E. Fuller Torrey, through his Treatment Advocacy Center, is the country’s most prominent advocate for outpatient commitment laws, which typically force people with a diagnosis of a severe mental illness to take antipsychotic medications. He has posted a review of Anatomy of an Epidemic on his TAC website, scathing—naturally—in kind, and I think his review provides a rare opportunity: In essence, we can now examine it to see if it provides a convincing defense of outpatient commitment laws and society’s decision to force certain adults to take antipsychotics.
The logic behind outpatient commitment laws is that antipsychotic medication is a necessary good for people with a diagnosis of severe mental illness. The medications are known to be helpful, but—or so the argument goes—people with “severe mental illness” lack insight into their disease and this is why they reject the medication.
However, if the history of science presented in Anatomy of an Epidemic is correct, antipsychotic medications, over the long term, worsen long-term outcomes in the aggregate, and thus a person refusing to take antipsychotic medications may, in fact, have good medical reason for doing so. And if that is so, the logic for forced treatment collapses.
We need to go over Torrey’s review, step by step. This may be a bit exhausting, but since his critical review can ultimately be seen as a defense of his advocacy of forced treatment, I think it will be worthwhile. In the end, we will be able to judge whether his is an honest review, or dishonest in kind, and if it is the latter, that—by itself—will reveal much about the scientific merits of outpatient commitment laws.
Part One: Diagnostic Criteria and Schizophrenia Outcomes
In my foreword to Anatomy of an Epidemic, I told of how, when co-writing a series for the Boston Globe in 1998 on abuses of psychiatric patients in research settings, I stumbled upon two outcome studies that I found difficult to understand. Dr. Torrey opens his review by setting out to show that my curiosity about those studies was misplaced, and that my subsequent reporting on those studies was in error.
The first such study was by Harvard researchers, who reported in 1994 that outcomes for schizophrenia patients had worsened during the past two decades and were now no better than they had been a century earlier. This outcome belied what I understood to be true at that time, which was that psychiatry had made great progress in treating schizophrenia.
This is the only context for my citing this study in Anatomy of an Epidemic, as a finding that piqued my curiosity. I do not mention the study again in the book, and thus do not cite it in the chapter examining the evidence base for antipsychotics. However, Dr. Torrey claims that I do, writing that after I summarized the findings from this study in the preface, I “later added that the worsened outcomes (in recent decades) were due to the use of antipsychotic drugs.”
Since Dr. Torrey has focused attention on this study, let’s look at what the researchers found and their discussion of their findings.
In a survey of outcome studies over the past century, which were conducted around the world, the researchers reported that from 1895 to 1955, 35.4% of schizophrenia patients “improved;” that this improvement rate increased from 1956 to the 1970s to 48.5%; and then it declined. They concluded that since 1986 the “likelihood of a favorable outcome has diminished to only 36.4%, or a level that is statistically indistinguishable from that found in the first half of the century.”
In their discussion, the researchers reasoned that improved outcomes in the middle part of the century were due to both a change in diagnostic criteria that broadened the definition to include patients who were less ill at disease onset and then to the introduction of neuroleptics. They attribute the decline in outcomes, which began to show up in the late 1970s, to a decline in social services and, starting in 1980 with the publication of DSM-III, a narrowing of the diagnostic criteria for schizophrenia.
So the study has two parts: One tells of how outcomes have deteriorated in recent times, and are now no better than they were in the first half of the 20th century, before the arrival of antipsychotics, which seems to belie the common wisdom that the arrival of the drugs “revolutionized” the treatment of schizophrenia. At the same time, in their discussion, the researcher write that that neuroleptics helped improve outcomes, at least when they were first introduced.
As I wrote above, I mentioned this study in my foreword to explain how I got interested in this subject. The deterioration in modern outcomes, such that they were now no better than in the pre-antipsychotic era, surprised me. But I didn’t discuss this study at any length, precisely because I don’t think it provides evidence regarding the long-term efficacy of neuroleptics, one way or another.
However, there is a non-drug explanation for the improvement of outcomes in the 1950s. In the first half of the century, up until the end of World War II, eugenic attitudes toward the mentally ill in the United States, which were also seen in Britain and other European countries, dramatically affected the outcomes of people hospitalized with a diagnosis of schizophrenia. Eugenicists argued that people with schizophrenia were genetically defective, and thus they needed to be segregated from the population—i.e. kept in mental hospitals—to keep them from breeding. This idea began to take hold in the late 1890s, and once it did, discharge rates plunged. Those low discharge rates in the eugenics era would be seen as evidence that patients didn’t improve, and thus the low improvement rate up until 1945 was in large part due to this social policy.
After World War II, eugenics came to be associated with Nazi Germany and the “science” that led to the Holocaust, and thus seen as a discredited, even shameful science. The need to keep schizophrenia patients in mental hospitals for eugenic reasons began to evaporate, and that led, in the wake of World War II, to new discussions within psychiatry and our society about providing care to patients in the community. Discharge rates for first-episode schizophrenia patients immediately began to climb. For instance, a study of first-episode psychotic patients admitted to Warren State Hospital in Pennsylvania from 1946 to 1950 found that 62 percent were discharged within 12 months, and that by the end of three years, 73% were living out of the hospital. Similarly, a study of 216 schizophrenia patients admitted to Delaware State Hospital from 1948 to 1950 found that six years later, 70% were successfully living in the community. These are very high “improvement” rates, and they predate the arrival of the first antipsychotic, Thorazine, in asylum medicine.
