“The very term [‘mental disease’] is nonsensical, a semantic mistake. The two words cannot go together except metaphorically; you can no more have a mental ‘disease’ than you can have a purple idea or a wise space. Similarly, there can no more be a “mental illness” than there can be a “moral illness.” The words “mental” and “illness” do not go together logically. Mental “illness” does not exist, and neither does mental “health.” These terms indicate only approval or disapproval of some aspect of a person’s mentality (thinking, emotions, or behavior).” E. Fuller Torrey, “The Death of Psychiatry”, 1974
The year before I was born, E. Fuller Torrey published ‘The Death of Psychiatry.’ Therein, he repeatedly made statements that are disdainful of the psychiatric profession and its core concepts. Other quotes include:
“”Many psychiatrists have had, at least to some degree, the unsettling and bewildering feeling that what they have been doing has been largely worthless and that the premises on which they have based their professional lives were partly fraudulent” (p. 199)
And
“The death of psychiatry, then, is not a negative event”(p.200)
At that point in his life, he also asserted that known brain diseases were responsible for “no more than 5 percent of the people we refer to as mentally ‘ill’” (p.176) In fact, as recently as 1991, he has been quoted as calling for the end of psychiatry. For example, in October of that year in American Health magazine, he said, “Now, if you give the people with brain diseases to neurology and the rest to education, there’s really no need for psychiatry'” (p. 26).
All This Begs Some Very Important Questions: How did the E. Fuller Torrey who wrote ‘Death of Psychiatry’ come to be the E. Fuller Torrey who founded the Treatment Advocacy Center in 1998? How did the man who called for the elimination of the psychiatric profession and eschewed the very idea of ‘mental illness’ become not only the rabid champion of both, but also of forced ‘treatments’ by way of methods in which he once professed not to believe?
Not long ago, I had a conversation with a local mental health provider regarding a notable figure in my own state. The individual about whom we spoke holds both a directorial role at a state hospital, and a seat on the Treatment Advocacy Center’s Board. I had shared that I was nervous about a recent interaction, given the extraordinary divergence of our views. I was somewhat surprised when that provider – who has been working in the field for many years – said that if we went back a few decades, that same individual might have been my biggest supporter. She said he’d somehow lost his tolerance for risk. Surprised, yes. But I shouldn’t have been. It rang a bell.
I thought of Torrey immediately. In fact, he is not an anomaly, and his early beliefs should come as no real surprise in spite of his current position. Rather, he is part of a sizable group of people – doctors, mental health professionals, parents, and so on – whose conservatism has grown rapidly with age. It left me wondering. Never mind those who espouse pro-force attitudes based on ignorance influenced largely by media. What brings on these changes for those who actually know? How many who are now calling for measures like the Murphy Bill and Outpatient Forced Commitment (so often euphemistically referred to as ‘Assisted Outpatient Treatment’) have undergone this brand of transformation? How do some of the strongest voices for one perspective so completely lose their bearings until they find their way to the opposing view and grab on for dear life?
Little did I know that almost exactly one month later, I’d get a big lesson in the ‘why’ of it all. On Saturday, May 17, a serious assault occurred at Afiya, the peer respite that is a part of the Western Massachusetts Recovery Learning Community where I work. I wasn’t there and I didn’t find out until early the next morning. A team member was hurt. Everyone was scared and upset. Someone who had been staying there was arrested under charges that included attempted murder. I remember exactly how I felt: Sick.
Maybe I remember it so clearly because I’ve woken up feeling sick almost every day after. Since it happened, sometimes I wake up with a jolt in the middle of the night and my brain is racing. I can’t stop visualizing every other awful thing that could ever happen within our community. (No matter that many of those awful things can and do happen with much greater frequency elsewhere.) When small conflicts occur, I feel panic overtaking what used to be even-keeled responsiveness. Several times, I’ve thought seriously about quitting – not because I don’t believe in what we do, but because I’m not sure how to fully move through the feeling that I’m just waiting for the next awful phone call.
This is post traumatic stress. It has the potential to effect not just those who were present, but all those whose world view and sense of ‘safety’ in this life were shaken. Personally, I’ve always lived with an extreme fear that I’ll lose my partner or children. Most days, I have intrusive thoughts about all the ways they could be taken from me and find myself visualizing those awful scenes. If I can’t reach them by phone or they are running late and haven’t called, I can go from 0 to panic in well under 60 seconds and they’re likely to find me a ranting, crying mess when they do finally return.
Right now, I’m there with work, too. Notice I don’t call this ‘post traumatic stress disorder.’ It’s not ‘disordered.’ It makes sense given what’s happened. I’m counting on the work aspect of all this settling down once we’ve found our footing and begun moving forward again. However, what I actually find most unsettling is the philosophical slippage I can feel in my own brain. It’s almost tangible. Ideas – like wearing panic buttons, searching people’s belongings and doing background checks – that used to sound flatly absurd to me now sound . . . well, still absurd, but slightly less so. I feel like I’ve lost just a little bit of touch with my own certainty.
Fortunately, as we’ve gone through an intensive review of what happened, the facts are reassuring me. A popular public response to this incident is to question whether or not it happened because most peer respites — including ours — do not have clinicians on board assessing people for dangerousness prior to entrance As it so happens, in this particular instance (although not the norm), a clinician did send this individual our way and had assessed him right before doing so. We actually think that that was a part of the problem – that perhaps this individual had been encouraged by a clinician to call, rather than truly, voluntarily wanting to be there.
Readers commenting on the related news stories online have also blamed our lack of background checks for what happened, as this individual did indeed have a history of violence in his past. And yet, the reality is that most providers and organizations do not do background checks. Not individual therapists who may see virtual strangers in otherwise empty offices. Not clinical respite programs. And, to the best of my awareness, not any other peer respite. Yet violence remains lowest in environments where force, coercion and power are most minimal. We have some work to do, but most of it is about fine tuning, updating and strengthening our commitment to our values . . . not changing them or our approach.
Nonetheless, knowing this intellectually hasn’t changed the part of me that just wants to react. That wants to lock everyone in and keep everyone ‘safe,’ even though the facts-based part of me knows that risk of violence would actually be higher for doing so. This impulse comes from somewhere deeper than intellect. It comes from a place that needs to feel like I’m ‘doing’ something. Anything. Even if it makes no sense whatsoever from a practical standpoint. It comes from the place inside that needs to deny the fact that violence can happen anywhere, and that can’t stand the idea that not everything is in our control.
