Doctors Need Support

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An old friend suggested to me that doctors need support after hearing the messages in Robert Whitaker’s book, “Anatomy of an Epidemic”. I agree. Doctors need support.

My friend thinks I’m one who can provide it through my writing. “About a hundred doctors are here in Medford, listening to Bob speak,” he wrote to me last weekend.

I imagine the feelings in that room full of doctors. Could they be like mine when I read this book? Could they feel very different from me? Perhaps they feel even more so. Maybe some feel so much more so as to need to slam and lock the door on it all. After all, they have a lot on their plates, big complicated jobs to do. And it’s not like there’s another doctor to step up and see their patients while they work this out for themselves.

Probably I’m not the best person to provide support for the complicated set of thoughts and feelings that can and do emerge inside doctors when they come up against this information. I regularly feel overwhelmed by the thousands of cars I see here in the Bay area, each with one driver, while we wage wars on multiple fronts and the polar ice caps melt to leave the bears to drown.

I’m on a sabattical right now, in part because of my own personal reactions to the fall of my walls of denial with regard to the safety and efficacy of psychiatric medicines. People celebrated when the Berlin wall came down. But then there were difficult and complicated adjustments. I’m more fortunate than most. I had the freedom to walk away for a while, so I’m probably not the best person to provide support to those hard-working folks still in the trenches.

They are likely harder working, better students and more dedicated physicians than I have ever been. I’ve always kept my professional life to part time, allowed space for family and relationships and introspection about the meaning of it all. If I felt bad after reading the unexpected truths in this book, and I did feel very very bad, how must those physicians that are exhausted from long hours and years of the pressured high speed jog of modern medical practice feel? I can only imagine. I can empathize. I can listen. But I can never burrow inside the tunnels of another doctor’s head and know exactly how he feels.

I found this book in the new nonfiction area of my neighborhood library. It was the random pickup of a stranger, not planned at all. I like to read. I had no idea what Robert Whitaker would reveal to me about modern pharmaceutical products, my professional organizations, the FDA drug approval process, medical education or myself as a physician. In all my years of thought and learning I somehow missed big swaths of financial conflicts of interest from the top to the bottom. I was too preoccupied with doing the best I could to help every patient that walked in my door.

The river channel of my focus has been too increasingly crammed with debris and flood waters to grasp the big picture. Five new patients today. New drugs. Doubts as side effects emerge. It seems to me that when drugs finally make it to the affordable four dollar lists they’re found lacking. They all start out so hot and new and marvelous and expensive. Check labs. Measure girth. Document movements. Review risk benefit analysis with the patient. More new medicines to layer over old medicines. Glossy ads in professional journals. Type this report. Sign this. Fill out that. Insurance company “care managers” questioning, ordaining, disallowing. This patient read about it on the internet. That patient on TV sounds just like me, Doctor Keys. It’s what my mother takes. If you don’t give it to me I’ll go somewhere else and get it. Another patient and another patient and another patient. Double booking. Triple booking. The meds, the meds, always the meds. Refills all day long.

The patient sits there. This endless stream of my fellow humans sits there. Another and another, each with his own personal sufferings, his own story to tell me. Each wants to be heard. Each one wants to feel happy and suffer less. And I want that for him as well. Underneath all the noise of modern medical practice, I love my patients. I care. I want the best for them.

I thought I was helping when I passed out the medicines. I really did. Now I’m not so certain. The “research” I relied upon has a few flaws. Maybe the meds don’t work as well as we thought or they don’t work in the ways we were told. And the risks. Maybe those are bigger, more long lasting than we initially were taught. After all, drug research is short term and done with small, hand-selected populations. And, oh yes, the one who pays for the research decides how to play the results. Good. Great. Not really.

I used to think of myself as one that could cut through the crap of the advertising conglomerate and find the truth. I muted advertisements on television even before I turned off broadcast media in our home ten years ago. I won’t even listen to public radio. I gave it up. I thought I was one of the last clear thinkers left in our media-seduced, materialistic nation. I was so cool, not a little grandiose. But this is part of the ad campaigns, the thought that I am more immune than the next guy to the brainwashing effects of pervasive marketing strategies, that I can still make good choices.

When I got the bigger picture, after I read Robert Whitaker’s book, my professional world view imploded. With it went my personal image of me as a clear thinker, a careful skeptic and a helping professional. This sucks. Big time.

