicals and not just in psychiatric settings. I am on the blood pressure pill candesartan which has annoying side effects and I’m now cutting down my food intake and taking up more exercise, also getting my own blood pressure monitor, to try and get off the pills completely.

    In Scotland Dr Peter Gordon, psychiatrist, has a petition “Calling on the Scottish Parliament to urge the Scottish Government to introduce a Sunshine Act for Scotland, creating a searchable record of all payments (including payments in kind) to NHS Scotland healthcare workers from Industry and Commerce.”:
    http://www.scottish.parliament.uk/GettingInvolved/Petitions/sunshineact

    There is also a new website which Dr Gordon, Dr Ben Goldacre, Dr Margaret McCartney and others have set up, Who Pays This Doctor:
    http://www.whopaysthisdoctor.org/
    which is about bringing more transparency regarding payments by pharmaceutical companies and any conflicts of interest.

    I am looking forward to a paradigm shift in psychiatry that will focus more on the person and not on the science, where there are a range of alternatives for people in altered mind states or psychoses, and level playing fields where every person is valued and respected, whatever their presentation or behaviour.

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  6. Thanks for the article….

    This might interest some people here….

    Alastair Morgan on ‘Is psychiatry dying? The contemporary “legitimation crisis” in psychiatry’, Joint Special Interest Group in Psychosis, 26 March 2014, 5.30 pm – 7 pm

    Durham University and Tees, Esk and Wear Valleys NHS Foundation Trust Joint Special Interest Group for Psychosis (JSIGP)

    Abstract: This talk explores the contemporary “legitimation crisis” in psychiatry. Does psychiatry know what it is for, does it have a role in the future and does it have a clear idea of its conceptual foundations ? Should we care if psychiatry withers away, and dissolves into a range of new disciplines, such as neuroscience, the science of wellbeing, or the pragmatic management of life issues in the name of mental health recovery ? The talk will examine a proliferation of new and competing “paradigms” for the ontological status of psychiatry and critical psychiatry, and tries to map a direction for the future of psychiatry in the 21st century.

    http://hearingthevoice.org/2014/03/06/alastair-morgan-on-is-psychiatry-dying-the-contemporary-legitimation-crisis-in-psychiatry-joint-special-interest-group-in-psychosis-26-march-2014-5-30-pm-7-pm/

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  7. OK now, let me get this straight. An entire profession has been needlessly harming (and in some cases killing) and even ruining the lives of many people and there’s evidence now that they knew this all along but did it anyway for the sake of their careers and finances… but now instead of locking them up for such serious crimes against humanity, we’re to hope that they can be convinced that they can keep making all that money doing something else?

    I can just envision it now. Heinrich Himmler is confronted and told “you don’t have to kill all of those jews and mentally impaired people. You can stop them from breeding with sterilization and then use them as slave workers! They don’t necessarily have to just be useless eaters, blah blah blah blah!”

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    • Oh and what a perfect analogy as well. Let’s not forget that Josef Mengele was liked and defended by some of his “patients”, surely no different than the pro-psychiatry NAMI crowd today. We have both the evidence of needless harm (and serious harm) along with decades of deceit by the people profiting from that harm. We shouldn’t need any more than that.

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      • JeffreyC
        I agree with you Psychiatry, Psychiatrists, PigPharma,must all be prosecuted in Nurenburg type, highly visible, crimes against humanity, trials.
        Otherwise the” most wonderful regular medical profession” would pick up where they left off without missing a beat. Check out the book “Sick and Tired” by Robert Young.
        Maybe this time we could drag the robber barons that avoided the last Nurenburg Trials to court as well as the ones responsible this time around for funding eugenic projects globally,
        Or are they all to big to fail ? Not!

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        • Exactly Fred.

          Social Darwinism and the Eugenics movement were doing quite well here in America in the 1920’s-30’s, funded in large part by foundations like the Rockefeller Foundation. In fact, at one point here in America we were sterilizing more people in mental institutions ect. than the German psychiatrists were in Germany. In fact, many of the German psychiatrists complained in their media that the U.S. was getting ahead of and doing a better job at this than Germany was.! So, when I hear someone say that terrible atrocities would never be done here in this country I give them a short American history lesson. The fact is it was done in this country! U.S. psychiatrists didn’t gas any of our “mentally ill” but don’t think some of them didn’t want to. I’ve posted somewhere else here on MIA about the keynote address given by a doctor in 1941, at the American Psychiatric Association’s yearly meeting in which he advocated the killing of the “mentally ill.” People in this country need to wake up and smell the coffee.

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          • I agree. Anyone who is ‘diagnosing’ (name calling) has areally warped brain. They objectify people. They tend to bully people even if they quit dishing out so many pills.

            The connection with eugenics is real, Stephen. Have you read The Rise of the Fourth Reich? And it is far from dead.

            I think Bob is wasting his time and money going around talking to psychiatrists. The ‘standard of care’ is not going to change because some big shot psychiatrist whispers they are wrong.

            We need to be teaching the average joe how to take care of his mental health. We need to help families and communities to become havens of healing and inclusiveness, This is probably what is helpful in India and Nigeria. Most people in America are lay psychiatrists, picking at weaknesses in others until they go for help. It’s lay psychiatric scapegoating. It’s a judgmental reflex in some people.

            Your money would be better spent funding a media campaign or funding an independent feature film. The psychiatric state goes deeper than just a self appointed profession. It’s a form of bullying and lay people do it. We need consciousness raising and then make available the tools like traveling workshops for people to go into homes and fix things like Open Dialogue style for any community that desires. We need real PR about the truth.

            We need to ignore psychiatrists and guide people elsewhere. Maybe they do need a stint in prison. Come to think of it nothing could please me more. They are not redeemable as a profession and regular MDs should be ashamed too.

            As describing in the book Mad in America, this all started from insecticide. I’d rather take a benzo for a short time or Tegretal always just could bring me down. Outlaw the rest! And that should be a healing family decision.

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    • Ooh, good comment JeffreyC. There really should be major consequences for psychiatry’s ruination of people’s lives/torture and all the other injustices/crimes against humanity this field has committed. It doesn’t matter if they ‘should have known better’ or not; what they have done (continue to do) is so unjust, backwards, wrong, and harmful that it needs to be recognized as such on a massive/official scale. (Obviously this doesn’t go for all psychiatrists, but the misleading biological/forced contingent of the field – [although it’s my belief that the existence of the field at all as a medical specialty is unnecessary and even nonsensical. Perhaps psychiatrists could specialize in ferreting out any real medical conditions that are causing psychological/behavioral symptoms, and leave the problems-in-living to psychologists/therapists/counselors and the like.])

