Do I Have Too Many Questions This Morning?

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What if it were the sun that could cure you; would you have the courage to go and find it? Would you wear sunscreen?

If it were the schools themselves that made your child unhappy and restless; would you take him home with you and keep him there? Would you be too afraid? What if he cried to go back to school? Would you let him?

What if the work that buys the bread for your table and keeps the roof over your head were killing you day by day, blackening your lungs or heart or soul; would you have to courage to walk away?

How about if the pills you swallow each morning to cope with the pain of existence were trimming away two days from your life for every one they blur for you today; would you reconsider? What could you do instead?

What if that quiet voice you almost hear whispering deep inside your chest really is the voice of God? Could you listen? Would you still believe the translations of middlemen?

What if the car you drive every day poisons the planet you depend upon for existence? Would it still be worth the convenience? Could there be other ways to live?

What if the dream of private home ownership and the long and winding roads between us and our neighbors were the cause of car dependency? Where would you live? How could you live? Is change possible?

What if the words “settlers” and “pioneers” meant “invaders” and “killers”? What if westward expansion were accomplished through a hundred years of planned  and intentional genocide? What if the Jamestown colonists were corporate shills forbidden to speak the truth? What if peaceful nations lived for thousands of years on this continent before Europeans sent their invading forces? What if we are both the offspring of these invaders and the children of those who escaped the killings? What if our blood is inseparably mixed?

What if the fuel you burn to drive your car to your American dream house underlies the cause of wars we wage half a planet away? Could you park it for one day a week in protest? Could you park it for two days a week? Could you give up your American dream house for a small apartment even when there’s a drummer that practices across the alley from your bedroom window late into the evening? Could your family manage with only one bathroom and no storage? Would you buy less stuff?

If the foods you buy for yourself and your family are made from chemicals and  poisons, are they worth the convenience? How hungry are you? How much hunger can you tolerate? Can you learn to cook one dish at home or grow lettuce in a pot or walk to the market?

 If, for your clean and polite cubical work that butters your bread and pays your house payment, you design electronic guidance systems for weapons used in the killing fields, what can you do? If you refuse to do the work, what will you eat? How will you make a home for your children?

What if your children tell you they’d rather be homeless than have you carve triggers in a factory all day?

What could your children know about the hard realities of homelessness? What could your children understand about work and bills and taxes and jobs and grindstones and noses? What do your children know about wars and killing the children of strangers?

Does it make sense to drive to a gym to walk on a treadmill?

Have you thought of making do with less, or smaller, or older?

Did you use it completely up?

Have you considered using it till it’s worn completely out?

Can you make it do?

What about doing without?

Why wait for weather reports filtered through anonymous others? Could there be better ways to tell which way the wind blows?

Can any other person know you better than you know yourself? How could they convince you that they do?

Could a paid professional understand your baby better than you? Were they up in the middle of the night rocking and walking and nursing?

Who will have your own best interests at heart if you do not? Can you?

How much fear is reasonable? What if things are scary? Should you be afraid?

How much anger do you want to carry around in your sack all day every day? Is there another way to manage it all?

Are there ways to make changes without fighting?

Who else could know the answers?

Is it possible to work together?

Is it the same sun that shines here and there and way over there, half a planet away?

What do their children know of hunger and homelessness and war and killing?

How much love can you feel in your heart? Is there room for that much? Where would all that extra love go?

Is it possible to love a person who has done things you disagree with? Can you love a person who’s filled with anger? What if she’s covered in scabs? What if he’s still learning, doesn’t have all the answers or struggles to find new ways to do old things?

What if he’s done things you find morally reprehensible?

Would you like to pull the trigger, push the button or tighten the noose? Can anger and killing ever be righteous?

What if you were wrong? How would you feel then?

Is it possible to change yourself even when others cannot, will not, may not change?

Is it possible to understand that others may have shifted their paradigms years ahead of you? Do you think they should have tolerated your lack of understanding, shortage of courage, or limited knowledge base? Did you even realize there was a paradigm to shift? Why not?

Have you discovered yet that all things are not known?

Is forgiveness possible? Can we forgive another? How about ourselves? Can we forgive and forgive and forgive again?

How much uncertainty can you tolerate?

 

As always, thanks for reading, thinking and writing.

Alice

 

 

 

 

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

74 COMMENTS

  1. What if you were being paid more for spending 15 minutes with a guy than he has to live on all week. Would you split the difference with him?

    What if your profession was ruining people’s lives? Would you believe you were different so it so it wasn’t your responsibility?

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    • “But I came home at the end of each day with a smile. It was fun to work on the locked psychiatric unit. I loved my patients.”

      I was really stunned to read that in your profile. I was really glad to read on another of your blogs that you aren’t currently practicing. I respectfully suggest that you continue on that path. And seek spiritual guidance. (I wouldn’t suggest psychiatric help to anyone). If you had fun on a locked Charity ward and came home with a smile on your face and believe you loved your patients I think it is likely that you are not capable of helping anyone. I hope you were not under the impression that your patients loved you back.

      I am glad you are seeking to find some meaning in your life. Just as a fellow human being I would advise you to move on and seek to make amends for the damage you did in some other field. You seem sad and defensive and I wish you the best. I hope this doesn’t seem like an attack to you I don’t meant it that way. Keep thinking and open your heart!

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      • Dr. D Lightful,

        I’m pretty good at being happy. I’m also pretty good at loving people. I even love folks that have less than glowing feelings about me. These have always been two of my specialities. I suppose one could do both of these (be happy and love people) just about anywhere and in any situation.

        I also don’t believe that being “loved back” figured into my motives back then. I was there because I believed I could help people. That’s why I went into medicine. That’s why I became a psychiatrist. That’s why I worked in the field of psychiatry for years.

        I love it when folks are “stunned” by my profile. There has been a bit of that going round. There may be other surprises in store for you. All psychiatrist are not cut from the same cookie cutter. There is a range of individuality in psychiatry that you could find in any field.