It turns out I have been a dupe, parroting lines from pharmaceutical marketing literature. “Seritonergic discontinuation syndrome”, “chemical imbalance”, “safety” and “efficacy”. I’ve been so busy studying the fine print in the drug bible, memorizing dosing schedules and side-effect profiles that I missed the big picture of the money and control chains that are so nicely elucidated in Mr. Whitaker’s book; drug dollars that fund drug approval at the FDA level, drug dollars that fund “medical education”, drug dollars that fund professional lobby organizations, drug dollars that fund and control “medical research” and the drug dollars that fund “patient support networks”. This is way beyond coffee mugs and pens.

I was so busy fighting for my patients’ “rights” to have the drugs that I missed the gradual death of all non-pharmacologic treatment approaches. I didn’t miss the dissolution of the doctor-patient relationship. I watched it go down the drain. I had been made powerless to stop it in this brave new world where all patient care comes at the bidding of third parties with stock dividends and tax payers to mind.

I am so not the right person to offer support to my disenchanted colleagues in the medical profession. I am certain all of us came to this party for better reasons than those that keep us here today. And I have slipped away, at least for a while, to ponder what the heck this means to me as a doctor, as a mother, as an American citizen.

I honestly have no idea what to do next.

***

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.

71 COMMENTS

  1. Thank you for this! I believe there are a number of psychiatrists in your position trying to figure out what to do next.

    My belief is, given all the pressures to prescribe drugs as psychiatric treatment, doctors who don’t want to do this need a seat at the table so their interests will be represented in public policy and treatment guidelines.

    They need a professional organization, the Union of Concerned Psychiatrists, maybe, to express their points of view.

  2. Your post could not have come at a more timely time for this website. We need the voices of those who are struggling with these issues, at all phases of the struggle. This post helps to frame that beautifully and, hopefully, provide a window through which people from various perspectives might see each other better. Thanks for this.

    • I truly believe that what all of us want is the opportunity to heal.

      For the past seven years, I have taken some shots at psychiatry – my tone has been harsh.

      But I think its fair to say, that even the most anti-psychiatry types, myself included (although I prefer to think of myself as pro-freedom, pro-wellness, pro-recovery) are longing to forgive one-another, to reconcile.

      Many of us have grown tired of the battle, and want to find some peace. Not by surrendering our concerns, but by coming together to build a system with a sold foundation of treatment options that offer hope.

      For the first time in years, I’m begining to feel that this may in fact be possible… To come-together, to forgive, to reconcile, and move beyond… toward a better paradigm, so we can live in a better world.

      Thank you again for your honesty!

      Duane

  3. The more difficult one’s life is, the higher the likelihood depression will result. The more one connects with the catastrophes of the world, the higher the likelihood depression will result. Narcissism also leads to depressions. It is the choice of the individual whether or not they will use antidepressants or street drugs. THE DOCTOR’S ROLE SHOULD BE TO FULLY EVALUATE THE PATIENT,INFORM THE PATIENT OF ALTERNATIVE TREATMENTS AND THEIR ADVERSE EFFECTS AND LET THE PATIENT MAKE THE DECISION. BUT THAT MEANS THE DOCTOR MUST ALSO BE FULLY INFORMED AND THAT MEANS GOING OUTSIDE OF THE BOX TO EDUCATE THEMSELVES. I tried two antidepressants on the advice of a pain specialist and then a medical doctor in a psychiatric ward. I only took them for less than two weeks. I felt they were not good for me. I also tried eating marijuana as a method to control physical pain, and I rejected it as a pain killer, although the high was very pleasant. I’ve avoided psychotropics my entire life. The only “mental health” problem I have is depression, and I live with it. There have been long periods of my life when I haven’t had depression and have been very happy. But I’ve also had very long periods of depression and have often felt suicidal, but have never attempted suicide.

    • Thanks for sharing your personal experiences. I agree with your description of a doctor’s role. You summed it up well. The physician/patient relationship must be a cooperative one to be of benefit. Learning, teaching and informing are central to the role of the physician. And, yes, you have to be the one to decide what to put in your body or not. Thanks for taking the time to comment.

  4. Its heart warming to think that the medical profession is open to questioning business as usual, and assumptions about what “we initially were taught.”

    “I honestly have no idea what to do next.”

    SUGGESTION: Listen to the long term survivors who discover the wisdom of the lived experience, and have found their own way “off” all psychiatric medications. Those people who get their education the hard way and come to know real truths, not quick and easy assumptions.