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      • But, probably not. Probably the field should just be abolished, condemned, and relegated to its rightful place of shame in the history books. Psychiatry has been too wrong and done too much damage for us to try to ‘save’ or reinvent the profession. Psychology and neurology should be able to cover the ostensible subject matter of psychiatry just fine.

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        • Absolutely. I was a psychiatric nurse way back in the days of the big psych hospitals. I was trained in counselling, none of my patients ever had ECT and we were very sparing of drugs. My supervisor was scared of giving anyone `tardive dyskinesia’. So we talked to people. I don’t know whether I ever really helped people, I hope I did. But I don’t think I harmed anyone too much. People are saying that now we are discarding the `chemical imbalance’ rubbish, and thinking maybe depression and even schizophrenia are socio-psychological issues, we have to re-think psychiatry. I always did believe that, maybe because I too, had had problems. I had some wonderful experiences getting to know some of our `labelled’ people. Across nearly 40 years I still have memories of some extraordinary people who enriched my life with their courage and strength. Tragically, faced with the prognosis of deterioration they were given, involuntary treatment that sapped the life right out of them, at least two of my lovely, talented kids killed themselves. I hope some of the rest got away but I doubt it.
          Some of the psychiatrists from that time are still working. I know who the really bad ones are, they never were allowed near our unit because we cared about our patients. Sadly these bad men have been destroying the unlucky for 40 years. It’s amazing to see that these psychopaths have got themselves into positions of power. These men who destroyed people for all this time, support anything that makes money. For the last 13 years I have been a `patient’. Following a toxic reaction to an unnecessary SSRII I have had 87 ECT treatments and multi-drugs, but last year I walked away. I have now joined up with the anti-psychiatry movement. They have to go. I don’t think many have the ability to change. Like most people who choose to be abusers, the damage done will always be someone else’s fault. If you can blame the patient, go for it.
          Hopefully the web will make a difference and live up to the Age of Information tag.

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    • “Capitalism should not be condemned, since we haven’t had capitalism.” –
      Ron Paul

      I think he’s on to something.
      We’ve had *crony* capitalism.

      The government needs to regulate; especially certain industries, such as pharma. But the government *does not*; because it’s in the pocket of pharma. Pharma funds re-election campaigns, pays fees to have its drugs approved by the FDA. Pharma is a *client* of government.

      The answer however, IMO, is *not* a bigger, bloated centralized bureaucracy. This tends to lead to a hill of skulls. We need to hold a *small* government accountable, and allow people to create alternatives to the status quo, one size fits all psychiatric system; but *not* turn the keys over to the same government that helped create this mess!

      “The problem is socialism is socialism. The problem with capitalism is capitalists.” – Milton Friedman

      Duane

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  8. One thing that is not addressed here is the issue of social control….

    http://www.iaapa.de/zwang/leifer.htm

    cut and paste from the above….

    A society could not be called free that is governed by laws which are so vague and broad as to regulate ordinary speech and behavior. The medical model developed as an ideology to disguise and justify covert forms of social control. Without invoking the medical model, could we call a society free where people can be deprived of their freedom and forcibly drugged because they are homeless and disturbing to the public? For hearing or speaking to their gods? For going on spending sprees? For believing the government is after them or that they are being monitored by electronic devices? For not being able to face the difficulties of life? It happens in this country and we pretend to the world to stand for the ideal of individual freedom. The problem is that society demands a greater degree of social control than law allows. The public wants to be protected from unconventional, threatening, and dangerous behavior. There is, thus, a public mandate for a covert form of social control which supplements rule of law. Medical-coercive psychiatry, in alliance with the state, performs this function disguised as medical diagnosis and treatment.

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  9. The “mental health” trip is a “mental health” trap. Can psychiatrists change? Of course. I just have a problem with the growing population of people who can’t manage to leave the system. Self-help and disability as a career choice sucks. I don’t believe the “mental health” community is just going to wither away into the general community of it’s own obsolescence. It’s too convenient for folks to assume the position so to speak. What works? Well, not treating people like broken and discarded hardware for one thing. Far too many of those people just seem totally convinced. Outside of the system, as the system is an invalidating system, is value and purpose. Given a ridiculous and cumbersome bureaucracy, it can be hard for mental health professionals to get a grip on such matters.

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    • In the state hospital where I work I deal constantly with people in their 20’s, 30’s, and 40’s who have no work history at all. They have always been on Disability and have never held a job. Now before anyone jumps on me for saying this I will also point out that part of what the “mental health”system instills in people is a very large dose of learned helplessness. You refer to this when you state that many people are convinced that they are “broken and discarded hardware.” These people have been in the “mental health” system almost all of their lives and have never been encouraged to view themselves as people that are capable of working and taking care of themselves. For all of the talk of “recovery” that the system spouts all of the time now, there is nothing done to support all the talk. The idea of “recovery” that’s fed to people amounts to taking the toxic drugs, being sent to a group home, and being satisfied with being constantly watched by staff. People in the system get a constant dose of “you can’t do anything like normal people because you aren’t normal, you’re broken for life and need to take the drugs forever.” Disability was never envisioned as something that people would be on for the rest of their lives. It’s supposed to be a support until a person gets back on their feet and moves on with her or his life. But, the message from the system is that you’ll never, ever be able to do anything of real value to society so go take your “meds,” go sit in the corner and be quiet, and don’t give anyone any trouble. The psychiatrists and psychologists and social workers don’t use these terms or words, it’s a much more subtle communication, subtle but very convincing to people. The system has created an entire generation of people who don’t know how to take care of themselves and can’t take care of themselves. Even if we could close every psychiatric institution tomorrow and send all the psychiatrists packing we would be faced with overwhelming numbers of people who would need to be taken care of because they do not have, through any fault of their own, any knowledge of how to do this on their own. The effects of what the system has done to people ripple on and on, like a stone thrown into a placid pond of water.