        All of us have to seek meaning in our lives. It’s a good lifelong practice. Spiritual guidance has always been a big part of that search for me. I hope spiritual guidance part for you as well on your own personal search for meaning.

        Thanks for taking the time to go back and read my other posts. It’s an ongoing story.

        Thanks for reading, thinking and writing.
        Best,
        Alice

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        • I know what it means to be happy in the lock down ward. Like St. Francis helping the poor and the lepers. It is a great joy serving those who no one else wants to serve and finding out that they are awesome people, much more so than the Ken and Barbie world. Keep up the Good work Alice! Peace, Tricia+

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    • Dr D Lightfull,
      Thanks for adding your own questions to the list. I could have gone on. It ws one of those mornings when every question I could think of to write about presented more questions. I try to keep things to a thousand words.

      I wasn’t sure…are your questions for me personally?

      Thanks for reading, thinking and writing.
      Alice

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      • Yes they were for you. At the time you were enjoying your work at Charity it was one of the most abusive big city hospitals in the country. If there were a truth and reconciliation program for the psychiatrists who abused these poor and powerless people at Charity would you apply for amnesty? Do you think you deserve it?

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          • You’re welcome. You didn’t answer my questions.

            “Yes they were for you. At the time you were enjoying your work at Charity it was one of the most abusive big city hospitals in the country. If there were a truth and reconciliation program for the psychiatrists who abused these poor and powerless people at Charity would you apply for amnesty? Do you think you deserve it?”

            I’m not pressuring you. I thought you might not have read the whole thread and missed them.

            Thanks
            Dr D Lightfull

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          • Dr D,
            I am certain that others will disagree with my answer on the grounds that I was a psychiatry resident and worked there. I also worked there as a neurology resident and as a medicine resident in addition to a psychiatry resident. The years were around 1981-84.

            Charity was a difficult setting for all patients. Dusty wind blew in the halls. People were assualted in the stairwells. Patients were cared for in open wards with curtains betweeen the beds. All the patients we cared for had no alternatives for care. People remained in lines to be seen in the “emergency department” for days at times. I worked long hours and through the night to provide the best care I could given the resources available at the time. Everyone I knew there did the same. There were months at a time that we lacked basic equipment to work with (ex. 10cc syringes). Nursing coverage was so short I had to stay up at night to change IV bags so the lines wouldn’t clot off and to pass vital medicines to the critically ill.

            It was a rough time. It was the only care available to those with none. Because of this, people were very,very ill by the time they came in.

            Is there a reason for your interest in the history of Charity Hospital? Have your had personal experiences there as well?

            All the best.
            Alice

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  2. That is a lot of questions!I think that asking myself similar questions about the world and the society I was living in at the age of 17/18, is exactly what drove me up the pole and made me rebel and led me to my break-down. If there is no help available some youngsters start smoking pot or just misbehaving. I think each of us has to find answers for ourselves and life is all about balance, about give and take We will never get everything right. Being able to forgive others as well as oneself is a great help. Also things go round in circles and God works in mysterious ways.

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    • Alix,
      This was one of those questioning days for me.

      You’re right: “each of us has to find answers for ourselves and life is all about balance”.

      Everyone has to find which of the questions are the most compelling to pursue. I like asking the same questions over time and seeing how the answers change.

      Thanks for reading, thinking and writing.
      Best,
      Alice

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  3. A question is a quest.

    “If you don’t ask the right questions, every answer feels wrong” ~ ani difranco, lyrics

    What is the correct answer? The correct answer is the correct question.

    Do you have too many questions? I don’t think so, but I’m wondering if you truly want “real” answers to any of them.

    I like this one: “Have you discovered yet that all things are not known?”. I think all things are knowable and many things are known. What matters most is Understanding.

    The question then becomes, “are all things understood?” and I would *think* the answer is NO.

    Understanding is the Highest Form. One can know something, but not understand it. When you understand something, you cannot not know what you understand. Understanding is the Highest Form – it cannot be surpassed.

    lack of understanding = chaos, confusion, strife

    Understanding = PEACE

    If the people of the world know how to achieve “peace” and “understanding”, will they choose it or not?

    The movie “The Hunger Games” had been equated to “educational” and was studied in American classrooms, while a documentary called “Bully” was fought for and went largely unknown by the masses.

    Advertisement for The Hunger Games was inescapable. People’s choice was made FOR them, without their knowledge that such was even occurring. *IF* “Bully” had been equal in advertisement and promotion, people truly would have had a choice. But they didn’t.

    The Hunger Games was rated PG-13, while the movie association wanted to give Bully an R rating. There was a petition to have the rating for Bully changed to PG-13. It’s more than money motives at work in an example like this.

    Is bullying, certainly an “epidemic”, simply part of basic “normal” human behavior and we can then understand (know full well) that we’ll never fully prevent bullying from happening? How many people would say they were “bullied”, silently, into accepting “The Hunger Games”?

    There’s a lot of action to “ban the advertisement” of psychiatric drugs – WHY? Because it’s a form of bombardment and unrelenting influence, and societal control? Because it’s a VIOLATION of your RIGHT to PEACE of MIND?

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    • mjk,
      Some of these questions I already have a good feel for myself. This was one of those mornings when every question seemed to raise five more. I decided to write the questions down.

      I’m not so sure I understand all the questions. Some seemed to be for me. Some seemed to not be for me.

      I haven’t seen either movie. But I’m out of the broadcast media zone as much as I can be. The media seems to be unrelenting in the agendas it promotes. Money is the motive force. I’ve had to “vote” with the “off” button for myself and my family. Ten years now away from broadcast media. I’m a bit out of the cultural loop but folks generally tell me when an earthquake happens or a tropical storm hits.

      Broadcast media (if you turn it on) gives people you don’t know direct access to the inside of your head. It is a common misperception that we can sort and filter this and not be effected. If it were true, that the mute button protects you or that you can be too clever to be effected, there would be no money in advertising. Nothing would get through. But it does get through. A lot.