    “I can listen. But I can never burrow inside the tunnels of another doctor’s head and know exactly how he feels.”

    You could try giving up a little of “I think therefore I am,” assumptions about the head & feelings? Perhaps you might like to check out the future of mental health & Stephen Porges Polyvagal Theory?

    Giving up my over-cognitive sense of self has helped me stay both medication & depression free for the past five years, after 27 years of classic manic depression.

    Reading both Porges, and Peter Levine I’ve come to feel how my altered mind states are dependent on physiological state and how to manage myself through an expanded self-awareness.

    The theory provides insights into symptoms observed in several behavioral, psychiatric, and physical disorders. Professor Porges has published approximately 200 peer-reviewed articles and has authored “The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation” (Norton, 2011).

    The Polyvagal Theory and the Face-Heart Connection: Neural mechanisms mediating social behavior and health. Friday, 14th September 2012. https://www.eabpcongress2012.co.uk/programme/programme-overview/104-the-polyvagal-theory.html#

    • I’m glad to have warmed a heart. Thanks for your suggestions and the link. Also thanks for sharing your personal recovery story. I agree that doctors can learn a lot from listening to the experiences of individuals. I am happy to hear of your successes.

  5. Dr. Keys,

    As a mental health advocate the two areas that I concentrate on are:

    1. Advancing Best Practice Assessment of Psychosis and Mania

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    2. Cultivating a Participatory Model of Mental Health Care

    http://participatoryconcepts.wordpress.com/

    To support my advocacy I volunteer and am a member of the International Society for Ethical Psychology and Psychiatry (ISEPP).

    The ISEPP annual conferences provide a wealth of information and support to both mental health professionals and consumers.

    Alternatives to Biological Psychiatry is the focus of this year’s conference.

    http://isepp.wordpress.com/2012/04/12/alternatives-to-biological-psychiatry-treatments-that-work-conference-updates/

    Both ISEPP and the Society for Participatory Medicine are organizations that can offer support and resources to your disenchanted colleagues.

    Discovering a new direction is not easy. I believe Dr. Moffic has it right that the hope for the future is in integrating the best of the past in new ways, and it will be up to psychiatrists to lead the way.

    • Maria,

      I hope the next post from Dr. Moffic is one that shows his support for real reform. I think that if this is the case, and he is able to express his concerns about the status quo, there will likely be a much more favorable response from readers.

      After having taken part in the heated comments, I have since felt like I personally should have been more open to listening to what he had to say, in hopes that there might be some room from healing.

      Also, after reading his bio, he seems proud of his two children, one of whom is a Rabbi. And as a fellow parent, I think this says a lot about him as a dad. So, I await his next post, with hope that some good may come from it, and help those of us who have children who were injured by conventional treatment to understand and forgive, if what he has to say expresses a desire for real reform. I hope so.

      Duane

  6. What to do next: Listen to the voices of those who’ve been harmed. Examine the worldview you’ve been trained to believe in. Use your medical training to assess for possible physiological causes of distress. Read the literature of the anti-psychiatry movement that began with R.D. Laing, Loren Mosher, Gregory Bateson, humanistic psychology, and the patient’s rights movement and continues in the research of Paula Caplan and Robert Whitaker and the practise of caring psychotherapists who abjure diagnoses and medication. Praise yourself for being self-critical and open to alternative ideas. Remember the words of Albert Einstein: “The theory creates what we observe.” Remember the words of Martin Buber when you’re with your patients: “All genuine meeting is healing.”

  7. Seems like the shoe is now on the other foot. I understood the bogus disease model of the illness well before Robert Whitaker’s book came out, but finding a medical professional to turn to for support was like finding a needle in a haystack. So, I urge you to listen to the patient, listen to the families and support and encourage them in their desire to manage their own lives as drug free as possible. This may well mean you will need to look for work in another area of medicine or retrain as a psychotherapist.

    • I’m old school. My training in psychiatry was primarily in psychotherapy; cognitive-behavioral, hypnoptherapy,group therapy, supportive therapy, psychodynamic therapy, gestalt therapy,couples and family therapy. My private practice focus (closed in 2003) was always therapy first. I declined the 9 out of 10 callers that wanted only pills. All this psychopharmacology has overgrown psychiatry in the past 20 years. Being a “prescriber” is all anyone has asked me to be for the past decade. The entire field of medicine has gone down the same pill path. Maybe I’ll drive a cab? 😉

      Thanks for your suggestions and thoughtful post.