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      • What we need are programs outside of the system that somehow help people gain some self esteem. We would also need groups that would help people taper off the toxic drugs, if this is what they wanted. Then, we could begin working with people on how to go about learning to stand on their own two feet and living their own lifes. I believe that this is a very frightening prospect for many people trapped in the system. How do you ever go about doing something that you’ve never done before when you’re an adult? The unknown can be very overwhelming and frightening.

        I walk through units every day that are filled with people whose lives have been circumscribed by the toxic drugs and the insidious message of psychiatry into these tiny facsimiles of what they could have and are capable of being, if the drugs were removed from the picture.

        But, another part of all of this is that many people are afraid of ever even entertaining the idea of removing the drugs from their lives. They have accepted the message of psychiatry and big pharma hook, line, and sinker and they respond very negatively when told that life can and does exist beyond the toxic drugs. Many of my friends tell me that they are afraid not to take the drugs. They are afraid of what “might” happen if they got off the drugs. They don’t listen to me when I remind them that there’s also a very good chance that nothing terrible would happen if they did get off. They feel that the odds are stacked against them, no matter what I try to share with them.

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        • I used to, when a resident of Virginia, volunteer with Virginia Organizing, known as the Virginia Organizing Project back then. I guess I would describe Virginia Organizing as a social change or social justice organization. There was a point when the then director of this organization, Joe Szakos, spoke to me about the possibility of working directly with landlords to make more affordable housing available from places they rented. This is the kind of thing I think the mental health system needs. People within the mental health system, in one capacity or another, working with members of the community to look beyond the mental health system, and to get people out,of that system. Anyway, that is my further two cents on the subject. I’ve seen it happen on a small scale, in some in stances, but it can also be sabotaged by the bureaucracy more than anything else.

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          • I agree, but know future survivors will need support weaning off drugs, and while going through the drug withdrawal super sensitivity psychosis. And if they didn’t have a sense of self prior to the drugs (or even if they did, since psychiatric mental abuse is so personally dehumanizing), many will need a human support system to help build them back up, and encourage them. Plus, help acclimating back into the community, especially since the drugs do seem to have some long run “tardive” effects, which may affect what type employment may be best for those most harmed by psychiatry.

            I’ve been trying to think about what kind of program could or should be set up to help others, and come up with a name for such an organization, maybe “Future Survivors” might be a good name? I went to my first Alanon meeting to start to learn about the 12 step program. I don’t know, but agree, getting people out of the system, de-stigmatizing them, and helping them heal from the drug induced and iatrogenic harm is the only chance those attacked by psychiatry have of healing.

            Psychiatric professionals, perhaps because of psychiatry’s history, or greed, have it in their heads no patient of theirs will ever heal, and seem to make that their mission. But society as a whole does not benefit from such scientifically “lacking in validity,” “life long, incurable, genetic mental illness” stigmatizers / doom and gloom mongers.

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          • Future survivors doesn’t work for me. Nobody survives the future. Sooner or later, the future does everybody in. You can count on it. It’s like clockwork. Present survivors, all’s fine and dandy. Perhaps what is needed, rather than more programing, is de-programming. If psychiatry is a cult, as has been suggested, de-programming makes a world of sense.

            When I mentioned working with landlords above, it doesn’t begin nor end there. You also have business owners, and every town seems to have an association of them. Start working with landlords and business owners and you can get people de-programmed from a couple of things that kept them in the patient role, namely lack of shelter and a job.

            Give a person a sense of security, shelter, and a job, and who would be lugging a burdensome old toad of a “mental illness” around with them anyway. I figure they’d be left with a broken leash and a shrug. You know, as in “good riddance”.

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          • Frank,

            I appreciate your perspective, I’m still trying to come up with a concept that implies hope. And, I’m trying to educate and enlighten others, too, in the hope they may choose to invest in a mission to help, and / or choose to prevent future harm to our countries’ children.

            I just bought another copy of Robert’s book this afternoon, my third. I read one. I’ve given another to the pastor at my childhood church, in the hopes he’ll read it and be able to garner insight into the almost unfathomable iatrogenic harm of American children going on in this country. He’s still reading.

            My daughter was diagnosed with pneumonia this afternoon, so we have to go see our new PCP next week, for a check up. He was very embarrassed when I went in for my first appointment with him, and medically explained the crimes committed against me by prior doctors – hopefully his embarrassment implies he’s a decent guy, though.

            And, of course, I researched him prior to choosing a new doctor, I do so hope he may be an ethical doctor. I’m thinking I’ll try and drop off a copy of “Anatomy” with him, and politely request he read it, and pass it on to other colleges within his hospital who work with families and children. He is head of primary care physicians at a nationally well respected hospital. We’ll see if he even takes the book.

            But I’m hoping most doctors and pastors are actually decent, and I just ran into psychopaths. And you get to a point you realize, the science is on your side, your goal is to protect and help children, you’ve realized perhaps the medical community was misinformed, and you realize you need to at least try and speak up.

            I pray we can find a way to curb psychiatry’s current stigmatization of innocent humans, before things get as grotesque as they did in WWII. The psychiatric industry has propaganda earned power, but information is power, as well. And we have the actual scientific evidence of the ineffective and toxic nature of the psychotropic drugs on our side.

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  10. Great interview. Thanks to Bob and Bruce putting this together. Essentially, I think Bob is right that intellectually and philosophically, psychiatry is in deep inner conflict. But in terms of the reality on the ground, not much, if anything has changed. And little s changing because there is enormous financial interest in keeping the drug therapy model going.

    I also want to nitpick with Bob over one point. He hopes for shifting to a model of care that is truly “science based”. I ask, what kind of science? “Science” has led us to promote drugs, ECT and outpatient involuntary treatment. If by science you mean creating truly impartial (not funded by drug companies) double blind studies of the effectiveness of different modalities, I would partially agree.

    But I would still question what “science” means in terms of mental health. The gold standard of randomized double standards to parse out a single variable to determine effectiveness just doesn’t jibe with the immense complexity of helping people in emotional distress. The holistic and deeply complex element of human nature just doesn’t adhere well to reductionistic double blind “scientific” studies.

    In any event, it’s a quibble. This post is great. Thanks for all your work Bob and Bruce.

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      • The terms scientifically researched, evidence based, proven through double blind studies…have all been used as cudgels to promote some of the worst abuses in psychiatry. Even impartial mental health research (if there is such a thing) is biased by what it wants to examine (while eschewing other templates for healing).