Moreover, once Thorazine was introduced in the mid 1950s, there was one large study that looked at how the new antipsychotics affected discharge rates for first-episode patients, and it did not find that the drugs were helpful in this regard. In 1961, the California Department of Mental Hygiene reported on the discharge rates for 1,413 first-episode schizophrenia patients hospitalized in 1956, and it found that 88% of those who weren’t prescribed a neuroleptics—about half of the 1,413 patients—were discharged within 18 months. Those treated with a neuroleptic had a lower discharge rate; only 74 percent were discharged within 18 months.
Thus, if we look closely at changing discharge rates during the middle part of the century, we see that they rose for first-episode patients following World War II, when eugenic attitudes became discredited, and that the arrival of neuroleptics in asylum medicine did not increase this rate. This change in social attitude, along with broadened diagnostic criteria, is what led to the improvement in outcomes following World War II. This change in social attitude grew in the 1950s and 1960s. Deinstitutionalization, as a social policy, took hold and that led to improved discharge rates in those decades.
As anyone can see, the study does raise a question. Why are outcomes today no better than they were in the first half of the century? Doesn’t this finding belie the common wisdom that antipsychotics kicked off a psychopharmacological revolution, a great advance in care. This was a study that understandably piqued my curiosity, which is how I presented it in my book, and yet Dr. Torrey, eager to discredit Anatomy of an Epidemic, states that I cited it as evidence that antipsychotics worsen long-term outcomes.
Call this dishonesty moment number one in his review.
Next, in my foreword to to Anatomy of an Epidemic, I also wrote of how my curiosity about the merits of our drug-based paradigm of care was triggered by studies conducted by the World Health Organization, which twice found that outcomes in three developing countries, India, Columbia, and Nigeria were “considerably better” than in the United States and other developed countries. That also seemed odd—why should outcomes in poor countries like India and Nigeria be better than in the U.S. and other rich countries?
In Anatomy of an Epidemic, I then reported on the WHO findings in the chapter on antipsychotics. This, I noted, was data from a cross-cultural study, in which medication use varied. I presented the WHO data as one piece in a larger body of evidence regarding the long-term merits of antipsychotics.
Here are the findings from the WHO study that included, as part of its reporting on outcomes, the patients’ use of antipsychotics.
- Outcomes were best in the three developing countries, where only 16% of patients were regularly maintained on antipsychotics (versus 61% of patients in the developed countries.)
- The best outcomes of all were seen in Agra, India, where only 3% of patients were maintained on the drugs. The worse outcomes of all—in terms of the highest percentage of patients who were constantly ill—were reported in Moscow, and it was there that medication usage was highest.
- In a 1997 followup (15 to 25 years after the initial study), the patients in the developing countries were still faring much better. “The outcome differential” held up for “general clinical state, symptomatology, disability, and social functioning,” the researchers noted.
In his review, Dr. Torrey seeks to discredit this finding. First, he notes that he and others have argued that the difference in outcomes was due to a difference in the type of schizophrenia suffered by people in the developing countries. Second, and this is more important, he implies that the authors of the WHO studies, in response to such criticism, in 2008 backed away from their initial findings.
The WHO authors, he says, wrote that “we do not argue that the prognosis of schizophrenia in developing countries is groupwise uniformly milder.” The WHO investigators admitted, he says, that “the proportions of continuous unremitting illness . . . did not different significantly across the two types [developed and developing) of settings.”
When you read that sentence, you are led to understand that the authors of the WHO study no longer believe that outcomes in the developing countries were truly better. It seems that they now agree with their critics, which is that the better outcomes were an artifact of diagnostic differences. If that is true, it would mean that this cross-cultural study should not be seen as an instance in which patients, who were treated in settings where antipsychotics were less frequently used, had better outcomes. That is how I presented the study, and so if the researchers did indeed conclude what Dr. Torrey said they did, my presentation of that study would be in error.
So let’s look at what the authors, Jablensky and Sartorius, actually wrote in their 2008 article.
There were two WHO studies that compared outcomes in developing and developed countries, they noted. The first was known as the WHO International Pilot Study of schizophrenia, which found “markedly better outcomes of schizophrenia patients in India and Nigeria at 2-year and 5-year follow-ups.” However, at that time, the researchers concluded that the divergent outcomes—in this first study—might be the result of a difference in patient groups. Thus, they mounted a rigorous second study, known as the DOSMeD study, to investigate that possibility. This study followed all new onset cases of psychosis within a geographical area for two years.
In 1992, the WHO investigators reported their findings, and as part of their report, they divided patients into schizophrenia subtypes and compared outcomes in the subgroups. But it didn’t matter. No matter how the data were cut ande sliced, outcomes in the developing countries were much better. “The findings of a better outcome in developing countries was confirmed,” they wrote.
Now, in their recent 2008 paper, Sartorius and Jablensky, rather than back away from their 1992 findings, vigorously defended them.
They noted the following results from the DOSMeD study:
- High rates of complete clinical remission were significantly more common in developing country areas (37%) than in developed countries (15.5%).
- Patients in developing countries experienced significantly longer periods of unimpaired functioning in the community, although only 16% of them were on continuous antipsychotic medications (compared with 61% in the developed countries.)
- In the study, one of the best predictors of outcome was “type of setting (developed vs. developing country.)”
- Elevated rates of early death (standardized mortality ratios) are more common in developed countries than developing ones.
So, where did Torrey’s misleading quote come from? In their 2008 report, Sartorius and Jablensky did observe that the percentage of patients with a “continuous unremitting illness” in the poor countries was 11.1 %, which was not significantly less than the percentage with this course in the rich countries (17.4%). In other words, there was a small percentage of patients in both settings that had a very bad course, but this did not reflect overall outcomes.
Dr. Torrey, in his review, was intent on discrediting the findings from this WHO study, which reported superior outcomes in poor countries where only a small percentage of patients were regularly maintained on antipsychotics. To do so, he implied that the WHO investigators now agreed with the critics of the study, when that is not true.