  8. What can a psychiatrist who now realizes the harm of psychiatric drugs do next? Help people who want to safely detox from these drugs! There are thousands of people who are desperate for an MD who will help them, and it’s almost impossible in most parts of the country to find a psychiatrist willing to do this. This would be the best possible use of your medical license and your experience!

    • One of the rules in the NICE guidlines in Britain is to take the patients “full history” but not many psychiatrsts in Britain follow that guidline and that is why usually things go wrong. They look at the symptoms but don’t bother to listen to “what brought it all on”. Junior psychiatrists are better at listening and nursing staff too but they are usually over-ruled by the consultants who think their role is to medicate.Now “Medicate them!” is another NICE guidline. If you don’t and something goes wrong, you might find yourself in deep trouble. So the consultant medicates as told by the NICE guidlines, just to be sure. Although psychiatrists are medical doctors, they are remarcably ignorent of the fact that psychosis can be brought on by fever, infection, sleep deprivation and by withdrawal from antipsychotic medication. Why is this? They don’t know how the meds they prescribe work and how to get people safely off them. They say that antipsychotics work on dopamine, what they dont say or don’t know is that they work also on adrenaline, histamines and serotonin and that all these things need to be taken in consideration. Stopping dopamine, serotonin, adrenaline and histamines from working normaly is bound to have a chain reaction in your body and will disrupt anybody’s endocrine system. The doctors blame the patients for their bad health. They should start by looking at what their medications do to a person’s physical health. Disrupting adrenaline and histamines has an effect on your metabolism as well as sleep, disrupting dopamine and seotonin is bound to have an effect on sexual functions and fertlity etc.

    • What a great idea.

      I have done some of this over the years. Before doctors had any information about seritonergic discontinuation symptoms from antidepressants, patients were told the symptoms couldn’t be from stopping the medicines. I could only say “I’ve been told it’s not supposed to happen, but I believe you.” Then I had to proceed in a mutual trusting partnership with the patient.This all takes time.

      It’s a good idea but not easy. We don’t known what to expect when withdrawing medicines. All is not known about the effects from coming off medicines, the effects of coming off the complex polypharmacy commonly about today. Then there is the part that every individual is exactly that, unlike any other person on the planet both from biologic, lifestyle and experience perspectives.

      There have been times when tapering off was relatively smooth and times it went…not so well.

      Thanks for your post.

  9. Thank you for this post. When you say you have “no idea what to do next,” I hope you realize that writing this article is an excellent first step.

    Your last few paragraphs illustrate plainly how psychiatry has devolved into its current state. It’s almost as if we’ve been distracted (by the free CME, the glossy ads, the corrupt journal articles, and yes, the mugs and pens) while “drug money” and those tainted by it have, out of our conscious awareness, determined the direction of our field.

    However, with all due respect, it’s one thing to be “duped,” it’s another thing to *allow* oneself to be duped. In my opinion, psychiatrists cannot claim ignorance to what has been happening over the last 10-15 years. Yes, Robert’s books have been a wake-up call, but our patients’ own experiences (not to mention their reports of adverse effects) should also have alerted us to the fact that our interventions are little more than high-risk hand-waving. I can’t speak for you, but I have little sympathy for the psychiatrists (and others who prescribe psychotropic medication) who have bought into the psychopharmacological pseudoscience and who are now wondering where they go from here.

  10. One thing that all doctors, not just psychiatrists, can do to change things is to begin listening once again to your patients. Patients, from the very beginnings of the use of psychiatric drugs, were telling doctors about how horrible the side effects were from using these toxic drugs. I suspect that some doctors listened but not nearly enough did so. For some reason, psychiatric patients tend to not be listened to and I think this tells some very interesting things about how we are perceived by many of those who say that they want to help us. forming a human connection is where healing begins and this can only be done by listening to the person you are treating. I’m sure that most of you who are doctors know this already, but the first doctors were originally priests. The job of any priest, regardless of what religion or belief system or time period, is to listen to the person they are ministering to. You seem to understand this intuitively and from the sound of it this is the way you deal with your patients. If you strive to walk with your patients on their Journeys, and minister to their spirits as much as to their bodies, then healing will be facilitated. Is this easy? Absolutely not. This is why so many doctors look to the meds to do their ministering for them.