        When applied to physics, astronomy and chemistry, I generally have no problem with science. When applied to health and human behavior, I have many many caveats and questions.

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        • I very much agree, and even in physics nowadays many researchers know that it is not possible to know about the observed phenomena without also taking notice of the one who observes the phenomena. That is one of the reasons why I have taken a stance against psychiatric diagnosis, since it says as much about the one who gives the diagnosis. I hope you understand my “broken” English.

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          • Your english is great. Yes there have been radical changes in the way physics is understood that can be truly mindbending from a strictly linear cartesian way of examining phenomena. Scientific principles of inquiry can be really useful for examining nature and reality. The idea that a hypothesis needs to be tested and verified repeatedly to determine accuracy (vs. blind faith) is a very useful construct.

            However, the terminology of science can be bent to promote ideas and treatment strategies that are simply wrong at best and outright damaging at worst.

            The answer to this problem does not mean the abandonment of scientific inquiry. It means a reappraisal of how scientific study is done: who is conducting he studies, how the studies are shaped, and the limits to the approach of reductionistic scientific methods when they are used for examining mental health.

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  11. Thank you for this update, Bruce and Robert. And thank you, Robert, for being so diplomatic in regards to a subject I, myself, am not yet able to be diplomatic regarding.

    “The one faint possibility I see—and this may seem counterintuitive—is for psychiatry to become the profession that provides a critical view of psychiatric drugs.”

    I believe this historically was psychiatry’s primary role; they were the “doctors” who knew how the psychotropic drugs worked. But, seemingly, this was not a role adequately large enough to fulfill their “guild interest” goals.

    “Family doctors do most of the prescribing of psychiatric drugs today, without any real sense of their risks and benefits, and so psychiatrists could stake out a role as being the experts who know how to use the drugs in a very selective, cautious manner, and the experts who know how to incorporate such drug treatment into a holistic, integrated form of care.”

    Since merely dealing with the actually “mentally ill” / disabled was not going to bring in as much in profits for the psycho / pharmaceutical industries as they desired. These industries intentionally chose to mislead and misinform the mainstream medical community, who now “do most of the prescribing of psychiatric drugs today.” And they chose to mislead and misinform the American public regarding the benefits and potential harms of their psychotropic drugs, with massive misleading marketing campaigns. This is an enormous betrayal of the American public by the psycho / pharmaceutical industries. Which begs the question, do those in charge of these industries actually have the betterment of society as a whole, as a goal? My recollection is that the APA has conceded it is an organization set up to help it’s members, but not their clients. Please correct me if I am wrong.

    And my personal experience with psychiatric practitioners is that they are not “experts who know how to use the drugs in a very selective, cautious manner, and the experts who know how to incorporate such drug treatment into a holistic, integrated form of care.” However, they do tend to emulate the level of ethics portrayed by the AMA, and hypocritically false advertise themselves as such caring experts.

    “If the public sees the drugs as quite problematic, as medications that can serve a purpose but only if prescribed in a very nuanced way, then it will want to turn to physicians who understand well the problems with the drugs and their limitations.”

    I agree, if psychiatry is to continue as a profession, this is what we should go back to. Especially since, I for one, believe psychiatry is to the point they are making a mockery of the respectability of the entire mainstream medical community now. And it would be nice for patients to be able to trust, as used to be the case, that when they are utilizing mainstream medical services they will not willy nilly be put on a mind altering drug by a regular care physician, without their knowledge. But since many mainstream drugs, like steroids, can also cause mind altering states, I’m not certain this is even a feasible option.

    “That is what I think must happen for psychiatry to change. Psychiatry must see a financial benefit from a proposed change, one consistent with guild interests.”

    I think for anyone to change, they need to really WANT to change. And I do not believe psychiatry wants to change. And I believe history has already shown that merely dealing with the severely “mentally ill” or disabled is not a big enough market for the psychiatric industries’ “guild interests.” I think that’s why we are in this enormous societal mess.

    So, I’m to the point, I have to agree with some of the others here who have said that Nuremberg – esque trials, or at least some sort of confession and accountability, really is what would best protect society from such public health destroying, corporate greed inspired betrayal, and medical crimes against humanity.

    People do not change, if they are not required to confess to their harm of others, and are not held accountable for their crimes. It’s just human nature.

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    • “Psychiatry must see a financial benefit from a proposed change, one consistent with guild interests.”

      Bribing psychiatrists to change, after they’ve harmed and killed so many, is not the answer, in my respectful opinion, Robert. And I do have the ultimate in respect for what you have done and are doing. Please do not underestimate my gratitude and respect for the difficult task you’ve taken on.

      Confession and accountability to those they’ve harmed is the only thing that will make the psychiatric industry change now. They are too big and powerful to ever choose to change.

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  12. Jonathan and Corinna,

    Jonathan, In a sense, I think you provided an eloquent reply to your own quibble. Yes, science comes within a cultural context, and the use of the word science may obscure subjective judgements being made (what is to be deemed helpful, etc., this was one of the questions I was interested in when I wrote Mad in America, what were the values present that enabled psychiatrists to deem say “lobotomy” as helpful.) But I do think that there is an approach to trying to know the world, which you have described as “scientific inquiry,” that has proven to be illuminating in many facets of human life, and that is what I meant as practice guided by “science,” i.e, that practices are informed by scientific inquiry.

    When applied to the use of psychiatric drugs, such scientific inquiry would want to investigate how the drugs affect the brain over time, how they change the brain, what happens during tapering, and a full inquiry into how the drugs may shape lives. As for the understanding that comes from “randomized clinical trials,” which are so reified in medicine, it is easy to argue they can obscure, rather than illuminate, partly because they may so narrow one’s focus (and partly because they can be easily designed to tell a story you want to tell.)

    All of which is to say that your comment, asking what we mean by science, is a good one, and your response, defending “scientific inquiry,” is an even better reply.

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  13. 1) As long as science, medicine, and the treatment of those labeled as mentally ill takes place in a profit based system there is the basis for corruption and multiple forms of oppression. Biological Psychiatry, which dominates the current paradigm of treatment, will NOT change on its own or slowly evolve over time. There will have to be a series of radical upheavals and systemic changes within and around the mental health system as part of a wider movement challenging the entire political and economic system we live under for true justice to be served.