Call this dishonesty moment number two in his review.
Part Two: Schizophrenia Outcomes and Medication
In this part of his review, Dr. Torrey takes aim at two longer-term studies (Courtenay Harding’s and Martin Harrow’s) and my reporting on those studies. He also takes aim at the results reported for patients treated with open-dialogue therapy in Western Lapland, Finland, and my reporting of that program.
Courtenay Harding’s Vermont Longitudinal Study
I wrote one paragraph on this study in Anatomy of an Epidemic. Here it is:
In the late 1950s and early 1960s, Vermont State Hospital discharged 269 chronic schizophrenics, most of whom were middle-aged, into the community. Twenty years later, Courtenay Harding interviewed 168 patients from this cohort (those who were still alive), and found that 34 percent were recovered, which meant they were “asymptomatic and living independently, had close relationships, were employed or otherwise productive citizens, were able to care for themselves and led full lives in general.” This was a startling good outcome for patients who had been seen as hopeless in the 1950s, and those who had recovered, Harding told the APA Monitor, had one thing in common: They all “had long since stopped taking medications.” She concluded that it was a “myth” that schizophrenia patients “must be on medications all their lives,” and that, in fact, “it may be a small percentage who need medication indefinitely.”
Now here is what Dr. Torrey writes. “As Whitaker describes it . . . ‘34 percent were recovered’ which he claims is a ‘startling good outcome.’ Whitaker attributes this outcome (emphasis added) to the fact that ‘they had all long since stopped taking their medications.’ ”
We can call this dishonesty moment number three in his review. I did not attribute the 34% recovery rate to the fact that they had “all long since stopped taking their medications,” as that would indicate that I had drawn that conclusion. Instead, I repeated what Dr. Harding had said in an interview with the APA Monitor about the recovered patients. Equally revealing is what he omits from his discussion of Dr. Harding’s study: he does not mention her conclusion that the conventional wisdom regarding the need for schizophrenia patients to stay on antipsychotics all their life is a “myth.”
Martin Harrow’s Longitudinal Study
As Dr. Torrey correctly notes (for once), I do consider Martin Harrow’s report on the long-term outcomes of people diagnosed with schizophrenia and milder psychotic disorders to be of great importance. His was a prospective study of 200 psychotic patients, whom he followed for 20 years, and it is the only such study in the scientific literature.
Dr. Torrey dismisses the study as “completely unremarkable,” and so let’s take a close look at it to see if that is a fair assessment of his findings.
In the study, everyone was treated conventionally in the hospital with antipsychotics and then discharged. Harrow then periodically assessed how they were doing over the next 20 years. At each followup, he looked at whether they were symptomatic, whether they were working, and a variety of other outcome measures. He also charted their use of antipsychotics and other psychiatric medications. At the end of 15 years, he still had 145 patients in his study (64 with schizophrenia and 81 with milder disorders. In one of his article, he also reported outcomes for a schizophrenia-spectrum group, which included the schizophrenia patients and a few others with schizoaffective disorder.)
Here is a summary of Harrow’s findings, taken from both his 2007 report on their 15-year outcomes, and his 2012 report on their 20-year outcomes. (See slides for a graphic presentation of this data.)
1. Recovery rates in the schizophrenia group
At the end of two years, the schizophrenia patients who had stopped taking antipsychotics were doing slightly better on a “global assessment scale” than those taking an antipsychotic. Then, over the next 30 months, the collective fates of the two groups began to dramatically diverge. The off-med group began to improve significantly, and by the end of 4.5 years, 39% were in recovery. In contrast, outcomes for the medicated group worsened during this 30-month period. As a group, their global functioning declined slightly, and at the 4.5-year mark, only six percent were in recovery, and few were working.
That stark divergence in outcomes remained for the next ten years. At the 15-year followup, 40 percent of the schizophrenia patients off antipsychotics (25 of the 64 patients) were in recovery, compared to five percent of those taking antipsychotics. (To be in recovery, a person had to have no positive or negative symptoms; couldn’t have been hospitalized in the previous year; and adequate work and social functioning.)
2. Spectrum of outcomes in the schizophrenia group
Harrow divided long-term outcomes for the 64 schizophrenia patients into three categories: recovered, fair, and uniformly poor. Of the 25 patients who stopped taking antipsychotics, 10 recovered (40%), 11 had fair outcomes (44%), and 4 (16%) had uniformly poor outcomes. In contrast, only 2 of the 39 patients who stayed on antipsychotics recovered (5%); 18 had fair outcomes (46%), and 19 (49%) had uniformly pair outcomes. In sum, medicated patients had one-eighth the recovery rate of unmedicated patients, and a threefold higher rate of faring miserably over the long term.
3. Global outcomes for schizophrenia patients by prognostic type.
At the start of the study, Harrow grouped his schizophrenia patients into two subgroups: those with a good prognosis and those with a bad prognosis. Although he didn’t provide the global data for these two subtypes, he did report this finding: “In addition, global outcome for the group of patients with schizophrenia who were on antipsychotics were compared with the off-medication schizophrenia patients with similar prognostic status. Starting with the 4.5-year followup and extending to the 15-year follow-up, the off-medication subgroup tended to show better global outcomes at each follow-up.”
In other words, in every subgroup of patients (by prognostic type), those off medication had better long-term outcomes (in the aggregate).
4. Psychotic symptoms in the schizophrenia-spectrum and schizophrenia-only group
At the two-year follow-up, about 35% of the “schizophrenia spectrum” group were off antipsychotics, and that percentage remained fairly stable throughout the next 15 years. There was no significant differences in severity of psychotic symptoms between the on-med and off-med groups at two years, but starting with the 4.5-year followup and continuing through year 20, those “who were not on antipsychotic medications were significantly less psychotic than those on antipsychotics.