And when I say ‘need,’ I don’t mean it in a superficial way; I mean it in the sense of a ‘need’ that must be met in order to quell the fear that otherwise might interrupt one’s ability to move through the day and pay attention to everything else. I’m going to work through this, with the support of my community. Fortunately, everyone who was directly involved is essentially okay. That helps a great deal. And, we’ve worked too hard to give up on what we know to be true based on our own lives and on the stories of so many around us.
However, as I go through this process, I find myself with a little bit more compassion for people like Torrey. They are so clearly operating from that ‘need’ place. Imagine how out of control their worlds must have felt at some point in order to drive them to a place where ‘control’ has become such a hyper-focus. I wonder what they’ve been through that has moved them to this place where they can no longer see that force and coercion so often make things worse. I’m unsure as to the answer, but I no longer want to just tell Torrey (or others like him) what’s wrong with him and his views. Instead of the massive debate I’ve always envisioned having should our paths ever cross, I now just want to ask him what has become the golden question of trauma-informed practice. Instead of ‘what’s wrong with you,’ I want to ask:
“Edwin Fuller Torrey, What Happened to You?”
I wish I could be as understanding as you are Sera. In fact, I think that it is in these occasions when you see a person’s true nature.
Whatever happened to Torrey that caused him to become the poster child of everything our movement deplores, it means he probably never held those older views sincerely and that he was a twisted man since the very beginning.
Speaking for myself, being civilly committed made me more understanding with civil liberties issues in general. I care about things that I previously didn’t pay much attention to. After having had my own personal freedom violated so viciously I understood how evil it is to have other people’s civil liberties violated for similarly non justifiable reasons.
You see the same phenomenon on family members of those who have been civilly committed. John Nash’s wife had a change of heart in 1970 after she realized that all the involuntary treatments had been a mistake and she took him in with assurances that she would never try to commit him again (per this PBS documentary https://www.youtube.com/watch?v=oM1SflhJDoc ). That provided Nash the safe environment he needed to calm down and recover. Other family members, like the people I refer to as my “ex family”, use the occasion to double down and throw at you all the accumulated bad feelings they had towards you. A second consequence of my civil commitment was to realize that these people never accepted for who I am in the first place :).
Maybe psychiatry has made me too cynical, but I do believe that those who believe in forced treatment in the way Torrey does never had any respect for other people’s individual freedom in the first place. Whatever happened to Torrey that caused him to adopt his current views was an “unmasking event” more than anything else.
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Here are some definitions of “cynical”:
distrusting or disparaging the motives of others; like or characteristic of a cynic.
showing contempt for accepted standards of honesty or morality by one’s actions, especially by actions that exploit the scruples of others.
bitterly or sneeringly distrustful, contemptuous, or pessimistic.
It’s also defined as “knowing the price of everything, and the value of nothing.”
When you have good reasons for being suspicious, it’s not “cynical?; it’s just natural distrust of a person or agency that has bred mistrust and done you or your loved ones harm— it’s a survival instinct.
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“distrusting or disparaging the motives of others; like or characteristic of a cynic.”
I think that one applies…
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Hey Cannotsay,
Nothing’s ever got a simple or black and white answer. I think it’s entirely possible and true that some people are just not good people, enjoy power, or somehow otherwise fundamentally don’t ‘get it’ or have ill intent.
Torrey was a convenient choice for focus for this piece because of the material that’s out there on him, but you may very well b e right that he was never sincere in his earlier material… Though he did go to the trouble of writing a whole book about it. Someone else has suggested to me that he was just ‘aping’ Szasz without fully understanding him and when his true believes really surfaced… well, we see what we’ve ended up with…
However, although I was happy to use Torrey to exemplify my point, i hope he also doesn’t distract from the underlying point which is true… I do wholeheartedly believe that the phenomenon I describe above is a real part of the picture for many people, and – given that – there are likely more effective ways for us to be approaching some of our conversations with them…
Though, in the end, I agree with you that what I write about here is NOT to be taken as a justification… But if our goal is to put an end to it all, I think it may nonetheless need to be a part of the conversation.
-Sera
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I am sorry it took such a tragic event for this blog to be written, but your conclusion is profound. I have long believed that professionals, myself included, are doing the best we can with the knowledge we have, and it is the job of the recovery community to educate us about, not oppose, our practices. You so eloquently expressed a key approach to this very idea: try and understand “what happened” that led to each of our current thought processes and methodologies. I believe a lot of ground can be gained with this approach. Thank you for your contribution!
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“I have long believed that professionals, myself included, are doing the best we can with the knowledge we have, and it is the job of the recovery community to educate us about, not oppose, our practices.”
That’s simple: psychiatrists are killing people and ruining lives with neuroleptics and other psychiatric drugs. Stop doing this. Support people in coming off psychiatric drugs.
Also stop (re-) traumatizing people. Read Trauma and Recovery by Judith Herman.
Thank you!
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And stop telling lies.
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My post made no mention of my specific profession within the field of psychiatry nor my fundamental beliefs. I am not a psychiatrist and I don’t believe in medication. Assumptions such as this are what turn people off to your message.
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You talked about “professionals”. In the context of the article I thinking of psychiatrists and “mental health” professionals. That was just my general advise to the profession (and not meant as a personal attack): first, do no harm.
Another advise (for everyone, myself included): Don’t take things too personal. Mad (and “normal”) people can push ones buttons, intentionally or non-intentionally. Don’t stop listening. Everyone has important stories to tell, but everyone tells it in a different way. Some people get mad to be able to tell their story.
In conclusion I think we don’t need psychiatry at all. We need people who are able to listen. We need people that educate about what is good nutrition for your body and brain. And we need doctors that are able to figure out if one’s psychological distress is connected to some real illnesses (gut, inflammation, autoimmune, etc…).
Enough advise from me! I never was a patient in psychiatry, but I visited regularly and talked to patients and the staff. There are nice people working there and I truly believe that they don’t have the intention to harm people. But still they do harm people. Why is that? Maybe they can educate us (the people who oppose psychiatry), why they are doing the things they are doing? What is their story?