    2) While our movement has grown in numbers and influence, at the same time the number of people taking psychiatric drugs and being harmed by this system is growing concurrently. Abilify is the largest selling drug of any medical category (18 billion dollars a year) with off label use spreading far and wide, especially to children. Biological Psychiatry is still growing with impunity. The more they drug people and create emotional and physical damage, the more potential customers they are creating who will get labeled and in desperation end up in their grasp. Their disease/drug model is constantly generating an unending supply of potential victims addicted and dependent on their prescribed drugs. and needing acute care.

    3) The underground movement of survivors and activists creating groups and other gatherings to help people get educated about the true nature of Biological Psychiatry and liberate themselves from psychiatric drugs ( with psych drug withdrawal aid) is a powerful indictment of this system by itself, as well as, a potential breeding ground for new activists to arise from its ranks

    4) While helping people get off, or reduce the drugs should be the essence of these groups, we should not underestimate the importance of recruiting people within those groups for our movement. And besides, people becoming activists against their oppressors can be a vital part of their overall success at liberation from the clutches of Biological Psychiatry and their toxic chemicals.

    5) Our goal and strategy should not be to hope for or engage in trying to change modern psychiatry, but rather to create the conditions for a real split within its ranks and organizations. This is more realistic because many of today’s Biological Psychiatrists will desperately hold on to their backwardness to the very end. Radical and dissident psychiatrists (even a small minority) uniting with survivors and other activists can play a very positive role within our movement.

    6) While various forms of education along with survivor drugs withdrawal group are very important to our movement, we desperately need the modern equivalent of the Black Panther Party for survivors and other mental health activists. It is this type of organization, raising hell and uniting with other human rights struggles, that could make a decisive difference in advancing our movement and ultimately defeating Biological Psychiatry.

    Richard

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    • Richard,

      I appreciate all that Reverend King did in the Civil Rights movement, but the Black Panthers?

      The Black Panthers *rejected* a non-violent approach:

      “Black Panthers, U.S. African-American militant party, founded (1966) in Oakland, Calif., by Huey P. Newton and Bobby Seale. Originally aimed at armed self-defense against the local police, the party grew to espouse violent revolution as the only means of achieving black liberation. The Black Panthers called on African Americans to arm themselves for the liberation struggle. In the late 1960s party members became involved in a series of violent confrontations with the police (resulting in deaths on both sides) and in a series of court cases, some resulting from direct shoot-outs with the police and some from independent charges.”

      More here:

      http://www.infoplease.com/encyclopedia/history/black-panthers.html

      And I’m sure you’re aware of their marxist philosophy, including the desire to abolish capitalism:

      http://www.britannica.com/EBchecked/topic/68134/Black-Panther-Party

      You’ve made your politics obvious on MIA. I hope you’re not condoning violence in the form exercised by the Black Panthers.

      I am adamantly opposed to violence in this effort to create a new paradigm of care. I hope you are too. And if your idea is to create some form of marxist movement, you can count me out.

      Duane

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      • Duane you are obviously intellligent and passionate but your arguments are
        often undermined by your tendency to throw around terms you don’t quite understand (conservativism, marxism, etc); and also by your willingness to accept “mainstream” media accounts and neocon talking points without having an adequate sense of history.

        What’s mainly setting me off here is your reference to the Black Panther Party for Self-Defense (the full name) as “violent.” The fact of the matter is that the Panthers were violently and systematically eliminated at the hands of racist police and the FBI. Fred Hampton, for example, after being given a barbiturate cocktail by a police collaborator was shot to death in his sleep by Chicago police; similar murders and frame-ups were carried out across the country.

        The reason this happened was not because the BPP was violent but because they
        encouraged Black people to throw off their victimization not only physically but by fighting their own self-defeating self-identification, i.e. seeing themselves as
        inferior and internalizing racist assumptions regarding their self-worth. It is this
        aspect of the organization that I believe Richard was referring to, not some sensationalist media image of crazy violent Black people. (Substitute crazy violent “mental patients” — sound familiar?) Just as Blacks had to throw off internalized self-hatred, so do the psychiatrized need to throw off the demeaning self-identification induced by psychiatric labeling and “treatment.”

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    • Excellent observations Richard. Especially profound since you don’t seem to be an ex-inmate.

      There’s actually no reason that the movement against psychiatry should be “underground” at this point in history. The reason it is is that the psychiatric inmates’ liberation movement was thoroughly coopted shortly after reaching its political zenith in the early to mid-80’s by the APA and others throwing money around to those they decided they could guide in a direction friendly to the industry (also by opportunists grabbing for that money). Hence the proliferation of “consumer” organizations with no analysis of what they are even “consuming.”

      The problem is twofold now: One, much of the left is totally bought into the psychiatric perspective and clueless in the face of “mental health” doublespeak; and secondly
      what currently remains of the “mental patients” movement is far too insular, and does not have a good analysis of the larger political realities. Psychiatric survivors need to reach out to political prisoners, for example; and socialists need to get beyond parroting the egotistical pronouncements of “progressive” shrinks — and we all need to understand that the future of civilization is presently at stake, and that if we don’t all get our act together soon we might all live to see the day when children are branded with bar codes at birth.

      Also your statement that “people becoming activists against their oppressors can be a vital part of their overall success at liberation” should be a point well taken by all. Hope to see more from you in MIA.

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      • Oldhead

        Thanks for the positive feedback. In the recent period I have been following your comments and I am very supportive of how you come at these vital issues.

        I have been fighting for a more radical perspective at MIA (from the Left side) for several years now. If you click on a person’s name in the discussion section at MIA (at the top of their comment) you can access every comment they have ever made at MIA (from the most recent to their very first comment). This is a great way of evaluating where some one is coming from on a multitude of issues.

        You are correct to point out the danger of radical/activist movements being coopted by the power structured and then rendered benign. This happened with almost all the movements coming out of the 60’s.

        Another danger is for our movement to end up just being a pressure group on the current host of politicians, begging them to create or change legislation. Or begging the APA and other organizations representing modern psychiatry to please change their ways. This happened all the time in the past where political activist groups would play “pin the tail on the Donkey” by focusing on trying to convince the Democratic Party to be something they never ever will be, that is, a party of revolutionary change.