Among the schizophrenia patients, at the 10-year follow-up, 23% off antipsychotics were experiencing psychotic symptoms, versus 79% of those still on the drugs. At the 15-year followup, 28% of those off antipsychotics had psychotic symptoms, versus 64% of those on the medications.
5. Anxiety symptoms in the schizophrenia-spectrum group
At the two-year followup, about 50% of those on antipsychotics and a similar percentage of those off medications were experiencing “high anxiety.” However, over the next 30 months, high anxiety symptoms soared in the on-antipsychotics group, such that nearly 75% were experiencing this distress by year 4.5, whereas anxiety markedly declined for those off antipsychotics, such that only about 20% were experiencing this distress by year 4.5. This dramatic difference in anxiety symptoms remained throughout the study, with more than half of those on antipsychotics still suffering from high anxiety at the end of 20 years.
6. Cognitive function in the schizophrenia-spectrum group
The researchers assessed cognitive function at each followup, with one test assessing ability to access general information, and the other abstract thinking. At three of the six follow-ups, those off antipsychotics showed significantly better cognitive functioning, and in the other three follow-ups, there was a general trend favoring those off antipsychotics.
7. Sustained periods of recovery in the schizophrenia-spectrum group.
Of the 24 schizophrenia patients who remained continuously on antipsychotics throughout the 20 years, only 4 (17%) “ever entered into a period meeting the operational definition of recovery during any of the six follow-ups.” The reasons they failed to do so was either because they were psychotic or not working, Harrow noted. In contrast, there were 15 in the group of 70 who were off antipsychotics by the two-year follow-up and remained off the drugs throughout the remaining 18 years. Thirteen of these 15 patients (87%) “experienced two or more periods of recovery,” which meant they were both asymptomatic and working more than 50% of the time.
8. Global outcomes of all 145 patients
Harrow provided global adjustment data for all four groups in his study: schizophrenia on meds, schizophrenia off psychiatric medications, milder disorders on psychiatric meds, milder disorders off. At the end of 15 years, the global outcomes for the four groups lined up like this, from best to worst: Milder disorders off meds, schizophrenia off meds, milder disorders on meds, and schizophrenia on meds.
As could be expected, Dr. Torrey does not report of any of these outcomes in detail. I’ll let readers of this blog decide whether such findings are—as Dr. Torrey writes— “completely unremarkable.”
In his discussion of the Harrow study, Dr. Torrey also makes this claim: “Whitaker . . . using tortured logic, asserts that the Harrow study proves that long-term antipsychotic use causes brain damage and is responsible for many of the symptoms of schizophrenia, when in fact the study does nothing of the kind.”
Here is my challenge to Dr. Torrey. I wrote about the Harrow study on pages 115 to 118 of Anatomy of An Epidemic. He should point to the passage on those pages where I asserted that the Harrow study “proves that long-term antipsychotic use causes brain damage and is responsible for many of the symptoms of schizophrenia.” If he can not point to such an assertion, then he should print this correction on his Treatment for Advocacy web page: “I lied about what Robert Whitaker wrote about the Harrow study.” He could then explain to his readers why he felt motivated to lie in this way.
But for our purposes, we can chalk this up as dishonesty moment number four in his review.
The Open Dialogue Program in Finland
In the solutions section of Anatomy of an Epidemic, I wrote about the good outcomes for psychotic patients in Western Lapland, a region in Finland, that—since 1992—has used antipsychotic drugs in a selective manner. Two-thirds of their first-episode patients have not been exposed to antipsychotics five years after initial diagnosis, and 80% are either working or back in school. These are extraordinarily good results, but Dr. Torrey dismisses them out of hand: “Most revealing and remarkable, however, is the fact that more than 40 years after the treatment program began, there are almost no publications describing its results and nobody in Finland or elsewhere has tried to replicate it. Robert Whitaker appears to be the person most impressed by it.
If Dr. Torrey had checked the notes section of my book, he would have found a number of citations documenting the good outcomes in Western Lapland since 1992, when that district began using antipsychotics in a selective manner. Here are five such published reports, and if Dr. Torrey likes, I can point him to others:
1. V. Lehtinen, “Two-year outcome in first-episode psychosis treated according to an integrated model,” European Psychiatry 15 (2000):312-20.
2. J. Seikkula. “Five year experience of first-episode non-affective psychosis in open-dialogue approach,” Psychotherapy Research 16 (2006): 214-28.
3. J. Seikkula. “A two-year follow-up on open dialogue treatment in first episode psychosis,” Society of Clinical Psychology 10 (2000):20-29.
4. J. Seikkula. “Open dialogue, good and poor outcome,” J of Constructivist Psychology 14 (2002):267-86.
5. J. Seikkula. “Open dialogue approach: treatment principles and preliminary results of a two-year follow-up on first episode schizophrenia.” Ethical Human Sciences Services 5 (2003):163-82.
There are also now groups in the United States and elsewhere seeking to “replicate” the open-dialogue model, and if Dr. Torrey likes, I could point him to a conference that will be held in Finland in late August devoted to this topic. Many others, who have read the published articles, apparently are “impressed” by the success of Open Dialogue Therapy.
Part Three: What SSI and SSDI Rates Say
In this part of his review, Dr. Torrey states that while the number of individuals on disability for SSI and SSDI has “indeed increased alarmingly,” he argues that this is because these programs “have become alternatives to welfare for poor and unemployed individuals who have any kind of psychiatric problem.”