    • You’re right. Listening to all patients is an essential part of the doctor/patient relationship. You’re also right. There’s not enough of it going on.

      Bear with me for what may sound like doctor whining. Part of the listening issue (not all) is the time contraints all doctors are put under. Most doctors now work for medical corporations and are bound to productivity schedules.

      Even in 1990, in community mental health settings, I was given 15 minutes, sometimes 20, for a follow up appointment. This included all time allowed to review a record and to make chart notes.

      Those were the “good old days”. Back then, I could flip through a chart and write while I talked. I had someone to find the chart, a casemanager/therapist in the room who was up on things, a nurse to help sort out prescriptions and medical information and a consistent caseload so I could get to know people better over time. I got a 30 minute lunch break. An eight hour day was eight hours long.

      Now there is an electronic medical record. I can’t look at you and listen as I type. The record is slow to page through. Building a prescription takes time. No casemanager (therapist). No nursing support. No team. The time allowed per patient is 15-30 minutes when not subjected to overbooking. Lunch is gone. As eight hour day is nine hours long. There is still little time to talk and listen.

      I wish things were better. That’s why we’re all here, posting and listening to one another. There’s got to be a better way. Together we can find it.

  11. It’s great to see psychiatrists talking with psychiatrists in this forum, which is in itself a good argument for keeping it safe for them. The dictum that everyone is more human than otherwise, if I remember it accurately, applies to all of us; psychiatrists included. I have seen beautifully intentioned people go into the training and come out brutalized at the other end of it and, in my opinion, forgetting some of what originally inspired them.

    Along with being human comes the shock of trying to make one’s way in a world that is confused with lots of information – some if it good, some of it not so much.

  12. I don’t think most psychiatrists have the life experience to truly be helpful to the people they purport to serve. Chances are, if anyone gets far enough in life to become a doctor, they have a basic belief in themselves, experience satisfying relationships as simple a given, and are in a good headspace. No wonder they’re so ready to believe that someone who doesn’t have these things simply has a brain defect – because they probably take for granted that feeling good is a given, and feeling bad means something is broken.

    That is in stark contrast to the people they serve, who have often lost themselves, feel overwhelmed, and are suffering from the results of various traumas that deeply impacted their sense of self-worth and self-efficacy. None of these issues are remotely medical, and there is no reason why someone with an MD and no related life experience would be any good at helping someone through those tough times.

    It’s time we recognized and started fighting the mystique around psychiatrists. Just because society has appointed them the managers of people labeled “mentally ill” doesn’t mean they’re necessarily the right person for the job. In fact, they’ve often hurt and traumatized the very people they purport to help.

    People have to earn their privilege to help others, in my opinion, and if you’ve made a career of coercing people and viewing them as defective machines, you’re going to have to do a hell of a lot to make up for all of that — if it’s even possible, which in many ways I doubt.

    I appreciate that the writer of this blog _is_ willing to honestly admit how shaken she is by what she’s learned, but I don’t think psychiatrists, of all people, are the ones who actually need support. If they want to be useful, they can be the MD who writes increasingly smaller prescriptions for people weaning off drugs. But there is simply no role for someone who studied the medical specialty of psychiatry to actually help people. Nothing in that specialty qualities them, and much of it disqualifies them.

    It’s similar in any profession. Would you rehire a daycare worker who molested children? Would you take a businessman who embezzled, and put him back in charge of the company? Both of those people violated other people’s trust. It’s the same in psychiatry, except that the “standard of care” itself violates trust and hurts people.

    Terry Lynch has some interesting thoughts about how doctors fail to empathize with patients in emotional distress, because of their privileged background. Check him out on YouTube:

    http://www.youtube.com/watch?v=xohjamv-p4w

    • To SA,

      Thanks for taking the time to both read my blog and to compose a response. I have to admit that being personally equated with a child molester and an embezzler by a stranger simply on the basis of becoming a physician seems a stretch. I can only surmise that you have had some bad experiences and reasons to have lost trust. I’m sorry if you have. Best.