      If there’s too much money in drug advertising to ever get it banned (likely), then that leaves us no other choice than to turn off the media at the user end, one at a time. This would be true grassroots rebellion.

      Once I “detoxed” from TV, radio, newspapers and magazines I found I was more relaxed and less materialistic. These are both good.

      Thanks for reading, thinking and writing.
      Best,
      Alice

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      • I’ve done the same – No television, movies, radio, microwave. It’s been many years, but I still “sin” by using the microwave sometimes. I know I’m much healthier for not watching television or movies.

        I think the internet is very much an “interactive television”. I find myself wanting (and struggling) to disconnect.

        The questions are good ones. I liked quite a few of them.

        A question is a quest. Maybe you’re on one. Maybe we all are.

        Yes, I’d wear sunscreen. And hat and glasses, too. *smiles*

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        • mjk,
          I skip the sunscreeen and go out in the morning and evening.

          I keep the internet down to a dull roar…email mostly. This is the first time I’ve done the interactive online thing. I use wikipedia when I don’t know what something is. I don’t have much luck with accuracy when I look for a business on line. I still get calls from the internet on a practice I closed in 2003.

          Certainly. I am on a quest.

          I’ll let you know when I figure out what it’s for. 😉

          All the best,
          Alice

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  4. My name is Jaime, fifteen years I’ve been to young
    Is it time to taste the truth and toss it off my tounge?
    The world has come a-calling and it’s bleeding at my door
    Am I supposed to turn away, or is this what I’m here for?

    Someone keeps calling my name
    Someone keeps calling my name
    Or is it just the rustling of the wind
    Or is it just that I need a friend
    Someone keeps calling my name, my name” _Harry Chapin.

    Or something keeps calling our name?

    Why an epidemic of mental illness in the Western world at a time when we face the greatest challenge in re-defining our way of life, towards planetary sustainability? A time when such sustainability may be demanding a re-interpretation of who & what we are, & our meaning within a Universe, we are not separate from?

    Can you invest your previous experience as a psychiatrist in this much needed paradigm shift in human awareness? Has psychosis always been an aspect of human experience for a reason?

    “The life of feeling is that primordial region of the psyche that is most sensitive to the religious encounter. Belief or reason alone does nothing to move the soul; without feeling, religious meaning becomes a vacant intellectual exercise. This is why the most exuberant spiritual moments are emotionally laden.” _Carl Jung.

    Can you ask yourself “if madness is not what psychiatry says it is, then what is it?” _M. Cornwall.

    Writing from Bangkok I can assure you it is certainly the same sun over here, just as it is in Laos with its 80 million deadly bombs left over from the Vietnam era. A country of 6 million souls where farm children get limbs blown off, even as you contemplate.

    “Does it make sense to drive to a gym to walk on a treadmill?”

    Interestingly neither Laos or Cambodia have an “epidemic” of mental illness despite obvious and ongoing trauma experience. These poor people might have a wry smile at the thought of such an epidemic, in the great God America? Perhaps its one of Gods lessons?

    Glad to see your searching for deeper perspective Alice:))

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    • David,
      Thanks for reading my essay, giving it thought and writing your comments here. I like your additional questions. All of us have to formulate our own questions.

      To me, the questions that arise in the field of psychiatry and psychopharmacology are mixed in with questions about everything else. I suspect the “epidemic of mental illness” in our country is not so much an actual epidemic as a wider and wider casting of the net for new drug customers. It’s more a case of diagnosis expansion. For example, I do not believe that autism prevelence is increasing as it seems to be. Only the diagnosis is. It’s one of the steps to getting special services in school systems. Getting an evaluation and diagnosis from a psychiatrist then leads to increased drug prescribing. When all you have is a hammer, everything begins to look like nails.

      “80 million deadly bombs left over form the Vietnam era” “farm children get limbs blown off”

      It’s like we are still at war with today’s children there all these years later. I suppose if we, as a country, are not taking responsibility for this that we will take responsibility for other things. BTW, there is some lovely radar mapping technology for finding buried landmines that could be used for cleanup of old minefields.

      “Can you invest your previous experience as a psychiatrist in this much needed paradigm shift in human awareness?”

      Here I am. I’m a writer. I write. I can do words.

      “Has psychosis always been an aspect of human experience for a reason?”
      Can you ask yourself “if madness is not what psychiatry says it is, then what is it?” _M. Cornwall

      I believe that psychosis is culturally defined. The definition of a “delusion” (a sub-type of psychosis) is “a fixed false belief in spite of evidence to the contrary”. I can find these in almost anyone, not simply those defined as psychotic. If you belong to a culture that values direct messages from God, these would be fine. If not, then they may be labeled “psychosis”.

      Poorer countries cannot afford the drug products that drive the “epidemic”. So maybe it’s not the trauma behind the “metal illness” boom?

      Keep reading, thinking and writing.
      Best,
      Alice

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      • TRAUMA:
        Could it be that a Cartesian, mechanical “cause & effect” logic, invested in the “intellectual” power of thought/words, does not understand our human susceptibility to getting stuck in a post trauma response of “tonic immobility.”

        Consider;
        “Most people think of trauma as a “mental” problem, even as a “brain disorder.” However, trauma is something that also happens in the body. We become scared stiff or we collapse, overwhelmed and defeated with helpless dread.

        In the aftermath of the Korean war, all poignancy was excised from the next generation of war trauma terminology. The term used here for combat trauma, operational exhaustion (resurrected as combat operational exhaustion for the Iraq war), certainly had nothing gritty or real in respect to the horrors of war.

        It was an objectified term, more applicable to a laptop computer of today when left on too long and needing a reboot.

        Finally, the current terminology, derived largely from the experience of the Vietnam war, is PTSD. As PTSD, the universal phenomenon of terror and paralysis – in which the nervous system has been strained to breaking point, leaving body, psyche and soul shattered – is now fully sanitized as a medical “disorder,” with its own convenient acronym, and serving the dispassionate nature of science.