And what kind of education you want to get from the recovery community? How should this education work? Who pays the recovery community for educating you?
This is also not meant to be offensive. I think these are important questions. And keep in mind, English is not my native language and I’m not from the U.S.. There might be cultural differences and misunderstandings.
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“the fact that I’m shouting (swearing/emotional…) doesn’t mean I’m wrong”
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Thanks for reading, intention. In truth, I think for true change to happen, we all have roles to play. I think that some of those roles include straight out opposition and truth telling, but I also don’t think that that alone will do it and that understanding and humanizing benefits us all.
-Sera
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This line of reasoning strikes a chord. The very worst treatment provider my daughter ever encountered was at the acute care facility, a secure psychiatric section of a private hospital in Eugene, Oregon. He is a psychiatrist who has been there a long time; and what struck me was his mediocrity and complete aversion to risk. He lacked a sense of curiosity about the human mind; he seemed robotic in some ways and in other ways, an enigma, exhibiting both compassion but lacking in courage and backbone and quick to give up on his patients. He gave up on my daughter from day one claiming ‘I can’t work with your daughter! She is too disturbed!” (less than 24 hours after she had been forcibly medicated with enough tranquilizers for an elephant and restrained with five point restraints even though she had never been violent) he had brand loyalties and he experimented on her from day one with anti psychotic medications that he claimed to be ‘fond’ of. “I like Geodon!” he gleefully told me one day, as if he had personally sampled it and found it to be delightful like pumpkin pie ala mode. After he contributed testimony that stripped my daughter of her rights and dammed her several times to be forcibly medicated and involuntarily committed to a large state institution he appeared to be genuinely compassionate in the hearing room but he was completely obtuse at the same time, unconscious or unwilling to acknowledge how his actions had contributed to her worsening condition. Much later, when I questioned why my daughter could not obtain a family pass or a day pass while being detained in this nightmarish fishbowl for three months while she was waiting for a bed to open at a state institution, he referred to an incident decades ago in which he had given a pass to someone and something bad had happened. He wasn’t specific. I then began to see him as a complex and whole individual, not simply a caricature of a medical doctor but someone who was jaded, traumatized, and haunted by memories. If we parents can reach a place of forgiveness when our children have been the victims of psychiatric harm and abuse, it will because we can somehow come to see our children’s treatment providers as human beings; even if they did not treat our children as equal human beings with the same rights.
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Madmom, Thanks so much for reading and sharing a part of your story. It reminds me of something Ruta Mazelis said about us needing to create space for providers to grieve some of the harm they’ve done in order to heal, move forward and change. How your daughter was treated sounds inexcusable, but your openness to trying to understand why it happened the way it did sounds like an important piece of the puzzle all the same. -Sera
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Sera, I always appreciate your thoughtful articles, and this one gives me an insight into what it’s like to run an agency that’s mental health system funded, but still wants to do what’s right.
I’m a little amused by your speculation about E. Fuller Torrey’s motivations, though. Myself, I wouldn’t give him the benefit of any doubt. I don’t think you can be serious, lol.
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Hi Ted, So, I may not be fully serious about Torrey. I think it’s still entirely possible that there are just awful people in our world. But I am completely serious about the overall concept of how so many people lose their stomach for ‘risk…’ Or what I’d be more inclined to frame as *acceptance* of lack of control over all bad things that may happen… And how that drives them into flurries of activity or – even sometimes wholehearted missions – to further the illusion that there is something that can be ‘done.’ Thanks for reading and commenting! 🙂 -Sera
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“Risk” yes but I don’t think this “risk” is usually physical harm. Most often it’s loss of reputation, potential lawsuit etc. Which is not a result of trauma – it’s simple human cowardice.
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This is a wonderful reflective piece and resonates with me , from the odd incidents we had at the recovery houses, that fear & need to feel in control can temporarily take over. What saved me each time was to be able to sit down and reflect and talk it over, some workers especially in big institutions unfortunately don’t have the time or don’t see the importance of reflective practice also they are usually working in highly blaming cultures that has to find someone to carry the fault, which then also leads to such risk averse practice. Thank you Sera for such an honest piece of writing
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From what I saw at a local hospital ward, I’d say that the staff was so busy because they were acting out paranoid fear non-stop. I don’t see how anyone is doing any vulnerable person any good by, let’s say, tossing their room while they’re sleeping and waking them up in the process; to make sure that the patient doesn’t have any contraband like a tea bag that has caffeine, that one is going to use in the morning, before the coffee and tea are made available. Gee, maybe patients could sleep longer if their weren’t a parade of staff members violating their space at random or for the patients who won’t be good little boys or girls and take drugs they’re prescribed without complaint— bad child, bad!
I had taken one of the drugs I refused before, and it made me very angry. They did not want to see me angry. I did not want to see me angry. But surely I was only refusing because I’m a “treatment resistant” problem child. How could they think otherwise? Seriously, how could they think otherwise? It’s a question they should be asking themselves.
One thing I know in any situation in which a person is out of control— don’t add your feelings to the mix. Stay calm. Be non-threatening. Lean back, relax your shoulders and your jaw and be relaxed in the moment. If staff members cannot handle most patients without force and constant surveillance, then maybe they should get more training or find another profession. Sure, there are scary times and scary people, but when the primary response to them is being more dangerous and controlling to everyone, then it’s paranoia— a state that most people recognize as dangerous most of the time. There’s no reason for someone in a disturbed state to feel like they have to take care of the people who are supposed to be taking care of them. It makes no more sense than turning high schools into prisons for all the students, instead of identifying the sociopaths and their minions. It’s lazy and mindless.
And, if mental health professionals can’t tell the difference between a sociopath using the mental health system to escape the consequences of their most recent crime; then how do they really distinguish the different labels they apply from one another? People given the power to use force out of the belief that they’re using it in the patients’ best interest, should know better than to put a wolf in the ward.
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Hey Wileywitch,
There’s a ton in what you wrote … but I’ll respond to at least this for the moment:
I will say that at least a substantial percentage of people who enter hospital and other provider environments to work are doing so because it requires minimal education and experience. When I’ve offered trainings to front line workers in a provider environment and heard them be asked, “Why are you doing this work,” I’ve sometimes heard answers like “I didn’t want to work retail.” I think the explanations of ‘why’ that apply to people in that place (some of whom it sounds like you might be describing) are definitely different than the ones I shared here.