    • I’m not so sure that people “need a basic belief in themselves, experience satisfying relationships” in order to get “far enough in life to become a doctor”, and certainly not to become a psychiatrist. I don’t think people choose their career path at random. Among the people I know personally, who chose to train and work in the field of psychiatry, psychology, and other helping professions, many actually had/have a remarkably low self-esteem, and their life was/is characterised by rather unsatisfying relationships. In other words, they are people who’ve experienced more or less significant trauma, they too. They chose a helping profession because it can make someone who feels quite bad about themselves feel better to associate with people whom they can define as feeling just as bad or, and preferably, even worse than they themselves, especially when they can take on the role of these people’s helper, thus creating the illusion that they know how to deal with whatever the hardship. It’s a bit like if only you can get enough theoretical knowledge about emotional distress, it will work almost like a shield against this distress for you. And also, if you then can use this theoretical knowledge in practise, and project your own misery onto others, you don’t have to face it in yourself: “I am the professional, YOU are the patient” (like in: “Me Tarzan, you Jane”), us and them.

      Unfortunately, if this is the — unconscious — motivation for choosing a career as a helper, you won’t really be able to help anyone. Not because you haven’t been there and done it, but because you’re not aware that you actually are there and doing it, and because you need to deny the possibility of you yourself being there and doing it. You will actually — unconsciously — seek to keep those you think you’re helping in the role of the miserable, dependent patient. Which in itself is extremely unsatisfying, and often leads to burn-out and “depression” (the German analyst Wolfgang Schmidbauer called this “the helper syndrome”). It’s a catch 22. If you really help someone, and they become better, you’re painfully made aware of your own misery. If you don’t help them, you’re a failure as a helper. Psychiatry has solved this problem by re-defining emotional distress as life-long misery that can’t be cured, and at best managed.

      I’ve closely observed staff at psych wards. Watching the behavior alone, one wouldn’t be able to tell the difference between staff and “patients”. Like watching a group of kids playing cowboys and Indians. The helplessness and despair is equally pronounced on both sides. Everybody is acting equally “mad”. It’s just that one group has keys and powerful drugs, which makes up for their lack of inner, personal strength, so they usually win.

      Everybody who feels an urge to become a helper should spend some quality time meditating about the true motive behind this urge. And everybody wo comes to the insight that their true motive is their fear of having to face their own misery, they ought to get some real help. Then maybe we would have a few more true helpers in the helping professions.

  13. Thank you to Dr Keys – Alice – for your honesty about the current position in psychiatry and the power of the drug companies.

    ‘I honestly have no idea what to do next.’

    I have skimmed through all the helpful posts – a mixture.
    I have read and met at conference Bob Whittaker.
    Brilliant expose of the situation and the power of the drug companies and the problems with meds as the only form of treatment.
    I take meds myself – bipolar diagnosis – but human being first and foremost.
    I believe in recovery without meds.
    I have learned various self help techniques and I have also availed myself of a useful 6 week 1 hour long session series with a psychologist on CBT.
    I have read a lot and I blog a lot and have ‘spoken’ on line and in person with various people in the mental health field.
    I speak to my GP who still believes in meds but who is listening to what I say, and I loaned her my book by psychiatrist Dr bob Johnson. Have you heard of him Alice?
    I have met him and been to conferences where he speaks and helps.
    He has two books I know – one about ‘Emotional Health’ and the other about drugs and how they are not the answer and in fact ‘do more harm than good’ I think is his quote.
    Dr Bob Johnson is based in London and he advocates a simple ‘Emotional Health’ model which as I understand it works well.

    I am no longer the child who was stuck/frozen in time emotionally when I was (whatever happened to me then), but now I am an independent adult etc and so the parentoid figure (usually the one responsible, for not protecting, if not the abuser), cannot hurt me anymore. I am therefore free and able to lead my own life.
    As simply as I understand this model, it does work and has been used effectively. To learn more google Dr Bob Johnson psychiatrist who is based in London and has hiw own website.

    My own GP listens to what I have to say about meds, and she listens to me, and she prescribes me reduced meds and supports me in gradually reducing. I told her the story about a stupid psychiatrist who once took me abruptly – just like that – off Effexor (venlafaxine – and the anxiety/suicidal feelings/worthlessness was awful to deal with. Silly psychiatrist, as it is well documented about how you need to taper off the Effexor gradually.

    I think Dr Bob Johnson’s website is Trust, Consent and is a foundation.

    Alice – please reply. Anne Brocklesby

    • You are fortunate to have developed an ongoing relationship with treatment providers who listen and are open to new information.I remember when antidepressants “had no withdrawel symptoms” according to all the available information. The marketing literature has been careful to not use the word “withdrawel”.