        Where it was once aptly conveyed by terms like, fright paralysis and shell shock, it is now simply an objectified disorder, amenable to scientific categorization.

        An Iraq war veteran objected to his combat anguish being labeled PTSD, and named it PTSI, the “I” designating “injury.” Rather than being a disease in the classical sense, trauma is a profound experience of “dis-ease” or “dis-order.”

        Exerts from “In an Unspoken Voice” by Peter Levine PhD.

        Can you see what he’s driving at Alice? How we use the intellect to dissociate from our own visceral nature? We might think with our brain, yet do we still react with gut instinct?

        Is the fundamental reason for our cognitive abilities, more to with maintaining social harmony (homeostsis), by further regulating raw internal energies, than insightful self-awareness?

        Perhaps there is less mental anguish resulting from trauma experience over here in South East Asia, because people retain more of an “embodied” sense of self? Although, there is also the “extended family” safety net of social support, which been diminishing in the West for decades?

        It is by using Levine’s methods of “sensate” awareness that I can now go through a full blown euphoric psychosis and discover its hidden intent, in brain stem neural reorganization. Like in the well known term “neurons that fire together, wire together,” and the notion of “brain plasticity” and the non-linear systems theory of the brain as a self-organizing and re-organizing biological system.

        Consider;
        “Noting the commonalities between elation as a basic practicing period mood in infants and manic symptomology in adults, Poa (1971) observes Elation as a basic mood is characterized by an experience of exaggerated omnipotence which corresponds to the child’s increasing awareness of his muscular and intellectual powers. The similarity between the two is striking. Manic disorder has also been described in terms of a chronic elevation of the early practicing affect of interest-excitement; this causes a “rushing” of intellectual activity and a driving of the body at uncontrollable and potentially dangerous speeds.”

        Exert from, “Affect Dysregulation & Disorders of Self.” by Allan N Schore.

        Do we need more “experiential” understandings of mental illness experience, to compliment all you were taught, Alice?

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        • David,
          I’m glad to hear that South East Asia has retained community and extended family relationships. The loss of both of these in our post-industrialization cultural has been devastating for us mammals that live here. We all need a web of others in order to be healthy. This concept, that we humans need close relationships, may be part of the underpinnings of why the Soteria model works.

          I was taught that the “full blown euphoric psychosis” you describe is self-limiting and was the experience that made the “diagnosis of Bipolar disorder” for a person. I was taught (before the advent of the many marketed products) that with time (weeks), this would pass and go completely away. I was taught that many would only have one “episode” and that those with recurring “episodes” would “return to their baseline of functioning between episodes”. I was taught that the “diagnosis of bipolar disorder” was “a hopeful diagnosis”, that people with these experiences were, between episodes, the same as anyone else ie would have jobs and families and “lead normal lives”. Who are the ones now labeled as having “bipolar disorder” and why are they in need of lifelong polypharmacy?

          I think we do have to look at real life experieinces for our evidence now. With marketed products driving diagnostic labeling, “research” and education, there is an unmistakable bias in the literature.

          Another of your great questions:

          “How we use the intellect to dissociate from our own visceral nature? We might think with our brain, yet do we still react with gut instinct?”

          I don’t believe it possible to dissect out the visceral from the thinking part. The theoritical chemistry of all of this is the same. “Stimultions” like anger, fear, excitement seem ot run on similar chemicals. All of these change the wy we think about things and our opinions.

          Keep reading, thinking and writing.
          Your thoughts help me think more.
          Alice

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  5. i dislike the explanation of the “mental illness epidemic” being just drug companies casting a wider net because it’s a little more complicated than that. psychiatry is one of richard dawkins’ memeplexes. psychiatry’s purpose is to create mental health workers and patients FIRST and be otherwise useful for money or happiness SECOND. the problem with psychiatry is that it is a memeplex that is based on trying to prove scientifically that some people are less deserving of liberty, equality, and dignity than others. that’s just never good. as long as this idea is is supported within a culture people will continue to use science to try to prove it.

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    • Paula,
      You’re right. It’s bound to be more complicated than this. Everything is.

      From my own personal experiences as a psychiatrist (and this may be too limited a view) I don’t recall wanting more mental health workers. I do remember hoping that the phone would ring and there would be a person I could work and help using psychotherapy who didn’t want pills. I hoped it would be a person that could afford to pay something to offset the rent and liability insurance. This was a money motive for me. I couldn’t be in business without income. Any doctor’s office is a business. I obviously wasn’t so good at “creating patients” as I ended up working without paying myself the last two years. (smiles) I did enjoy (happy) working with patients a lot or I would have closed my office years sooner.

      I used the (“science”?) of human relationships and cognitive/behavioral therapy to help people get on a path of a happier life that worked better for them.

      Perhaps you’re looking at things from a more global perspective here?

      Thanks for reading, thinking and writing.
      Best.
      Alice

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    • How could you say that when so many of the questions are quality-of-life related?

      “How about if the pills you swallow each morning to cope with the pain of existence were trimming away two days from your life for every one they blur for you today; would you reconsider? What could you do instead?”

      I really like this one: “What if the fuel you burn to drive your car to your American dream house underlies the cause of wars we wage half a planet away? Could you park it for one day a week in protest? Could you park it for two days a week? Could you give up your American dream house for a small apartment even when there’s a drummer that practices across the alley from your bedroom window late into the evening? Could your family manage with only one bathroom and no storage? Would you buy less stuff?”

      Let’s go for a ride.

      War? Housing? Transportation & Mobility? HUGE factors in matters of wellness and suffering – yes or no?

      War? I watched images of real, live War on television and was severely deeply disturbed by it. My dreams were nightmares and my days were panic stricken. Oh, but those responses meant that I was “mentally ill”? Technically speaking, one might accurately suggest that I was rather intellectually challenged because I didn’t think to turn off the damned television. Duh. But turning off the TV wouldn’t magically make the war end, would it. I was a 15 year old girl – what reason did I have to be disturbed by watching War, LIVE, on television? None, because that sort of thing doesn’t cause mental illness, right?