The issue of how the mental health system is used to address criminal issues is another HUGE problem that I’ve been thinking a lot about lately, too.
Anyway, thanks for reading the blog and so many of the comments 🙂
-Sera
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“The doctors here are more crazy than their patients” a quote that has stayed with me from a fellow “inmate”. It’s so true that many of people who work there would benefit from some serious counseling…
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Hi Karen,
I think it’s a very good point you make: The culture of blaming, liability and litigation that we’re currently living within. Thus, the fear I’m talking about can ultimately include not only the very human not wanting to witness tragedy and see people hurt, but also fears about loss of jobs and licenses and even dents to the ego. Thank you for reading and commenting!
-Sera
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Thank you for this fascinating article, and I truly hope that, in time, you are able to heal from this tragic event. I certainly believe that trauma can have a significant impact on behavior, but I never believe that it can be an excuse for causing harm to another human being. As a point of comparison, the overwhelming majority of my biological family is extremely abusive. Other than the one other relative that I know of who left the family and never went back, most of them deny their own abuse and then, proceed to act it out on the next generation. This has been going on for four generations, that I know of. I understand the root of my relatives’ actions, but I do not, in any way, excuse such actions (except under very specific circumstances, such as when I’ve seen very young children who truly did not understand what they were doing act out in this way). I made a choice to leave most of this family behind and do everything in my power to find safety and healing, and even in moments when I’ve been tempted to deny my own history, I could never imagine causing any kind of harm to a child. To be fair, part of that is because I simply don’t understand what even makes people want to do such things, but part of it is a very conscious decision that I would never cause the kind of harm that I suffered to another human being. In the end, everything is a choice, and bad experiences are not an excuse to harm others- even when that harm is not caused by the worst of intentions. While we certainly need to understand where our opponents are coming from, I truly hope we can make the distinction between understanding and excusing.
It amazes me that these very rare incidents of violence at programs that serve as alternatives to hospitalization become publicized and used as an excuse for pro-force opponents to cite the need for forced interventions, while the daily violence that occurs in locked psych units goes largely unnoticed. I was once in a hospital where one nurse stated that every staff member there (and there were at least a couple dozen) had been attacked by a patient. This was attributed to the crazy and violent nature of these individuals, rather than the more logical conclusion- that when you treat people like caged animals, some of them will act like caged animals. I very much appreciate the logic, reason, and empathy that you bring to this conversation.
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Thanks for reading and commenting 🙂
I hope that nothing in what I wrote is taken for excusing abusive behavior, as I absolutely agree with you on that count.
You raise another tremendously important point: That violence in environments where force and invasive/disrespectful process is far more the norm than in the alternative spaces. I hope that more people will come to understand the point you raise here.
-Sera
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“This was attributed to the crazy and violent nature of these individuals, rather than the more logical conclusion-that when you treat people like caged animals, some of them will act like caged animals”
That would follow with another logical conclusion: what we do is morally wrong and clinically counterproductive. And with a question: so what should we do? People are neither happy to blame themselves and admit failure nor to be proactive in trying to find complex solutions to complex problems (or they feel powerless to do so).
On the other hand you’re right:
“I understand the root of my relatives’ actions, but I do not, in any way, excuse such actions”
Many people here at MIA turned their personal trauma into an experience that helps them to better support others and fight injustice. That’s not only true for psychiatry – look at any other civil rights movement, organisations such as Veterans Against the War etc.
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Hi Sera,
Thank you once again for your eloquence and honesty. Although one might say that in my own career I have moved in the opposite direction (I was less conflicted about being an agent of control when I was younger than I am now), I certainly resonate with the struggle over the desire to control scary and disturbing behaviors. You seem to suggest that one problem is that the person at the center of concern in your program may not have truly wanted to be there; so then what is to be done when the person who has disturbing or scary behaviors who does not want to be anywhere? Professionals are not the only ones who may respond in this way; I think a similar response occurs in some families.
This is for me an interesting article in its contrast to Daniel Mackler’s post (http://www.madinamerica.com/2014/06/ode-biological-psychiatry/) that garnered so much attention.
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Here I agree. I was myself a bit shocked by the Daniel Mackler’s post – while we should criticize (biological) psychiatry and its practitioners for the faults, we should not not turn a reasonable critique into an angry, insultive attack. Psychiatry, despite all its negative legacy, is neither totally wrong nor totally evil. It is one of many possible ways of dealing with mental problems and distress of people – along with psychotherapy, social work, pedagogy or spiritual practice.
A combination of medical and biological knowlegdge with psychosocial and humanitarian one is a necessity for the approaches for mental work which include the usage of drugs – and such approaches has their legitimate place and usage. For example, there was a psychedelic research and therapy of people like Stanislav Grof, who was a psychiatrist; his medical knowledge was very useful to him during his explorations of consciousness.
I think, most negative facts for which we criticize psychiatry are due not to psychiatry itself; they are mostly due to its institutuional status – and the licence to coerce which was given to it. Deinstitutionalization is the actual priority; but “end of psychiatry” is a bad idea. With psychiatry, we will lose a lot of knowdge of psychophysical problems of people, as well as methods of solving these problems. What is important to protect people against the forceful, nonconsensual attempts to use these methods.
Dr. Stengard, I also want to make an additional comment about the problem of coersion. During our last dialogue in the comment thread of the “Paradigm Shift” post of yours, your asked me what should we do with violent sufferers of psychotic episodes – given that a few of them really can intiate violence, and they won’t accept anybody’s help, whether of “mainstream” or “alternative” type.
I thought about this hard question a lot since then. And, with all honesty, I have to confess that I have no answer. And I can’t name anyone who has.
However, I’m still strongly against giving mental health professionals coercive power – because there is no sharp link between a relatively small number of cases of violent psychotics and a very big number of cases of rebellious and nonconformist persons who are labelled as “danger for society” by authorities. I’m myself a libertarian who is highly critical of the modern force-based society; I know a lot of people who share the same views. We are not liked by the ruling elite – especially because of other tendency of questioning official versions. So, should, for example, questioning of the official interpretation of 9/11 World Trade Center terrorist attacks be dismissed as “paranoid delusion”, despite the fact that many of questioners are highly-qualified scientists and technicians? Or – if we look at the non-conventional views not linked to the power-structure problems – should the interest towards psychic phenomena be treated as a sign of mental confusion, despite the fact that such phenomena is a topic of research of many serious and reputable scientists, such as high-level psychologists Daryl Bem and Stanely Krippner, and there are even some specialized parapsychological research groups in universities – such as Division of Perceptual Studies in the University of Virginia?