        Those on the Right can try, but they can’t get around the fact, that Biological Psychiatry is inseparable from its formation within the U.S. capitalist system. Its rapid growth has been dictated by its (the large pharmaceutical corporations and the more petty bourgeoise psychiatric guild’s) need to expand its profit margins, and its inherent need to constantly seek out new markets. Declare more people mentally ill and/or create more psychological dysfunction as more people become dependent on their drugs.

        Biological Psychiatry’s “genetic theories of original sin” are also useful to the capitalist power structure in order to shift people’s attention away from the inherent inequalities in this system and all the daily traumas that poverty a class structure creates. They have a classic “blame the victim” and “blame it on bad genes” routine going here, and they have been quite successful so far.

        We need a new radical organization in our movement with a manifesto and program that exposes and condemns Biological Psychiatry (using genuine science combined with survivor experiences) and haunts them where ever they go with carefully chosen militant direct action. (No, Duane, I am not talking about violence).

        Let’s create conditions for Biological Psychiatry to become paranoid. Where ever they go and try to speak they start to look around the audience wondering when and if they will be disrupted by some one exposing their crimes and bogus science.

        Duane and others,

        I used the Black Panther Party example to point out the fact that they arose out of an oppressed minority, fought militantly against their oppression, and also attempted to serve the direct needs of the masses within that struggle. They truly captured the imagination of millions of young people of all races who wanted to change the world.

        A few Black Panther members could leave Calif. and go to a distant city and stand on a street corner with a bullhorn in any urban ghetto and immediately recruit new members for a local organization. They had the right organization for the right time

        As far as violence goes with the Black Panther Party, in almost every case it was violence initiated by the Ruling Class aimed at destroying their party and dividing its members. They were the victims (by the FBI and COINTELPRO counter insurgency) of one of this countries most concerted campaigns to destroy political opposition, including targeted assassination and police murder.

        While the analogies to organization are not exactly the same, I believe the conditions exist today to capture the imagination of thousands of victims/survivors of Biological Psychiatry to join with other activists working in the mental health field who are sickened by what they observe every day at their jobs.

        While MIA has been an invaluable resource, and it must be supported and expanded in its influence, we need separate and new forms of resistance and organization to emerge within our movement. “Dare to struggle, Dare to win.”

        BTW, Oldhead what part of the country are you from?

        Richard

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        • Richard, my daughter conducted a face to face interview of one of the surviving founders of the Black Panther Party for a paper she was writing in her freshman year of high school. The Black Panther party in the city where I was raised established a free medical clinic and distributed food and other aid to low income people in the African american community. The individuals within radical organizations come in many stripes and the diversity within broader coalitions within social movements is even greater. In a nutshell, movements for social change usually have a radical vanguard. You saw this with the ‘Earth First’ splintering off the environmental movement due to the rate of forest destruction in the Pacific Northwest. Since ‘Earth First’ moved the poles of the debate, it made it much easier for the Sierra Club to make greater legislative demands for old growth set asides.

          Movements for social change are complex entities with an evolving agenda. Groups typically splinter off because some individuals have a ‘no compromise’ stance and feel that any compromise is capitulation. When the statusquo reacts to movements for social change disingenuously by offering non substantive changes, a radical group breaks off out of frustration.

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          • madmom

            You make some important points. History has proven the value and necessity for vanguard organizations for every significant political movement. The very existence of vanguard organizations corresponds to a correct understanding of the theory of knowledge and its development in the material world.

            A minority of people first come to understand certain scientific principles and social phenomena before others. A minority may also grasp the fact that the actual material conditions exist for a movement to take hold and grow in significant numbers to exact political and/or scientific change in the world.

            It’s a whole different matter to take that understanding and translate it into the organizational forms that can educate and move the masses in a forward direction.

            These are no easy tasks. Effective political organizations are difficult to build and sustain. Differences in strategy inevitably emerge, and then there is always the issues of individual egos and some people becoming intoxicated with power.

            These are all risks and efforts well worth taking; for the world demands that we do not remain silent or back away from the responsibility to find the ways to end all forms of oppression.

            We are at a cross roads within our movement where there is a desperate need for such an organization to emerge.

            Richard

            Richard

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          • There’s more then enough knowledge ,and innovative ideas within the psych survivor experiencers to do what Lang and Mosher and the Finnish model do even better then ever under the leadership of psych survivors of course. Psychiatrists and Pharma can fund this effort with no strings attached with all the funds they previously stole and are still stealing from their victims.

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        • Richard I think any vanguard organisation and action should, as madmom says in another comment, be demanding that psychiatric (and big pharma) set up “protocols and centers”, initiatives to support people in tapering and coming off psych drugs. That would be a revolutionary act and the leadership of psychiatric survivors a crucial part of the mix.

          I want to see the “mental illness” label done away with it, together with the stigma and discrimination, the naming and shaming, that sticks like glue. And the biological, genetic blaming of mothers. Which I have much personal experience of. “family history of” written in the notes to be cast back at every opportunity when your family members happen to experience mental distress and try to resist treatment.

          The targeting of generations in a family because of mental illness labels is a despicable trick of power and control. It’s happened to me and mine, and that’s why I’m a psychiatric survivor activist and human rights campaigner. Now I’ve started speaking out I won’t be stopping whatever they do or say. It’s a matter of justice. Any vanguard movement has to be about justice, equality and human rights, as I see it.

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    • You are correct, Richard, “Biological Psychiatry, which dominates the current paradigm of treatment, will NOT change on its own or slowly evolve over time.” They do not want to change, and they have enough power, they don’t have to change. But information is power, and getting information out that discredits their power structure is happening, thanks to the many here and elsewhere.

      “Our goal and strategy should not be to hope for or engage in trying to change modern psychiatry, but rather to create the conditions for a real split within its ranks and organizations.” Divide and conquer, always a good strategy for the eventual win.

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    • Richard, your comments about the role of survivor-run groups to support people becoming free of the psych drugs really resonate with me. I’ve become close with someone lately who is running such a group, after years of her own struggle, and that is exactly what she is accomplishing. For one thing, anyone who is willing to go through the agony of psych drug withdrawal and comes through that is never going to be content to be a “consumer” again.

      I already have met several members of this group who are starting to be activists.

      I also think (or at least hope) in general that what will replace most of psychiatry for the 95%of people with problems in life now called “disorders” are groups like these that provide nurturing and community. My friend acts from her own experiences and her commitment to a cause bigger than her. I’ve never met a more nurturing and ethical person. I’m not saying that a certain amount of training would never be needed, but without an authentic human connection, I don’t see how anyone can be helped to live a life that they control and choose.