      Park my car and give up my American dream home? Haha.

      I was in panic for months when MY VEHICLE WAS MY HOME – and feared every day that I’d lose possession of it. It was wintertime, one of the coldest winters of the past ten years, and gas prices were the highest they’d ever been. Five dollars per gallon and my source of heat was a parked and running motor vehicle. I also experienced real starvation those days. I lived in grocery heaven (parking lots of shopping plazas) but couldn’t eat a thing. I wandered 24-hour stores at 2 and 3 AM – terrified of food – because it would “make me sick”. I didn’t know anymore how to feed myself – what was “healthy” and what wasn’t! I was in sheer terror. I was alone in a brand new state, where I didn’t know anyone. I was starving and freezing and in the most severe and extreme pain. Maybe I deserved it, though.

      I’d say these questions are very much on topic. Does it seem like maybe the replies and responses might help to “make or break” this article?

      What really are the issues that cause and DRIVE (no pun intended) our extreme states, conditions, sicknesses and our unwellness? Birth defects, of course. Rotten brains from the start! But war is normal, Doritos cannot hurt me and only a pill or injection will “save my life”.

      Here’s another question I like: “Have you considered using it till it’s worn completely out?”

      Have you ever considered why, after some time, I might grow to become “extremely” ungrateful to STILL have to be wearing OTHER PEOPLE’S CLOTHES my whole entire life – in a country of INCREDIBLE luxury that I can never put my hands on? I *love* Nine West, Calvin Klein … oh, just shut up.

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      • mjk,
        Wow. Thanks. You got it. This is what I meant. Your personal comments say it so much better than I could.

        Thanks for the vivid and vital re-stating from your experiences.

        Turning off the TV won’t make the wars end but it will reduce the impact of the terrorist media on our own emotional selves. Terrorizing ourselves by watching will not make the wars end, either.

        Yes. These symptoms we label as “mental illness” could be caused by the real life experiences. Of course. But our minds really can’t sort the deaths and explosions we get from vivid second hand sources like TV out from things that happened to people close to us. I have had Viet Nam “PTSD” nightmares from running therapy groups with combat veterans. I have had nightmares from media exposure.

        I can understand about having to wear other people’s clothes. I grew up in a materially poor “hand-me-down” family. I reacted for a time in adulthood by wanting a lot of stuff. Thankfully, I am back to living with few things and haunting thrift shops to clothe me and my family. Yes. I do know the difference between making a voluntary choice to live with less and having no choice.

        Thanks for your well-thought comments.
        Alice

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        • In one story that I shared, the emergency department workers wanted to stop a woman’s disruptive and sickened behavior. They would’ve needed to use restrains and drugs to do that. Funny, I didn’t want to stop or control anything about her – but just by caring about her, SHE stopped and SHE had self-control. Must’ve been a fluke.

          Your questions are care-based and *that* is the sort of thing that the medical, mental health-care establishment has yet to master, in my experience. I still say care *is* the treatment.

          I could almost “guarantee” that if drugs weren’t in your way, either – you’d probably still be in the field of … whatever it is. I think you might’ve made an excellent shift though; words are magical and I feel like I’m not saying anything you don’t already know.

          Every word you offered up in this blog entry was worth gobbling down. The engagement of correspondence with others keeps you writing. You’re a writer. You write.

          It’s good stuff.

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          • mjk,
            I love the engagement. I keeps me writing and thinking and smiling. Wait a moment. Am I allowed to have fun here?

            If drugs weren’t in the way I would, indeed still be in the field of… whatever it is.

            Words rock.

            Thanks for your kind words.
            Alice

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    • anonymous,
      You are absolutely right. It is what came out of the hands that morning.

      I think there are “on-topic” things woven in. This more accurately reflects how I feel psychiatry is embedded in the bigger picture of living life in our country.

      I will aim for 200 comments.(smiles)

      Thanks,
      Alice

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  6. Well, like Anonymous, I have to say that this doesn’t grab me as much as some of your other posts. However, I’m wondering if these are the questions that led you to move to the position that you’ve taken at this point in time. I had many of the same questions as these and had to finally change professions not once but twice because in one I felt I was eing used to promote propaganda and not to do the job as I saw it, and secondly because I was not being honest in the position I held. I was a “wolf in sheep’s clothing” and couldn’t continue to live like that. I’ve pointed this out before, that I don’t believe that lot of Americans sit down and evaluate their lives. They allow their lives to be filled with all the “trash” that you’ve cut out of your life. I would suggest that it would be a good idea for all adults to try these questions on for size and see what happens. I do believe that many psychiatrists do know the harm that they contribute to and have done in the past but they don’t want to evaluate it becuase the answers they would come up with would most likely demand some real changes in their lives and they would have economic repercussions. Many people are not willing to take the chance of ruining their lifestyle they’ve grown accustomed to. I too got rid of the media and the car but spend way too much time on the internet. Am working on dealing with that. I think these are important and good questions and that people could benefit from them if they sat down and asked themselves what the answers are. The problem with the post is that there isn’t much to argue about and to post dissenting opinions and facts about. You really can’t say that these aren’t important questions and that evaluating you life isn’t important. Keep writing. by the way, I admire you for working at Charity in New Orleans. Many people don’t or cant understand why some of us purposely seek jobs in the worst of places. I guess they feel that by our presence we are saying “yes” to the terrible things that are done. Call me silly and unrealistic, but I believe in taking a stand for what is right in the middle of all the bad stuff. Others probably see it differently and I don’t have the energy to try to convince them otherwise.

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    • Stephen,
      You’re right. This one didn’t “grab me” as much either. This is not the first one to make a softer landing here. Perhaps the muses have days off, too.

      I will work to give people more to argue about (smiles).

      These are questions for us all.