Or – if we move from the mere views to the actual social behaviour – should we treat “indescent” behaviour as a sign of illness? The meaning of “decency” is highly debatable, and was changed greatly by the efforts of rebels during the 20th century. Was all these rebels – such as hippies and punks – “mentally ill” because of their active protest against the “decent” society?
Or – if we look at the realms of experience – should we treat the people who had the transpersonal spiritual experiences as “hallucinating psychotics”? I think we should not!
So, while there is indeed a danger of violent, severely mentally disturbed persons attacking others, it is not enough for me to give up the principle of non-coersion. We put ourselves at a constant danger of abuse this way – because no one can say what and who will be next target of authorities’ ire.
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Sorry, but psychiatry IS totally wrong and totally evil Any actual “help” that one finds in the psych system is in spite of it, not because of it.
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Well, what about Loren Mosher and Soteria Project? Mosher was a psychiatrist; and, while he was in favor of psychotherapetic approach, he did not reject psychotropic drugs totally. He was for their very limited and short-term usage in the cases of most severe psychosis.
Were Moser and Soteria totally wrong and totally evil? I think you would agree that they were not.
That’s why black-and-white dichotomies never work. Whatever you look at, the more you look, the more shades of grey and delicate nuances you will find. I still haven’t find anything “purely wrong and evil” or “purely good and right”, despite my years-long personal inquiry into nearly every controversy – scientific, scholarly or social – I heard of. In fact, the more I learn, the more complex and diverse picture of the world I see; the picture where anything, including (biological) psychiatry, have a chance to bring us knowledge and potential which would otherwise be lost – as long as we remain critical enough to spot mistakes and fallacies in the message.
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“because there is no sharp link between a relatively small number of cases of violent psychotics and a very big number of cases of rebellious and nonconformist persons who are labelled as “danger for society” by authorities”
“They who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety.” Benjamin Franklin
You can’t prevent every act of violence without eliminating all freedoms. There is always a trade off and the legal system knows it – hence innocent until proven guilty and no pre-crime. These principles don’t exist in psychiatry – you’re guilty until proven innocent, which you can never prove sine it’s based on pre-crime: “potentially dangerous”.
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Thanks for reading and commenting, Sandy. What you’re asking – where does someone go and/or what should the community response be to someone who doesn’t want to go anywhere voluntarily, but they seem to not be able to be ‘safe’ out in the world on their own.
I don’t feel like I have the answer to this, though it’s a question I at least attempted to raise in my blog, ‘Mind the Gap.’ We have a serious gap in options between the voluntary alternative options and the much more standard forced and medicalized approaches. I wish I had the answer to what should happen, though a reader on my ‘Mind the Gap’ blog did comment about the idea of further exploring the difference between forced detainment and forced ‘treatment’ that bears some thought…
Though I also would caution that I also think there’s a problem with what gets labeled as ‘scary’ or ‘disturbing’ behavior in our world… Those things don’t necessarily equate with ‘dangerous.’ For example, the person responsible for the assault at Afiya wasn’t doing much of anything that anyone would interpret to be ‘disturbing’ or ‘scary’ up until the actual assault.
-Sera
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The delusional, psychotic person is a poster boy for dangerously mentally ill. But we don’t know how many of these “dangerous for self and others” people would be if the system was totally non-coercive and didn’t scare people off? How many people would go and seek help before they decide that they can trust no one and everyone is on a conspiracy to get them? These delusions don’t usually develop overnight.
Coercive system is not wrong only on principle – it’s first and foremost counterproductive.
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Dear Dr Sandy
Am I right in saying that assaults on staff are far more common in General medicine than in Psychiatry, carried out by people that are not ‘mentally ill’, and that people identified as ‘mentally ill’ generally speaking have a lower capacity than average towards violence.
As I know it, when ‘mentally ill’ people explode there’s often a chemical (drug) reason.
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Sandra,
Can you please explain how you feel this post contrasts with Daniel Mackler’s “Ode to Biological Psychiatry” post, for which you’ve provided a link?
I very much appreciate both of these posts, so I am curious as to what you see as the notable difference between them. Thanks.
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Hi Uprising,
Sera speaks to the impact that another person’s action can have on those who are trying to help that person. She wonders how these kinds of experiences influence people. She tries to understand the “other”.
Daniel Mackler’s blog spoke in very broad generalities. He made pronouncements that are just hard to refute (biological psychiatry is no more a science than scientology, psychiatrists do not want to help people, etc). These are very broad generalizations and they are opinions presented as facts.
I respect Daniel and I am interested in engagement but I just do not even know how to begin. I think about the many thoughtful psychiatrists (and other clinicians and family members and “experiencers”) I know who may approach human suffering from a disease model but who may be curious to learn from the experiences of those who write here. When one is labeled in that way, one is more likely to just walk away from the conversation.
I hope that explains my different reactions to these posts.
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Sandra, I like reading your blogs and I hope that there will be more people like you to support people in psychological distress. But in this discussion I wonder if you are really listening to what Daniel is saying:
“Sometimes I get so sick of the lies of biological psychiatry that I must speak out. At these moments I find silence to be a kind of emotional death: a death of my spirit, a death of my critical faculties, a death of my courage. I speak out because I am alive and I wish to align with life. I speak out to express my lack of indifference. ”
I feel the same. The lies of psychiatry are sickening. And it feels to me like you are deflecting the conversation.
It’s not my task, responsibility or goal to support reforming psychiatry. I think we would better off without psychiatry. So I don’t see the need that everything we are saying should be avoiding conflict with the psychiatric system.
I believe what is needed is dialogue within your community of psychiatrist and mental health workers. Don’t expect that we will bring it to you on a silver platter. You need to empower yourself and not be dependent on big pharma and bunch of idiots who pretend to do science. Otherwise we will continue to talk about the abusive system of psychiatry and that psychiatry is built on lies and kills people.