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  14. Robert,
    As many readers of MIA will agree, psychiatry never was and never will be an authentic branch of medicine or science. The future of the guild with respect to medicine is to be subsumed into either neurology or anesthesiology. From that position medicine can “become the profession that provides a critical view of psychiatric drugs”, as you say. In the future they will be called psychotropic – not psychiatric – drugs.

    There is another fundamental role that the guild has, which is important in relation to its future and which you don’t address in this interview. That role is to sanction and control socially “unacceptable” behavior. The mechanism society has to sanction illegal behavior is the law enforcement/judicial/penal system. Psychiatry catches everything else society needs to control but is not codified in law. Psychiatry is in the extraordinary position to wield the power of law without being subject to its constraints. The whole of society is responsible of empowering the psychiatric guild in its unique position of power under the guise of medical moral authority.

    I think most have faith in capacity of the human race to have much more humane ways – so to speak – to deal with the outliers of behavior and of respecting the fundamental rights of those who display them. As the WHO suggest to me, the “less developed” societies may be actually much more advanced in this regard. Maybe it’s because of the more stable and closely knit family and community environments that the institutions of developed societies cannot replace. Maybe the future lies in our “advanced” society catching up with the backward ones when it comes to community based solutions. Only when alternative ways reach a large enough scale can the role of the psychiatric guild as enforcer of social order disappear.

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  15. Concerning the last part of this interview, where Robert says:

    “Yet, as you suggest, this is why it is going to be so hard for psychiatry to reform. Diagnosis and the prescribing of drugs constitute the main function of psychiatrists today in our society. From a guild perspective, the profession needs to maintain the public’s belief in the value of that function. So I don’t believe it will be possible for psychiatry to change unless it identifies a new function that would be marketable, so to speak. Psychiatry needs to identify a change that would be consistent with its interests as a guild.”

    I think I agree. Much of the way psychiatrists react is because they want to strengthen, defend, etc, their own status, credibility, etc, and by proxy that of their own profession. Maybe it’s similar to Nietzsche’s concept of “will to power”. It’s also one of the reasons some of the current psychologists have come to support the current critique of psychiatry – they see it may give more power to their guild. Psychiatrists likely won’t stop doing what they do because they suddenly understand through some kind of logical claims that it’s not “good”. Maybe psychiatry is now kind of aspirating for the next revolution to come, whether it’s a totally new kind of a drug, magnetic or other ways of stimulating brain, other ways to change the functioning of brain, maybe implanting things in brain and so on. That’s their hope and aspiration. Until the technology, I guess they’ll try to hang on to their current power as forcibly as they can.

    This same thing happens in physics and all kinds of “hard” sciences as well.

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  16. One important role that the psychiatric ‘guild’ could adopt is protocols and centers where patients who wish to live a drug free lifestyle could safely taper off their medications. That way psychiatrists could undo some of the harm that has been done to our children.

    It’s a process which can take years and years depending on the level of the damage done and they are not used to developing long term relationships with low income clients, let alone in facilities that honor people’s right to choice.

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    • madmom I agree with you about psychiatry taking responsibility for getting their converts off the drugs if that is what they prefer. It seems a fitting task for a guild that has overprescribed at will without, what seems like, fear of consequences. And I think big pharma should also be involved in this, by supporting the tapering and withdrawal initiatives.

      Crucial to this initiative would be the participation and leadership of psychiatric survivors, people who have successfully tapered psych drugs and made a complete recovery. They would be the vanguard action, leading from the front, demonstrating just what is possible.

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  17. There are some additional organized efforts that work synergistically to strengthen , support , and embolden this deadly psychiatric extortion inc. guild . The bogus media guild manufacturing the consent of the public, into accepting more and more polices, procedures, and products that endanger their own lives and that of there loved ones including their children . Starting with the blind trust of the family physician coercion inc. guild. Vaccinations ( putrifications and poisons) injected directly into the blood stream from birth for many repeatedly ,causing brain inflammation and more down the line. Driven by their faulty interpretation of germ theory. (Yes there is precedent here for covering up lies and pushing lies forward for guild enrichment in total disregard of the deaths and suffering of millions.)
    78 % of the U.S. population with amalgam fillings made of 50% mercury installed close to their brains. Mercury the second most toxic substance listed on the periodic table next to metallic plutonium. Over 50% of all packaged food in local grocery stores
    containing mercury from the caustic soda used to clean the machines that package food. Unlabeled GMO foods which will after time lead to multitudes unable to produce children and
    G-d knows what else.The supply of drinking water in most places with added fluoride the same poison Hitler had introduced into the water supply of countries before he would invade them because it was proven to make people more complacent. BTW fluoride does harden the teeth but makes bones so hard they become brittle and can shatter.Better to use organic freshly made carrot and celery juice.Fluoride is a poison. Fluoride in water is banned in some countries as well as mercury in amalgam. Monsanto the guild from hell genetically modifying seeds and foods not labeling them trying to own the right to all seed stocks of all foods. Probably the same people own interests in all these cartels as they try to move us forward on their genetic, eugenic, behavioral ,medical, psychiatric, social control, trail of tears ,while they strike poses as the benefactors of humanity.We might all need our own Round Table Ivy League Think Tank to help figure how to mutually guarantee our survival as free human beings on this planet.

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  18. I’d like to take a moment to apologize to Richard and to fellow readers for my earlier comments on this thread. They were done in a moment of passion, but I should have refrained from the personal attacks. I hope you will accept my apologies.

    I am going to take a much-needed break from this site. I wish you all the best.

    Duane

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  19. Very interesting article. Australia has also had it’s problem with rogue psychiatrists – anyone interested in this look up Chelmsford Psychiatric Hospital. This facility operated in the 60s and 70s and used patients (often without their approval) as lab-rats where they were drugged into a deep coma and tortured with electroshock therapy. This practice resulted in many patients dying & others being permanently brain damaged, many of which soon committed suicide.
    None of the doctors or nurses were ever jailed and none of the victims ever received proper justice. It seems that someone can wear a white coat or a $10,000 suit and hide behind a profession and get away with crimes that anyone else would be jailed for life. There is very little accountability in pyschiatry and nothing in Australia was done to prevent such a thing happening again – it was all totally 100% legal….