      Thanks for reading and commenting.
      Alice

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      • I think people look forward to your writings for all kinds of reasons. Your posts that are not as “soft” create a lot of good, informative discussion. I see MIA as sort of a “testing ground” for people as they hone their experiences and knowledge into form and shape. It gives us all a chance to evaluate what we really believe and don’t believe. One thing that I’ve noticed and appreciate is that your skin seems to have “thickened” in the good sense, allowing you to really “listen” to what people are posting. You come right back and wade right in, even after you’ve been zinged a couple of good ones. You don’t start crying and go running home with your toys. I sometimes get the feeling that some people who present their ideas for comment are totally surprised when all of their comments aren’t accepted with great gratitude on our part. You seem to be willing to join in the give and take of it all and don’t run home to pout with your feelings hurt. Maybe you do, but you don’t let us all know about it.

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        • Stephen,
          I like the give and take. I think more when I have intelligent, thinking people to communicate with. This all helps me get clearer about things.

          Have there been zings? Nothing but sweetness and light on MIA. ;-))

          Seriously. People here know me by the words I write. I try to be clear. Some make assumptions about who I am and how I’ve lead my life based on me being a doctor and psychiatrist. Sometimes they’re right. Sometimes they’re wrong.I try to sort it out as it comes but I can’t always do this.

          I’m still having a good time here.

          All the best.
          Alice

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  7. I liked this, because I think it gets to the core of what is wrong with psychiatry. It is assumed that the “patient’s” suffering is a result of some internal process going awry, which the technician doctors will fix for you for a fee.

    But many of the questions Alice asks here are fundamental and can be depressing or angering or inspiring or scary. Psychiatry denies the possibility that a person’s suffering may be a SANE response to a rather INSANE world. Those that “cope well” with the current realty may be suffering similar pains but have learned to repress them effectively, so they can continue to go to work in the missile factory and come home and watch TV and get to sleep at night without processing that they are creating death and being paid for it.

    It seems that values, morals and ethics are all denied by psychiatry as valid parts of the human experience. Instead, we are all expected to “Adjust” to the status quo and “be happy” (but not TOO happy, that would be manic!) with what we have, and not ask the kinds of questions Alice puts forth in her essay.

    Asking questions is painful, but it’s also threatening to the current rulers of the status quo. Psychiatry’s main job seems to be to stop us from asking these questions, or to marginalize those who do into misfits and disease sufferers, so that the only “humane” thing to do is to drug them back into compliance or apathy.

    —- Steve

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    • “Societal problems from an emotional systems view:

      All of the people who were, or are members of families replicate the same emotional patterns in society. Family and societal emotional forces function in a reciprocal equilibrium to each other, each influencing the other and being influenced by the other. These observations are based on the same criteria used to estimate family functioning, which is the amount of principle determined “self” in comparison to the “feeling-orientation” which strives for an immediate short term feeling solution to the anxiety of the moment.

      The triangling process in a large family will help illustrate the process in society. It may begin with conflict between a parent and child. When another takes sides emotionally, he is potentially triangled. When he talks (to influence others) or he takes action based on feelings, he is actively triangled. Each person who becomes involved can involve others until a fair percentage of the group is actively taking sides. The controversy is defined on “right” and “wrong” issues, and often as victimizer and victim. In societal conflict, those who side with the “victim” are more likely to demonstrate and take activist postures. Those who “feel more responsible” for the total group will side with the parental side. They are more likely to stay silent or take action in letters to the editor, or to actively counteract the activists.

      One interesting group of activists is made up of members of professional and scientific organizations who attempt to use knowledge and social status to further entangle the triangular emotional system. To summarize the process, it begins with emotional tension in a bipolar situation, it spreads by involving emotionally vulnerable others, it is fed by emotional reactiveness and response to denial and accusation and it becomes quiescent when emotional energy is exhausted.” _Murray Bowen.

      THE SYSTEM, is inside each and every one of us & is “projected” onto that moving picture show we sense as the external environment.

      Its called the “autonomic nervous system,” and mediates survival by whatever means available. That’s why the “identified patient” is a reciprocal volunteer in their adapted functioning. All the rationalizing about the “nature” of human problems will “see” nothing until it turns the emotional projection machine around and feels the impulse and truth of “self preservation.”

      The “status quo” is inside us all, as the need to maintain homeostasis, (comfort-zone, dynamic equilibrium) label it what you will. All the clever subjectivity in the world is meaningless until we come to understand what really makes us tick?

      Until we face up to “what we are,” we will continue down this weary road of, “the more things change, the more they ….”

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  8. If we could just get some Republicans on board we could take away the cable TV and the cell phones from the SSI folks and restrict food stamps to fruits and veggies (no junk food) and take away disabled bus passes so folk could enjoy the exercise while saving the planet by walking and require 20 hours of volunteer work a week to receive disability and thus receive the benefits of community involvement and fellowship …….Seriously why should simple living be a luxury for only the elite? Why should the state sponsor disease causing lifestyles?

    Just posting in the interest of diversity 🙂

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    • Dear Dr D Lightfull,

      Do you like to fish?

      Last I knew, efforts are already underway to reform food stamps, now known as SNAP. I thought that was a very unintelligent acronym: “I’m gonna SNAP one of these days!”. Gee, don’t they consider sensitivities? I forget exactly what their grand plan is, but I watched a one hour Harvard presentation about it. It was pretty good, actually.

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      • I don’t fish. I only eat plants. I’m all loony left in my heart but my head says the fastest way to start reforming the mental health biz is to stop funding it. If the laws were changed to stop SSI from paying kids labelled mentally ill, it would save thousands of kids. There was an article in the NYTimes I think the other day about poor women putting their kids on drugs to up the chances of getting them SSI. That’s pure evil.

        All the emoting about the problem is is fine and I enjoy it too but it doesn’t get anything done and it alienates a lot of people. It would be more effective to find common ground and get something done than try to convert everyone to your own point of view.

        I’m not mad. But my voice counts too.