I agree this is partly true. But, as I detail in Anatomy of an Epidemic, our drug-based paradigm of care is fueling this epidemic too. One, the widespread use of stimulants and antidepressants has helped create a “bipolar boom” and the disability numbers are soaring, in large part, because of an extraordinary influx of bipolar patients. Two, a review of the long-term outcomes data for antipsychotics, anti-anxiety agents, and antidepressants reveals that these drugs, in the aggregate, increase the risk of long-term disability.
Part Four: The Dopamine Receptor Story
This section of Dr. Torrey’s review has its interesting moments. He writes that if antipsychotics do indeed cause an increase in dopamine receptors (as I report in Anatomy of an Epidemic,) then “Whitaker is correct that this could potentially be a serious problem, but at this point in time the reality of the problem in humans is unknown.” Although antipsychotics have been shown to cause an increase in dopamine receptors in rats, he writes, it “still is not clear whether or not this also occurs in humans.”
But as Dr. Torrey well knows, there is in fact good evidence that it does indeed occur in humans.
As Philip Seeman first reported in Nature in 1978, the brains of schizophrenia patients at autopsy have 50 percent more dopamine receptors than controls. But at that time, Seeman and his collaborators were uncertain whether this increase in dopamine receptors was due to the disease, or caused by the antipsychotics. During the next decade, investigators in the United States, England and Germany investigated this question, and all determined that neuroleptics led to an increase in brain dopamine receptors.
“From our data,” German investigators wrote in 1989, “we conclude that changes in [receptor density] values in schizophrenics are entirely iatrogenic [drug caused.]”
Finally, in 2002, Seeman reported that, in a study that utilized positron emission tomography, he had documented this increase in dopamine receptors in living patients. This study, he reported, “demonstrates for the first time, using in vivo neuroreceptor imaging, that dopamine D2 receptor binding is increased after long-term treatment with antipsychotics in humans.”
Here is why this is so important. This increase in D2 receptors is thought to make patients more biologically vulnerable to psychosis. The increase may lead to severe relapses when patients abruptly withdraw from antipsychotics, and the worry is that it also leads to tardive psychosis—a deepening of psychotic symptoms—over the long term (when patients stay on the drugs.) In his 2002 paper, Seeman also found that those patients that had the “highest degree of D2 receptor upregulation” subsequently developed “severe and persistent tardive dyskinesia.”
So, in this instance, give Dr. Torrey credit for acknowledging that a drug-induced increase in dopamine receptors could be a troubling thing indeed. But when he writes that it is “not clear whether or not this occurs in humans,” we have a new moment of dishonesty in his review to tally up.
I could point to many other instances from Dr. Torrey’s review in which he hasn’t accurately represented what I wrote in the book, or has misrepresented the research literature. But detailing all such problems would take several thousand words more, and so I will let those pass.
However, there is one final bit of miscellany in his review that I want to address, and it has to do with Loren Mosher’s ouster from the NIMH.
Dr. Torrey states that Loren Mosher was not ousted from his position at NIMH as head of the Center for Schizophrenia Studies because he had led the Soteria experiment, but because the field “was moving strongly in a biological direction” and thus Mosher held views of schizophrenia that were at odds with this new wave in psychiatry. Dr. Torrey then writes this of my reporting on Dr. Mosher’s ouster from the NIMH:
“What is perhaps most surprising in Whitaker’s book, given his past career as a respected journalist, is his willingness to uncritically accept anything he has been told as long as it fits his thesis and his wish to blame antipsychotics for everything except global warming.”
The story of Dr. Mosher’s fall from grace at the NIMH is, in fact, easily documented, and it indeed is associated with the Soteria project. As internal written records reveal, the psychiatric establishment began attacking Dr. Mosher the minute he reported good outcomes for his Soteria patients. The study had “serious flaws,” the NIMH review committee snapped. “The credibility of the pilot study is very low,” it wrote. Evidence of superior outcomes for the Soteria patients is “not compelling.” And so on, and then, after the initial reports appeared the committee hit Mosher with the lowest blow of all: It would approve further funding for the Soteria project only if he was replaced by another investigator, who would then work with the committee to redesign the experiment.
“The message was clear,” Mosher said, when I interviewed him years later about the Soteria project. “If we were getting outcomes this good, then I must not be an honest scientist.”
When I reported this story in Mad in America, I obtained the written documents that detailed this response to Loren Mosher’s Soteria experiment. Those documents laid bare the hostility of the biological faction within psychiatry toward his study, and toward Mosher personally because of it. So rather than accept this story “uncritically,” as Dr. Torrey suggests, I dotted my I’s and crossed by T’s. In fact, this was the same reporting path–a reliance on documents–that led me to write Mad in America and Anatomy of an Epidemic. If I had been willing to “uncritically accept anything [I] had been told,” then I would have written about the wonders of the “psychopharmacological revolution.”
Dr. Torrey’s Review as a Foil for Assessing the Merits of Outpatient Commitment Laws
The fact that Dr. Torrey has written a scathing review of Anatomy of an Epidemic, asserting that I “made so many errors it is difficult to know where to begin,” is—in its guise as a book review–of little import. I had exchanged a couple of emails with him before his review appeared, and I knew this was coming. You cannot write a book like Anatomy of an Epidemic, which so directly challenges conventional beliefs, and not expect to be attacked, and it should not be surprising when the attacker misrepresents what you wrote, or twists things in order to try to publicly discredit you. Indeed, in the two years since my book was published, I have gotten quite used to reviews of this type, with defenders of the faith eager to inform readers that all is well in the world of psychiatric medications.
But here is why the review could be considered important to us as a society. We are embracing the increased use of outpatient commitment laws that force people to take antipsychotic medications, and we do so under the belief that these drugs are a necessary good for those people. This is an extraordinary thing for a society to do, to force people to take medications that alter their minds and experience of the world.