    But I would also add that we should be careful not to ‘throw the baby out with the bathwater’. There are some biological anomalies that are associated with depression and there is no doubt that brain disorders exists i.e. Alzheimers, Parkinsons, neuropathies and these have physical causes.
    For instance certain nutrient and vitamin deficiencies have been shown to be associated with depression
    Vitamin B12
    Vitamin B6
    Folate B9
    Vitamin D

    Indeed it is now known that a genetic polymorphism in the MTHFR gene can cause problems with the methylation of
    cyanocobalamin – into the useable mitochondrial form of methylcobalamin
    pyridoxine into pyridoxal-5-phosphate
    folic acid into methyl-folate
    This is still a new area of research but it may be shown in future that MTHFR gene polymorphisms may produce deficiencies of these vitamins which cause problems downstream in the production and recycling of neurotrasmitters, myelin maintenance etc….
    Also it appears that people suffering depression have reduced Glutathione in brain tissue
    http://www.ncbi.nlm.nih.gov/pubmed/21552194
    Perhaps a depletion of antioxidants in neurons is associated with increased oxidative stress that degrades the health and function of these cells….
    Problems with Glutathione synthesis seem to be linked with a number of diseases which is not surprising seeing as it plays a critical role in neutralising free radicals, toxins which is essential for protection mitochondria and cells from oxidative damage.
    Glutathione may yet be one of the key pieces to understanding neurological health…

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    • Also to add to the above, the article below is a case study of a patient who suffered what appeared to be a psychiatric breakdown but was found to be caused by B12 and iron deficiency.

      http://www.ncbi.nlm.nih.gov/pubmed/15029091

      The interesting thing is that doctors tell us we can get all of our nutrients from a balanced diet but what constitutes a balanced diet?
      And other factors have to be taken into consideration. People can have parasitical infections, Croehns disease, IBS, low stomach acidity which will all contribute to decreased nutrient absorption from their diets (particuarly a problem with B12). Throw in genetic polymorphisms and allergies etc and it gets even more tricky to understand. Then there is also the possibility that much of the food we eat is low in nutrients because of depleted soils, high productivity/fast turnover of crops & livestock so their is less time for essential nutrients to be absorbed etc….
      Also modern humans are now exposed to 10,000s of industrial chemicals that we have no idea of how they interact biologically. Don’t expect the FDA or EPA to protect you. How long did it take for them to ban asbestos, lead additives in fuel and paint, DDT, dioxins, mercury fillings etc….
      In the meantime our plastic food storage containers contain BPA, aerosol cans have aluminium, our crops are exposed to pesticides, we insist on building residential homes in areas exposed to diesel fumes, restaurants add MSG to their food, we cook with non-stick pans etc. Now we also have low fat foods that are packed full of sugar or artificial sweeteners instead….aspartame which will breakdown in the blood to methanol and formaldehyde…..
      Do we really know what we are doing to our longterm health? Are these chemical exposures behind the rise in autoimmune disorders that we are now seeing?

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  20. In Switzerland the Paracelsus Klinic (yes with a K) treats 5000 patients a year from around the world with various issues. They have a team of around 80 professionals including various disciplines. Upon arrival before any diagnosis is made everyone of them first must have all metals removed from their teeth , root canals removed, and all are checked for cavitations. They get advanced dentistry all restorations are inert high tech ceramics. Out of 5000 patients after the dental work 3500, thats 75% go home with their issues resolved. For the rest diagnosis can then be made without confusion and various tests and treatments are initiated as determined by the staff. They have books available.

    @Richard D. Lewis , Your 6 points made above Mar.7 are solid ,I must agree . I would add we need to distribute some pamphlet that gives the population not yet captured accurate info on how to avoid all things psychiatric and what to do instead, put together by psych-survivors working together.

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  21. Almost all “mental illness” is the result of child abuse–emotional, mental, sexual, physical. We have a society of wounded trapped in repetition compulsion. Power defaults to sociopaths who are the only ones who benefit from suppressing the truth about “psychiatric problems” and ‘behavioral problems.” The abusers are the ones with the problems, but also the ones who can disguise, deflect and disarm any efforts to expose them.

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    • Ann,
      Your analysis is spot on . What do you think can be done about it? Would open dialog really expose abusers ? What about the people who have been abused and within themselves are aware of what happened to themselves and have it as a main goal to not do to another what was done to them ? What do you think it takes to be successful with this goal? While what you site is the main cause in the most people, I also believe that in many cases other factors also contribute to making a person more or less susceptible to “breakdown.” It seems to me that many survivors speak most strongly about the factors within their lived experience and know what has adversely affected them.I know that is true for me as a psych-survivor free of any of their services and yet still having diagnosis labels written in medical records that would cause me to be discriminated against in ways someone who never spent time in the psych-gulog would not be. I fight on for my fellow human being.
      Fred

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  22. Whereas this issue is about to come before the State of NH’s legislature in the form of NH Senate bill 270 next week (a “complete overview of mental/behavioral health system), and there seem to be limited opportunities for peer to peer support, administration of services, implementation and support of alternatives vs. pharmacuticals, “outside of conventional practice”.

    I have just just written and shared this article/ interview with our NH Governor Hassan.

    Additionally, I mentioned a suggestion of reading this prior to; NAMI’s invitation of which she has accepted, for their March 5 Annual Conference/Workshop & Keynote here in Concord,NH.

    FYI some of you may know: The keynote is: Stand Up For Mental Health: Using Comedy to Fight Stigma!
    David Granirer, Founder, Stand Up For Mental Health

    Thanks again-
    Just thought this may be a very transformative time here in NH.

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  23. It is not so much the “medical model” as the mechanical model. This is a metaphysical question. If all that exists is matter or substance or physical stuff then there is some basis for treating not only the body but also the mind as a machine. Mental illness is a defective mind or a broken mind . . . essentially like a car or computer. Replace a part or make an adjustment. This is actually rather a stupid position if looked with care. What we call mental illness is a state of affairs resulting from past behavior. Depression arises out of a way of life, a way of thinking and acting. The same is true of anxiety. As a result Yoga or Buddhism or other practices are very good at changing the mind and its moods. With a pill though one can continue down the wrong road indefinitely. It is a matter of divorcing one’s life from the causal chain. Just a bad bit of machinery. A lemon.

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