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https://www.youtube.com/watch?v=4oLLAjBOFTg#t=49m46s
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Sandra Steingard writes:
“I respect Daniel and I am interested in engagement but I just do not even know how to begin. I think about the many thoughtful psychiatrists (and other clinicians and family members and “experiencers”) I know who may approach human suffering from a disease model but who may be curious to learn from the experiences of those who write here. When one is labeled in that way, one is more likely to just walk away from the conversation.
I hope that explains my different reactions to these posts.“
Well I don`t know where to begin either. I will say that during the civil rights movement there were also many “supporters“ of the movement that were quite aghast with the voices and actions of the oppressed and wished to steer the words and deeds of the oppressed in a more “correct“ and contained fashion. Malcolm X spoke of this and referred to this strata as the “wolves in sheeps clothing“. So I guess it depends on what your goals are: a kinder gentler face from the slavemaster with some modest reforms? or and end to psychiatric oppression and some semblance of equality? Personally I’m not interested in some kind of miss manners course for psychiatric surviours with regard to how to express themselves.
“When one is labeled in that way, one is more likely to just walk away from the conversation.“
exactly! haha! wow!…is this intended irony?…the mind reels! …metaphorically speaking! jeez!….easy
In conclusion when I am mandated the power to forcibly confine and drug psychiatrists (and the power to label them with fake diseases…can`t forget that one) I will once again consider becoming fully engaged with psychiatrists
sincerely
abbot
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Hi Sera- your posts are always thoughtful, as well as insiteful. Seeing one of your worst fears- losing your ” child” is now the fate my family and I live after losing my 25 y/o son, almost 29 months ago to suicide. I sadly have been thrust into ” the system” of MH which for the 27 months my son was entangled in this web is a completely broken one (imo). The education I’ve received includes everything written at MIA, whether I agree or not. I have since longed for the peer respite communities like Afiya, where you are affiliated, when my son was caught up in ” the system”. Sadly, there was no such alternative program that my husband and I were aware of the hellish night Oct ’09 when our then 23 y/o son, literally overnight, morphed into someone with delusional thoughts, while experiencing a nervous breakdown ( truly the best description though no longer correct jargon). I regret bringing my son to a psych hosp, though we were beyond overwhelmed not knowing how to help our son get his always healthy, charismatic, sharp, dynamic personality back to “normal”. After we were told to leave, my son willlingly accompanied the staff person not realizing the hell he would meet on the other side of the locked ward- where he tried to escape from the fear realizing he was going to be forcibly drugged which he resisted so was beaten to a pulp by the night staff, twice over the next 36 hours until we were finally allowed to visit. That was my son’s introduction to ” the system” in a CA psych hospital, by the sea. I’ve often thought why was there just a–hole p-docs, instead of ones who seem genuinely compassionate and aren’t afraid to think outside the box, to accept any brain can experience a psychosis NOS, and heal, like Sandy Steingard, or the p-doc I found last year ( out-of- state) when I sought an unbias opinion of my son’s ” treatment” since I obtained his medical records at the second ( and final) psych hosp 18 months later when my son had a second reality break, both times testing (+) for THC. It didn’t matter, to ” the system” that my son had tested for a recreational drug, twice, ( and IF the hosp and treating p-doc had done their job, completely, and honestly, ( IMO) the somatic cause of his altered reality was due to DRUGS, not the ubitiquous ” bipolar” label he was assigned. Both times my son emerged back to ” normal” but being stigmatized ” bipolar for life” and being left in a ” drugged stupor” gaining 55 lbs in the first 4 months he was released because he agreed to accept the terms ” meds for life”. A daily reminder for the rest of his life was the stretch marks all over his abdomen from the rapid wt gain from the neuroleptics, indeed, branded MI by ” the system”. Did any professional, either hosp, ask ” what happened to you” – or inquired who he was for the first 23 and 24 yrs of his life that had they cared would have known ny son was the kind of trusted friend, as he was respected employee, and witty, beloved son whom any parent would be so proud to celebrate. Ultimately, my son chose to wean off these toxic meds which ( IMO) did nothing but create havoc with his body physically, but the damage was done. How does a young man, full of pride, survive because the stigma of MI is sooo isolating? Why does society instantly distance themselves from people who emerge traumatized after being a caged prisoner? I feel such guilt not understanding what my son was subjected to, and not telling him that I would never , ever again believe ” the system” was compassionate, caring or healing.
So, Sera, we know the world we’re living in is going to continue to be full of uncertainty. The community you work in will find additional safeguards, but I ask you to stay the course. I will always believe had my son been evaluated, counseled and supported by a peer respite community, unlike the atrocities inside two different locked CA psych hospitals an hour apart geographically, he wouldn’t have been haunted by the labeling he received and lived, in fear, which he told his therapist ( and I was told after my son died) ” I will never go back inside one of those facilities again”.
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Thank you, Larmac. I really appreciate your speaking up and sharing a part of your story. I also wish there’d been more alternatives for you and for your son and I definitely plan on doing my best to stay our course. 🙂
-Sera
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“I will never go back inside one of those facilities again”.
As a person who was at the receiving end of the treatment much alike to one your son had to endure (I got out thanks to my family) I sadly agree with him. Had I been faced with a perspective of being locked up and abused by the system for unknown time I’d have truly become a danger to self and others and probably end up hurting someone and/or committing suicide.
Honestly, I think that anyone who uses the coercion, forced drugging etc. in their practice should stop whining if they ever get attacked by a patient. You’re asking for it and that’s what you get. I have no sympathy for people like that unless they actually sit down and think for 5 minutes about what is exactly they’re doing and STOP. This is inexcusable and anyone who doesn’t see the problem is either stupid, lying or in denial.
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Btw, that’s also why I’ll never ever in my life go seek any psychological/psychiatric treatment for myself or anyone I know, not even the worst enemy. And I’ll advice anyone not to do it either. This system is so broken it can’t be trusted and until it’s fixed the only way is to stay the hell away from it.
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Hi Sera–I haven’t read down the thread yet, but will–so, I just wanted to jump in with initial reactions to your piece here. First of all, you are coming to a fine level of journalistic communication skills, or however I should name what your writing is showing. I think the first piece that I knew of and looked at from you was about “no shoes”, and not long ago you reframed your position about working in the field. Since then you’re just putting finer and finer points on things, I believe.