Yet, here is the story told in Anatomy of an Epidemic: If we look closely at Harrow’s study and a long list of other research, there is good reason to believe that these medications increase psychotic symptoms over the long-term, increase feelings of anxiety, impair cognitive function, cause tardive dyskinesia with some frequency, and dramatically reduce the likelihood that people will fully recover and be able to work. If this is so, how can we, as a society, defend our increasing embrace of forced treatment laws?
We can now ask this key question about Dr. Torrey’s review of Anatomy of an Epidemic. Given that he is a foremost proponent of outpatient commitment laws, what are we—as a society—to make of the fact that, in order to attack the book, he had to do so in a dishonest way?
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Torrey’s a forced drugging lobbyist and carnival barker, with an entirely unremarkable career apart from his sordid legacy of increasing the use of forced drugging. If he hadn’t hoodwinked a rich family into believing their kid had a ‘brain disease’, he’d be a forgotten nobody by now. In 50 years he’ll be remembered as one of the ugliest lobbyists for medical atrocities in the history of America. It should come as no surprise that he lied in his book review, his clown prince deputy forced drugging lobbyist DJ Jaffe regularly shows us the kind of dishonest tactics their lobbying involves. The story of the forced treatment advocacy center is one of the most appalling stories of quacks who don’t know and can’t prove jack about anybody’s brain, being evil illiberal busybodies who seek to push brain altering drugs on the public by force.
Why did he take two years to review the book? does he regularly review books? or only ones that threaten his belief system?
Honestly, I am highly skeptical about his motifs as to his own family history and how much he was really “affected” by that. It’s a tearful story of a bright scientists who goes on a quest to solve mental illness because of the personal tragedy. Well, I’ve been in a relationship with a guy who proclaimed the same kind of concern for the fate of his sexually abused sisters and he turned out to be a psychopathic individual who tried using psychiatry on my to cover up emotional and at times physical abuse. It didn’t work quite as well as he intended but I escaped only thanks for my “paranoia” and my family and people around who saw through him. So I am very wary of individuals like that who proclaim things like that. Maybe I’m wrong about Mr. Torrey and he’s just extremely misguided and has convinced himself about his ideas to the point he’s going to die defending them but I’d just in general be careful with people using tearful family tragedies for personal advancement.
Readers should know that Dr. Torrey’s viewpoints do not have much favor with most psychiatrists, and certainly not with me. He is viewed as being on the fringe, though he should be given a chance to try to prove his theories about whether something biological causes certain problems.
I also just saw his review and was appalled by most of what Mr. Whitaker just rebutted, but even more so that Dr. Torrey just found out that the pharmaceutical companies controlled the Texas Algorithm Project, which greatly influenced the prescribing of new and expensive psychiatric medications in Texas. I, and many other psychiatrists concerned with the influence of pharmaceutical companies have known this for many, many years and adjusted our practices accordingly.
Finally, a reflection on outpatient commitment. Often, it is better, and more humane, than inpatient commitment if there really is some danger. Psychiatrists, of course, are not required to continue or prescribe medications in such cases. I know I sometimes decrease or stop them, or recommend psychotherapy instead. The outpatient commitment requires coming to treatment as long as recommended, but not which treatment, or actually any treatment at all. Now I realize that many will not agree that any sort of commitment is needed at any time, but think of the homeless who die on the street when they don’t need to, the suicides in those who have never received any treatment whatsoever, and the violence that could be prevented.
@Steve, I remember when I was trapped in the mental health system as a child and the constant fear I lived in of the psychiatrists. I had so many bad reactions to drugs that by the time I was 13 I was so apprehensive of future appointments that I wound up out of school because I couldn’t sleep due to the anxiety, a problem that wound up putting me in a state mental hospital for 4 and a half months on Haldol. If I ever was forced to have to see a psychiatrist under court order, I would probably kill myself, even if that psychiatrist didn’t immediately want to put me on drugs, but as long as I knew he had the power to do so, I would not be able to live with the fear. You should think about that.
I know the fear you are talking about. My son is terrified of psychiatrists and their power.He doesn’t dare to speak up and feels constantly like a prisonner on the run, just in case…
This fear is such a terrible indictment of psychiatry.
Yep, I would suicide as well.
I really, truly hope things never get to the point that you are forced to suicide out, but I will support your decision. And I’m glad that I didn’t have to scroll through all 238+ comments here, to reply!….
I hope it doesn’t come to that, either. I have very good social skills and so far I’ve always been able to engineer my way out of hazardous situations, but if I’m finally cornered I won’t hesitate for a moment to hit Eject.
It doesn’t take a rocket scientist to figure out that people who are homeless are homeless. This means they don’t have a place to live. It also doesn’t take a rocket scientist to figure out that being warehoused in a foster care facility and doped up to such a degree that you cant’ respond, think or feel anymore isn’t a humane alternative. It also doesn’t take a rocket scientist to figure out that when you go to jails and diagnose people with a mental illness, and say they weren’t getting treatment and give this as the reason for their behavior, this doesn’t magically erase the fact that (as stated above in the whole article this blog is about) “treatment” doesn’t fix the situation; and diagnosing them in order put in place a system which doesn’t help them isn’t going to help them. And it doesn’t take a rocket scientist to figure out that all of this isn’t going to help prevent suicides either. That people with a diagnosis for a biological condition that doesn’t exist, and who are given “medications” some of which have the warning label that they can cause violence and suicide, and who aren’t given any true therapeutic help aren’t going to be helped with their suicidal tendencies. And when they aren’t helped, and things get worse, this doesn’t mean that there should be involuntary treatment. It doesn’t take a rocket scientist to figure out that someone who doesn’t get any treatment whatsoever is more likely to come through in a positive manner.