      You are also fortunate to have access to medical care. Many do not. In my work in emergency psychiatry, I have seen patients walk in the door shaking, crying and sweating from running out of antidepressants abruptly. Most of the time this was because they had run out of employment, out of insurance, out of money, out of access. This ‘lack of access to medical care’ is a whole other rant I should not get started on here.

      Thank you for your thoughtful and informative post.

      All the best.

    • Anne,

      Thank you for the information on Dr. Bob Johnson.
      I was able to find his website, and will spend time on it. For others, this is the link –

      http://www.truthtrustconsent.com/

      Dr. Johnson appears to want informed consent for ECT. This is something my friend, John Breeding of Austin, Texas has pushed for. Due to his tireless fight, Texas has some of the strictest ECT consent laws in the United States –

      http://www.wildestcolts.com/psych_opp/d-electroshock/3-shock_ny2.html

      These are the kind of reforms that are needed for REAL transformation. And they are the kinds of reforms many of are not only calling for, but demanding.

      My best,

      Duane Sherry, M.S.
      discoverandrecover.wordpress.com

  14. Dr. Keys,
    Just this post and all your doubts are support for others!! We are supposed to be sure of everything all the time – and we know that’s a lie. I have a dream for what next steps to take – how about organizing all of the hospital staff, most of whom are doing their best in a broken system, to make a joint statement about the impossibility of helping anyone in the hospital with medications only? I add the ‘only’ just to be generous, as I personally believe we do great harm with the medications. I visualize practitioners who join with the “patients” and the “don-to” people and demand change – a system that cares for people in distress instead of restraining, punishing, and truly torturing them by calling them “needy and violent attention seekers.” How about Compassion Hospitals – an entire neighborhood that takes people into their homes and attends to their wounds? I don’t know, but I think that the practitioners need to stand up and say, “We won’t do this to people anymore.”

    • Lowry,

      Thanks for your support.

      I agree that unification is the key to finding a path to change. Change has been in order for a long time. I am also acutely aware that no one individual and no one sub-group has the power alone for change of this magnitude. I and others I have know have been making efforts for years.

      One important thing is to have a forum in which to gather all these thoughts and energies. My thanks to Bob Whitaker for making this possible for us all. Another critical thing is to find a direction to point in. If two people in one boat paddle vigorously in opposite directions, they only exhaust themselves without making progress. However much things have historically been divided into “us” and “them”, “me” and “you”, we are truly all in this together.

      Thank you for your contributions to this discussion.

      Alice

  15. Since my son’s SSRI-induced suicide, I am increasingly frustrated at the position of medical professionals. Generally they tell me at length how they personally have turned away from the use of psychiatric drugs to treat emotional distress and are very concerned about the pathologising of normal distress and over prescribing. Great. They then tell me however that they cannot speak out publicly about these issues, or align themselves with the critical psychiatry movement because it would harm their careers. Doctors may need support but in my view their most critical need is courage. I worry that no obvious successor to Prof Healy is on the Horizon, I am angry that doctors will privately support mothers like me who constantly put themselves in the firing line but fail to back us publicly and I’m distraught that while doctors endlessly discuss their feelings about the evidence their practice is harmful, children like mine die needlessly because the dominant discourse goes unchallenged. I’m not unsympathetic to the plight of those who find their world view turned upside down by new evidence – when your child dies as a result of the drugs the doctor you trusted prescribed, you know all about how devastating it can be to find the world is not the place you thought it was. I am however totally unsympathetic to failing to have the courage to stand up and say “we were wrong and this is how things need to change.” In my view, this is the answer to the question “what next?”

  16. The doctors who put your son on the medication should be the ones saying sorry. I bet they never did. The psychiatrist who put my son on olanzapine and faled to spot the NMS he developed from it and nearly killed him, never said sorry. She put on his discharge form from hospital that he had suffered “hot and cold flushes” instead, thus misleading her collegues who took over from her in the community and who in turn failed to believe what we were telling them. My son tried then to kill himself because of the side effects of that drug. The next lot of psychiatrists didn’t say sorry either but started covering up and protecting their own backs.

  17. You would be a true gem and an asset in the psychiatric or rather, the mental healthcare community. Perhaps you could travel, offer workshops and teach the “disenchanted” psychiatrists. This is an opportunity for them to challenge their brains and all they thought was true.

    A most inspiring article! Thank you.