Here you mention the unfortunate tranformations we can unwisely invite ourselves to undergo: and you consciously bring in the psychological concept for controlling and elucidate it without jargon and just such as it matters to your specific themes. On that note, what appears true to me is that you’re careful to keep thinking over the numerous contradictions that go along with the asymmetrical divide between providers and consumers, and the double standard the fields are known and not called to account for, in recurrent and effusive negative criticism of behaviors depending on your relationship to behavioral healthcare, inside or outside the field.
I mean, how can psychotherapists make so much of “controlling” in the home everyday stiuations in life, and carry on like they do, relatively blaming “controlling types”? But then not juxtapose that with recognition of the inflexible, brutish controls that mark almost all institutional treatments of people suffering in treatment and from those treatments, intrusive thoughts of how reminiscent these hospital and outpatient facility dynamics are of the various circumstances that led them to feel bad and lose control over some aspect of their lives? I am really glad that you focus on your themes constructively and treat that huge problem as something implicit and justifiably a worry on its own terms.
I have only recently been able to think over controlling behaviors that used to affect my interactions, and the freezing up that you refer to was obvious. So were the do as I say and not as I do advisements.
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Thanks for reading! I really appreciate your taking so much time to be thoughtful in your responses.
I particularly appreciate your raising the contradiction of the focus on ‘controlling’ types while being so invested in such a controlling system… I hadn’t thought of it quite like that before!
-Sera
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Sera–Along the lines of Dr. Steingard’s meta-comment on the fact that you really measure up well “in contrast”, the survivor testimonials that you have elicited are really great. I so appreciate the community voices here sticking to the criticisms that almost everyone I’ve ever met are patently blind to or totally silent about. And if silent when you shouldn’t be, blind you are.
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Thanks, again 🙂 I’m also really appreciating what people are sharing here, whether they’re agreeing with or challenging what’s been offered. Great last line, as well!
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Sera — I think you might be carrying the “understanding” thing too far. I have a friend who is obssessed with, sans logic, labeling war criminals like Bush & Cheney “sociopathic” and arguing that we should try to “help” them. But even if one buys such reasoning and ignores the deadly interests these people serve, we first have to protect ourselves from
That said, I have pondered the EF Torrey thing myself. When I did anti-psych organizing in the late 70’s we used “The Death of Psychiatry” as one of our resources when debunking the medical model in front of classes, on the radio, etc. For that matter, I often still use a quote from that book, which is that it’s as impossible to have a sick mind as it is to have a purple idea. And it’s still true.
This shows that Torrey knows the truth and spits on it, as we know that since that book he has become possibly the #1 enemy of our movement and all we hold dear. This to me is opportunism clear & simple. But regardless, our #1 task is to expose him, not feel sorry for him.
Maybe someone could clarify this — wasn’t Torrey at one point all about “orthomolecular” psychiatry (i.e. vitamins) or am I thinking of someone else?
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The end of my 1st paragraph above should end “protect ourselves from <i them.
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Hi oldhead… I focused on Torrey because .. well, there was so much to focus on in terms of contradictory material ‘out there.’
That said, I hope that that focus doesn’t take away from the underlying principle/concept of what i’ve written about here which I do also think is a critical piece.
I also would emphasize that understanding doesn’t mean accepting…
Thank you, though, for reading and responding 🙂
-Sera
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Cool, yeah I didn’t want to divert the discussion & if I have anything pertinent to add later I surely will — it was just that seeing those quotes from the Death of Psychiatry back in my face after all these years started giving me flashbacks & I couldn’t help chiming in on that alone. 🙂 Stay well!
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Sera,
Interesting and ironic tale of Torrey, thank you, and I’m sorry you experienced a traumatic situation. But I truly believe addressing it head on and assessing your feelings honestly, and writing is a wonderful way to do that, is how one works on healing.
Why don’t psychiatric professionals know this? Why do they think stigmatizing people with disorders, majorly tranquilizing people so they can’t rationally work on healing, and declaring people’s real life concerns a “credible fictional story” is beneficial? I think the reason people are angry with the psychiatric community is because in actuality, they really do do everything wrong, they lie, and they’re unrepentant hypocrites.
But I believe your approach to healing is quite logical, and will result in a good long run outcome. And I hope the psychiatric profession will someday gain some insight into how people actually recover, and stop victimizing victims.
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Thanks for reading, Someone Else. ‘Tale of Torrey.’ I like it. 🙂
In any case, I too hope that our culture reaches a massive group epiphany that the way they’re approaching human suffering is off base.
-Sera
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Larmac, is there a way I can write something to you? I have a story that is related indirectly to your experience.
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Sera – Thanks for insightful, honest post. I have witnessed several clinics/facilities react to violent/disturbing events – and most of the time they lock into a hyper-vigilant over-reaction such as installing metal detectors, security guards, barriers between consumers and staff. I think you are bravely doing something that they often do not – transparently discussing the fear, vulnerability and urge to act (Don’t just do something -sit there!) It’s hard for leaders to not try to give people the illusion of safety.
Interesting that in our country, much the same phenomena has played out post 9/11 and in our search for simple (but invariably wrong) answers to complex problems. (such as mass shootings)
Keep up the good work.
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Thanks for reading and posting, Wayne. It’s certainly true that this sort of thing seems to play out in many aspects of our society, as you point out. Just ‘sitting with it’ rather than acting in ultimately unhelpful ways can be really painful, but we’re doing our best!
-Sera
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Sera, this is brilliant! When I first started reading this I thought you were going in the direction of reverse-diagnosis and I was nervous but you totally went the other way–undiagnosing.
This is the most powerful article I’ve read on MIA to date. Yay honesty and vulnerability and humility!
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Thanks, Malaika! This is high praise, given all the great blogs on Mad in America. 😉 Thank you for reading and commenting!
-Sera
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Good article, Sera. I have often wondered myself how Torrey swung from an almost Szaszian viewpoint to his current paradigm. The cynic in me suspects it had much to do with a shitload of funding via the Stanley Institute.
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Thanks for reading and commenting, Francesca. You may be right about Torrey. I don’t know. But, again – Torrey aside – I do think what I describe is very real. 🙂
Sera
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I seem to remember something about Torrey having a relative, maybe a sister, who was diagnosed with “schizophrenia” and had a bad time of it. I could be wrong, but I have some memory of this.