And it doesn’t take a rocket scientist to figure out that just because you have a group of magnets that one can tack onto a problem and act like it’s solved, much like you’d attach them to your refrigerator: there is a difference between human beings and refrigerators. No matter how many years went into studying which magnet to put where, and how many degrees you have in it.
mental illness does not and cannot cause homelessness. Homelessness is a totally different situation, and one that I have been in. I was homeless for the same reason I was labelled as mentally ill for growing up in a pedophile ring. The ONLY way I could stop the abuse was to live on the streets. And of course my attempt to get help and treatment, resulted in me being forcibly drugged. The drugs did not help. I was unaware that there were anti rape syndrome drugs. How can you drug someone to the point of allowing them to recover from the torture and trauma that I went through – the fact is you can’t. Common sense says that, and most of the kids at the local special school would have the intelligence to work that out. The fact that psychiatrists can’t says more about them.
Most of the people I know who are homeless are homeles to get away from the system and how it is treating them. ANY accommodation they are given is based on them taking medication. These people want and are desperate for help, but when that help is so torutrous that you would rather die, then one really does have to question how a doctor in a white coat, with a medical degree from college can call that a sucess.
What people need when they are in acute states of distress is simply for people to be with them, not to force toxic drugs, electricity or the like through there brains. They do not need to be stripped naked and locked in bare concrete rooms as a way of supposedly calming them down!!
If someone is suicidal, the most logical thing to do would be to find out WHY they want to die. Not rocket science, just common sense. No one wants to die for no reason, find out why and you may be able to address it. Telling them it is an irrational belief and sedating them or numbing them doesn’t help and will not help.
As for the rates of disability other countries are the best evidence of that. Most developed countries do have ongoing and unlimited unemployment benefits through a social security type system. There are people in all of these countries who have been on such benefits for over 20 years. There are whole generations of people growing up on them and then going onto them themselves. Despite this these countries still have massive increases in disability pensioners. And many of these countries have made massive changes to the criteria for entitlment to disability benefits. Within Australia every 5 years or so the criteria are getting tigher and tigher, one has to be more and more and more disabled. Those on them now, simply would not meet the current criteria, it really is as simple as that. Despite that those on them for mental illness are the ONLY group that is continuing to increase and this is happening at much higher rates than population increases. Yet for ALL other disability types it is decreasing. ALL other disability groups are having increasing numbers of people work in open employment. Those labelled at mentally ill have employment rates that are lowering and they are now setting up supported employment services/sheltered workshops for those labelled as mentally ill as no one else knows what to do with them.
The other thing I can say is that before I read Whitakers books I believed that these medications were just like insulin for diabetes. I have always found it ironical that in recent years they have began to justify the bad outcome rates with low levels of social support. A diabetic does not need socail support. They just need insulin and a bit of education about how to manage diet, measure the insulin, test themselves, etc. Type 2 is a different thing, but type one who are not able to produce any insulin in there own bodies, do not require social support they just need the medication!! And if these medications were the cure all they have been promoted as, then WHY do people need socail support as well. If I am to understand conventional wisdom I would know that these medications CURE the condition if the person stays on them. Now they claim they need intensive socail support as well, they need everything under the sun, but of course they still need the medications as well!! Why not at least do a study in which you give people ALL the socail support they claim these people need, and then only give half the medication as well. Then we will truly see what is having the most positive benefit. Strange how these studies don’t exist!!!
“think of the homeless who die on the street when they don’t need to, the suicides in those who have never received any treatment whatsoever, and the violence that could be prevented.”
Steve, we should also think of those who die 25 years earlier than average due to the mental health system, the suicides of those desperate to escape the terror of psychiatric coercion, and the violence that is caused by psychiatric drugs.
“Finally, a reflection on outpatient commitment. Often, it is better, and more humane, than inpatient commitment if there really is some danger.”
To round up the homeless and drug them by force with tranqulizer drugs is not “humane”, it is the violent and forced meddling by society in that person’s biology. Biology neither you nor Torrey can prove is diseased.
I suggest you Dr. Moffic, UNDERGO having the state confiscate your body from you, and forcibly drug you in your own home, before you comment on what is “humane”.
You like to talk about violence and crime, what about the violence and crime the government is committing when it assaults the dignity of the citizens it targets for forced drugging?
Do you NOT see how the WIDESPREAD FEAR these policies inspire in many people is counterproductive to recovery?
Do you NOT see how the WIDESPREAD FEAR that people are going to wind up being forcibly drugged in their own homes (which is what outpatient commitment is), is going to DISCOURAGE people from risking any contact with psychiatry?
Do you NOT see this Dr. Moffic?
Do you NOT care? Do you AIM to terrorize all of us?
What gives your pathetic pseudoscience of a profession the right to impose itself on any and all human beings in society? especially considering you can’t prove a single human being you label ‘brain diseased’ actually has a diseased brain? (and I assume you don’t propose to include objective evidence of brain disease in your threshold for forced community drugging).
What part of NO don’t you understand?
I would rather be homeless than be terrorized by the designs you seem to have on our bodies!
Dr. Moffic I’ve never broken into your home, I’ve never violated the bodies of you or your family members. Why do you seek to violate my body?
If not you, then why do you seek to allow the government to empower your colleagues to violate my body? Don’t you see how violent the actions of your profession are?
“Of all tyrannies, a tyranny sincerely exercised for the good of its victim may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience.” – C. S. Lewis
I’m amazed anew every time how they don’t seem to realize the fear that we live in. Do they truly not get it, or do they simply not care?