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          • Dr D L,
            Nope. I didn’t answer your question directly. You asked one of those questions that it doesn’t pay to attempt to answer directly. It’s very much like the classic “Are you still beating your wife?” question that implies guilt and is aimed to “trick” a person into admissions of guilt.

            You are not the first here in MIA comment land to take on this approach with me. Probably not the last.

            The best I can do is tell you what I lived and experienced there. If you or someone you loved was there at the time, I’d be happy to compare notes.

            Imagine. I do this for fun in my spare time.

            Thanks for reading, thinking and writing.

            All the best,
            Alice

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        • “All the emoting about the problem is is fine and I enjoy it too but it doesn’t get anything done and it alienates a lot of people. It would be more effective to find common ground and get something done than try to convert everyone to your own point of view.”

          Who is “trying to convert everyone” to their own point of view? What does that statement have to do with food stamp reform and defunding “state sponsor disease causing lifestyles”?

          I would think that the amount of people who intentionally (and unnecessarily) put their children on drugs by a motivation of monetary gain is extremely small.

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          • I don’t know what you mean about the flow of money. People who need assistance will still need it but not at the cost of disabling their own children with labels and “medical treatments”. What most people need most is jobs.

            “Nope. I didn’t answer your question directly. You asked one of those questions that it doesn’t pay to attempt to answer directly. It’s very much like the classic “Are you still beating your wife?” question that implies guilt and is aimed to “trick” a person into admissions of guilt” No I really wasn’t trying to trick you. I guess I’m not a very subtle thinker.(To me a trick question would be Are you still having sex with your patients after you kill them with Haldol? 😉 )

            Your answer that you don’t want to answer is fine.

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          • Dr D Lightful,

            What people need more is jobs. Absolutely true.

            I would never suggest that money should be an acceptable motive to drug a child. However, a psychiatric diagnosis is sometimes required to access special educational services, health insurance and income. A psychiatric diagnosis often comes with a prescription.

            Disability payments do not come from simply being unable to perform life functions, they require diagnoses. These days a diagnosis frequently requires a prescription. If the prescription goes away the disability may go away.

            Sometimes stopping medicines means a person will lose their income. This doesn’t make sense. And loss of disability also comes with loss of medical coverage.

            How is it that we’ve tied prescriptions to diagnosis to disability to health insurance and income?

            I was taught (long ago in the history of my own medical training) that one can never reason backwards from medication effect to diagnosis. For example, if one focuses better on psychostimulants this does not mean you have ADD.

            Somehow, we’ve gotten into the habit of saying that taking an antidepressant means he’s depressed and taking an antipsychotic means she’s psychotic.

            This ‘stinking thinking’ happens in internal medicine as well. For example, if a histamine blocker makes your stomach pain better then you must have had overactive histamine in your stomach. If a medicine for reflux makes your stomach pain better then you must have reflux.

            I have treated stage fright with blood pressure medicine (in addition to cognitive and behavioral interventions) This doesn’t mean the person has high blood pressure.

            Thanks for reading, thinking and writing.

            All the best.
            Alice

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        • DR DL,
          You sound serious about amnesty hearings. I got that.

          Are they really making foodstamps only for “healthy food” and taking away bus passes to make people walk and be healthy? That’s what I was referring to when I said careful or they’ll pick it up as a cost savings measure. Perhaps these have already been done?

          Alice

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          • Here is the Harvard presentation on Farm Bill reform:

            In election year 2012, the U.S. Congress will be considering a new Farm Bill, the government’s primary means of setting food and agriculture policy. The current Farm Bill has been criticized by public health experts for subsidizing crops used in ingredients — such as high-fructose corn syrup — in unhealthy foods. At the same time, the bill helps fund food assistance programs in the U.S., making food — healthy or otherwise — more affordable for many Americans. Amid calls for federal budget cuts, this Forum webcast focused on the implications for feeding the nation when politics, economics and nutrition collide.

            http://youtu.be/P0H-tbm9r9c
            Link ID: Reforming the 2012 Farm Bill: Subsidies, Food Assistance and America’s Health

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      • In defense of your now infamous need to have fun.

        “You can discover more about a person in an hour of play than in a year of conversation.” _Plato.

        Also play is considered vital to trauma resolution in children.

        Perhaps some may consider where they are @ on their recovery journey?

        For a long time I was stuck in the “Pain – Anger – Rage – Revenge,” stage of recovery. Perhaps people might consider what it is, that they really want for the future?

        Looking from afar it seems that so much American debate is unconsciously immersed in “us vs them,” and if your not with us, you must be against us. Its a divide and conquer propaganda tool that elites have used against the masses for centuries.

        When I think up my rationalized responses, I try to pause and feel the gut impulse of my “reaction,” how affect/emotion is creating a cerebral “tone.”

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        • David

          They had tennis courts for the guards at concentration camps didn’t they?

          Girls just wanna have fun yeah
          Girls just wanna have fun!

          But I’m grateful that she got out of psychiatry even if her motivation wasn’t lack of fun in practicing it 🙂

          Maybe some people are so far ahead of you in their “journey” you can’t hear what they are saying or see who they are? Don’t be too quick to judge the rest of us ok? I shall endeavor to do like wise!

          This site IS about the history of psychiatry among other things. And Alice was part of that.

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          • Dr D L,
            Were there really tennis courts for prison guards? You hav a real interest in history, then. I had no idea.

            Actually, my motivation for stopping my practice of psychiatry did have a lot to do with a lack of fun. Fun has been gradually drained from the whole medical world over the decades since I went to school. The practice of psychiatry has come to focus more and more on medicating people and less and less in helping people grow lives that work better for them. Being a psychiatrist has turned into writing prescriptions as an interchangeable cog on a too-fast conveyor belt. This doesn’t help people. It’s also not fun at all.

            What do you do for fun?

            All the best,
            Alice

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        • David,
          Thanks for your supportive and kind words.