In any case, Sera, I believe you are mostly correct, though there are a few folks near the top who have no such excuse and are just in it for the profit. I think a lot of medical decision-making in all spheres is highly influenced by professional “trauma”, as it were.
The problem, however, is that when the patient is traumatized, s/he is genuinely powerless to stop the system from doing its thing, whereas when the doctor/clinician is traumatized, because of his/her privileged position, s/he has the option of taking it out on his/her client. While the reaction (such as yours) is very understandable, the core of professionalism, in my view, is the ability to differentiate between what I need as a professional and what the client needs from me. It is never appropriate or ethical for me to take action to make myself feel better that might be harmful to the client. I am responsible for taking care of my professional needs by consultation, supervision, training, and just plain gut-wrenching and brutal self-honesty. Which is what you appear to be doing at your facility, rather than reacting by backing away from your mission.
So I can feel compassion for Torrey only as long as he isn’t taking out his fears and sadness and anger regarding his lost relative out on innocent victims who have nothing to do with his personal losses. It’s fine for his experience to drive him toward creating better treatment for those suffering similar conditions, but not to try to capture and forcibly drug anyone who remotely reminds him of his own personal situation, just so that he’ll feel safe and in more control.
And of course, as Francesca points out, he is now profiting from his projection of his bad experience onto others, which raises the unethical needle up to another level. No, I can’t feel bad for him until he comes clean about his personal life affecting what were once much more compassionate views on what genuinely helps people do and feel better.
— Steve
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Steve,
Fair enough. In many ways, I think you’re right. When your ‘trauma reaction’ leads to abuse of others, it can’t suffice as an excuse… and yet, understanding why people react in the way that they do and creating space and support for people to change feels important to me, Torrey aside.
Thank you for reading and commentong!
Sera
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I absolutely agree, as we will be unable to successfully engage professionals if we’re unable to have compassion for their experience, even if we aren’t able to support their methods of dealing with it. Healing begins with compassion!
—- Steve
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“There are so many things in human living that we should regard not as traumatic learning but as incomplete learning, unfinished learning.” –Milton Erickson
So, what remains to be learned? I suppose one resort would be to learn martial arts. Maybe someone working in a setting like yours needs to be prepared for someone suddenly experiencing a trauma thaw out that transports them to another time and place. I think this would be a wise course of action. It is also likely that some education and training would give you the skill to recognize someone with a history of violent behavior. Some people have this ability naturally. I can usually sense when someone is like a strung bow or a cocked pistol. So there now are two positive and constructive things you might do.
Maybe Dr. Torrey had a large mortgage to pay or children to educate and found himself without any clients of course since he had essentially dumped his profession. I doubt the change was due to illumination. He starts out rather idealistically and then runs out of cash. And runs to where the money is. It is hard to figure the cause any other way. Usually people go from a bias to a more enlightened point of view.
Bad memories will manifest as what people call mental illness. Nothing like a congested subconscious to bring on a range of irrational behavior and strange thoughts and emotions. Call it what you will the solution is to deal with the dragons. And it may help to have an experienced dragon hunter and guide along. How many people though would call up someone who listed himself as a dragon hunter or guide? Still it might be a more honest presentation. What do you think?
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Another thing about E. Fuller Torrey, his distant cousin was, of all things, a 19th century abolitionist. Dr. Torrey’s most recent book is about this cousin, Charles Turner Torrey. who led some 400 hundred enslaved people (more than 4xs the number Harriet Tubman is credited with guiding) to freedom along the underground railroad. The book is entitled The Martyrdom of Charles T. Turner. This is the same Dr. Torrey who is so virulently against the abolition of forced psychiatry. I don’t know whether or not trauma is an issue here. I do know that it represents a singular blindness (one might say “lack of insight”) regarding the parallels between their abolitionist movement and our own abolitionist movement on Dr. Torrey’s part. E. Fuller Torrey, a major promoter of the psychiatric plantation system, sings the praises of this cousin who helped to bring about the end of chattel slavery. This is something to think about as we break people out of state hospitals and lead them to freedom beyond the borders of nation and state. Spare us the hypocrisy, E. Fuller, but thanks for the inspirational example provided by your relation. May we think fondly on him every time we glance up at ‘ye ole’ north star’.
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Sera
You and have known each other for more than a few years and we have not always been on the same side of an issue. But I have firmly believed that growth comes from a strong civil debate between two strong people.
In August we will do it again and I can’t wait as I feel, you, perhaps more that anyone pushes me to sincerely revaluate my points of view.
When I heard what happened at the respite my heart broke. We both put a lot of work into that house. I spent three years on the ground hogs and you brought it to life.
I have had an idea of the Gordian knot the incident created for you.
My message, to you, from one old warrior to anotheris simple DON’T CHANGE NOW.
In every life there are great challenges, and in every challenge there are great doses of life to be lived.
Whether you judge a challenge to be a problem or an opportunity says more about you than about the challenge itself.
The way you choose to see the world is the way your world will be.
This is what gives life its magic; it’s a continuous, dynamic phenomenon that becomes exactly what you choose to make it.
So, today in the middle of this muddle you are slogging through I ask you to Do something extraordinary.
Accept life’s opportunities. Realize that if you never step up to a challenge that’s a bit over your head, you’ll never know how tall you truly are.
Rise to each challenge and continue adding value to the ever-growing possibilities that awaits our special Peer brand of unique brilliance.
You are right here, right now, breathing. Enjoy it. You’ve got nothing to do today except to smile.
Happiness is valuing what you have, and enjoying the people, places, objects and events in your life for what they are.
It’s not about changing and achieving all the time, it’s about being and appreciating. And you can nearly always enjoy the things happening around you if you make up your mind firmly that you will.
OK, climbing down off my soap box 😉
Below are what some great folks had to say about challenging times. It should not surprise you that the last one is my favorite 😉
I ask not for a lighter burden, but for broader shoulders. – Jewish Proverb
One who gains strength by overcoming obstacles possesses the only strength which can overcome adversity. – Albert Schweitzer
I learned there are troubles of more than one kind. Some come from ahead, others come from behind. But I’ve bought a big bat. I’m all ready, you see. Now my troubles are going to have trouble with me. – Dr. Seuss
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If I ever lose my tolerance for risk, anyone reading this comment has permission to shoot me in the head.
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