          I like this: I have an “infamous need to have fun.” I suppose if one has to be infamous for something…

          I agree that being stuck in the ““Pain – Anger – Rage – Revenge,” stage” keeps us from moving forward into the future. The anger/retribution stance interferes with thoughts and both emotional and physical well-being. It blocks cooperation. (Even worse, it blocks fun).

          My ever-so-small suspicious streak would have me thinking that the great American “us vs them” attitude is indeed the result of divide and conquer propaganda. It works so well in so many ways to keep grassroots campaigns from going anywhere. We have the perfect channels in place to promote these attitudes.

          Thanks for reading, thinking and writing.
          Best,
          Alice

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          • Alice it might be fun some time to rephrase fun into something that others would find less offensive and at the same time would be true. But that would also eliminate the fun of all these conversations ;

            fun

            1.
            something that provides mirth or amusement: A picnic would be fun.
            2.
            enjoyment or playfulness: She’s full of fun.

            Synonyms: amusing, boisterous, convivial, diverting, enjoyable, entertaining, lively, merry, pleasant, witty

            I don’t think I’m adding anything to the conversation so I think I’ll exit this one.

            Good luck

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          • Dr. D L,

            fun (fn)
            n.
            1. A source of enjoyment, amusement, or pleasure.
            2. Enjoyment; amusement: have fun at the beach.
            3. Playful, often noisy, activity.

            I meant fun in the “enjoyment” sense. Not like a day at the beach.

            The guys on that first VA ward taught me how to shoot pool after lunch. They smiled and laughed and talked about thier lives. I enjoy listening to people and learning about them. This is fun to me. Maybe it wouldn’t be to everyone.

            Those guys seemed to have fun (ie enjoyment) as well. The job I referred to specifically was my very first time working in psychiatry as a required part of my neurology training.

            Remember, psychiatry was not so much about drugs in those days. We had “mileau therapy”, “occupational therapy”, group therapy, family therapy, individual therapy. We had “therapeutic relationships”.

            Today’s psychiatric units and hospitals do not sound like “fun” to me. I do not work in those. I’ve spent decades doing everything I can to keep people from going to psychiatric hospitals.

            I appreciate your contributions here. Every time you reply I get to think more. I enjoy this. It’s fun.

            Alice

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  9. Not too many questions at all.

    I read this slowly and thoughtfully, as I have been downsizing my life in all areas for nine years. We all need some soft time, even if you don’t get “200 comments”. Don’t blame the muse, or absence of it. This is so good, to accompany you on your journey.

    You’re not just a psychiatrist anymore, you are a Thinker and maybe a Philosopher?

    And a Writer. Definitely a Writer.

    Thank you for the (breakfast) food for thought.

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    • Marianne,

      Thanks for your kind and supportive words.

      I think a lot. Writing helps me think. Writing conversations with people helps me think even more. I am very grateful for the opportunity to converse with all kinds of people from all over the world here on MIA. What a miracle. I enjoy everyone I meet here for as many different reasons as there are different people.

      I’m downsizing here as well for several years. Downsizing is a philosphical stance as well.

      I’m still a doctor and a psychiatrist, though. A person doesn’t stop being these even if no longer praticing medicine or psychiatry. I had a friend that was a psychiatrist till he died at 99 even though he hadn’t worked in a long time. He was a reader, thinker, philosopher. Many things.

      I hope that more people can see that being a psychiatrist is not just one thing.

      Thanks for talking here.
      Alice

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    • Yesterday is past, gone, you’ll NEVER get it back. What do you want BE, NOW?

      Some people say we have two aspects of attention on a continuum of self-preservation awareness, we either judge (foreground awareness) or we perceive (background awareness)?

      Then again there is that advice to the feuding couple, “do you want to BE happy or do you just NEED to be right?”

      “Deepening awareness is a challenge. It isn’t a challenge because my parents didn’t love me enough. It’s a challenge because it’s a challenge. I don’t need to take it personally. I’ve spent years excavating my past, sorting and cataloguing the wreckage. But who I really am, the essential truth of my being, can’t be grasped by the mind, no matter how acute my insights. I’ve confused introspection with awareness, but they’re not the same. Becoming the worlds leading expert on myself has nothing to do with being fully present.” Exert from: “In an Unspoken Voice.” by Peter Levine, PhD.

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  10. Friend Alice

    The best way to defeat the system is to leave it. This place is as destructive in its own way as the APA and big pharm put together. I am fleeing.

    Remember what the dormouse said! Feed your head!
    It was nice talking to you. Who is Kermit and why is he removing posts? Who is funding this place? What’s the agenda?

    Friend Delightfull

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    • Friend Dr D Lightful,

      Sorry to see you go. I appreciate your input.

      I know what you mean about leaving a system. I skipped out of the AMA in the late 1980’s, dumped the APA about ten years ago, closed the office in 2003 and haven’t worked as a psychiatrist since last August. But the system chugs on just fine without me.

      Kermit is an editor here. He occasionally edit posts. My understanding is that they watch for things that may be considered personal attacks that would make people not feel safe to post here. I’m certain you can email him at this site directly. All my dealings with Kermit have been good.

      I also have the capacity to remove or edit any posts on my own essays but have only removed two by specific requests of the people that put them up. I’m not real celar how this works for sure.

      Funding this place? I have no idea if there is any. I write for free here for the fun of it. Robert Whitaker invited me after he read something I wrote. I hope to have an impact on making things better through the use of my writing. I’ve written eleven (I think) essays here about my own personal experiences, thoughts and opinions with regard to the field of psychiatry.

      My understanding of the agenda is to promote conversations that will lead to re-thinking psychiatry and making the future of care for people that have been labeled as mentally ill better. I’m certain you could email Robert Whitaker care of this site and have his own ideas. It’s his webzine. Other agendas may also be here. For example, he is a writer and speaker on these topics. Some of the bloggers may have their own books or businesses related to this field.

      I hope this covers your questions. I’m pretty new around the word of on-line conversation and this webzine. A couple months, I think.

      All the best,
      Alice

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