It’s BOTH, *AND*, the pseudoscience lies of biopsychiatry attract evil sociopaths and psychopaths, who are pure sadists…. The don’t get it, and they don’t care that they don’t get it…. A couple years ago, I was fraudulently arrested and charged by a cop who also raises money for NAMI, and the local CMHC…. Our fears are REAL…
I find this 1996 article (below at the end of my comment) to be of the same tone as Moffic’s comment above where Moffic writes:
“Now I realize that many will not agree that any sort of commitment is needed at any time, but think of the homeless who die on the street when they don’t need to, the suicides in those who have never received any treatment whatsoever, and the violence that could be prevented.”
#1 Psychiatry is not the answer to homelessness
#2 Just because people are homeless does not mean they are “mentally ill”
#3 Prevention of suicide is not necessarily preventable with the drugs (treatment)psychiatry offers as a solution
This article is an example of the indoctrination of psych med based psychiatry paradigm Torrey et al boast as “solutions” he is a self-appointed leader in the field of “schizophrenia” and his (Torrey’s) spewings of delusions are a platform many believe, which is scary–and fearmongering. Torrey and TAC send the message that people are violent and need to be removed, he promotes out patient drugging by court-orders and is all around bizarre. He called himself ‘delusional’ when I heard him speak in public–and his platform needs to be retired and buried along with the over-dx’ing and over-drugging of Americans. In Torrey’s own words, he said everyone has the virus that carries bipolar and SZ and it is unknown who will “get it”.
Honestly, consider the source when it comes to Torrey, the only problem is, he has full mainstream media attention when he opens his mouth or writes something, which pushes his message in constant forward motion.
1996-American Dream: Help The Afflicted Get Off The Streets
“Torrey’s solutions: First, single-source funding and accountability, preferably at the state level, for treating the mentally ill. “If mentally ill homeless people are overrunning the local parks, everybody should know whom to call,” he writes. “If the mentally ill are overflowing the local jails, everybody should know whom to call.”
Second, compelling mental patients to take their medication as a condition for staying out of the hospitals. For the majority of patients, the medications do work. But many patients lack what Torrey calls “insight” into their diseases. They have no awareness that they are ill and see no need to take medicine.
Third, recognition that mental illness is an organic disease, not a freely chosen alternate lifestyle; not the result of poverty, racism and the injustices of the capitalist system; not a government plot like fluoridation of water and black helicopters.”
–1996 article above
Seriously, “fluoridation of water” IS a “government plot”. There is NO known biological mechanism by which the fluoride added to drinking water is then extracted by the human body, and deposited on, or otherwise used to build up and protect teeth. The impetus for fluoridation came in the early – to- mid 20th Century, from marketing and “Public Relations” types, as a way to extract tax funds from municipalities, by selling fluoride. The fluoride was supplied by the growing chemical processing industry, using wastes from bauxite mining operations for aluminum. Repeat: There is NO known mechanism by which the human body uses fluoride. Fluoride is in fact highly toxic. Just sayin’!….
It’s a corporate-government plot. As a toxic industrial b y-product fluoride would be difficult and costly to dispose of. So corporations came up with a great idea. Dump it in the water reservoirs for Americans citizens to ingest– and claim it prevents tooth decay. They saved millions of dollars.
may slightly decrease tooth decay when placed on the teeth, but it is a toxin when absorded into mucous membranes.)Seth Farber, Ph.D.
About “medications” when they are in an “outpatient” setting: “I know I sometimes decrease or stop them, or recommend psychotherapy instead.”
Sometimes? What is this some aleatoric setting that allows one to act open minded because “sometimes” one actually does the logical rather than the programmed (which has been shown to be detrimental)?
And no, what’s left over after the “sometimes” chip isn’t going to magically stop homelessness or the rest. I somehow can surmise that if all the money and effort spent on outpatient and or inpatient pro drugging actually went to treat the people as humans not as faulty chemistry and/or genes, that there would perhaps maybe even be enough left over for some housing for the homeless.
Your post reminds me of my recent visit to a physician who demanded I see a psychiatrist. She decided to misinterpret my frustration with current treatment as a mental illness.
What was laughable was that she said that seeing a psychiatrist didn’t necessary mean I would be prescribed medication. Since medications are the only thing that most psychiatrists know to offer as a treatment, I found that quite statement quite idiotic.
Same with outpatient/inpatient commitment. Most psychiatrists feel that a patient wouldn’t be under a commitment order unless they were a danger to themselves and the only thing that is going to arrest their condition is drugs.
So even if they aren’t required to continue medications, I find it very hard to believe that most of wouldn’t in light of the so called standard of care that exists in psychiatry.
By the way, commitments aren’t preventing suicides. When my state was threatening to pass stronger commitment laws, I worked with people who said they were suicidal every day but then said that hell would freeze over before they would seek help.
It always intestes me how so many people can defend mandated in or outpatient treatment when they’ve never expeerienced anything about what it’s like themselves. How can they be such experts on this when they themselves know very little or nothing about it. I wish that I could put them into mandated treatment for thirty days and see what they think about it then. They write the order that creates the forced treatment for someone and then they go blithly on their way, back to their own house and to their own pursuits, with no constraints on them as to what they want and can do.
“It always intestes me how so many people can defend mandated in or outpatient treatment when they’ve never expeerienced anything about what it’s like themselves.”
It always interests me how so many people can defend cancer treatment (peace negotiations, the necessity of jails, etc) when they’ve never experienced anything about what it’s like themselves.
This is the weakest argument around.
Yes, I can see that when you have to defend something that hasn’t been proven to help, that you say experiencing that it doesn’t work is a weak argument.
And it’s an amazing turn to try to compare peace negotiations with involuntary commitment. Is the lack of involuntary commitment procedures also something that would prevent the “big bang?” IS the singularity that created the whole Universe and that EACH and EVERY one of us is part of, is this something that would be prevent when certain people aren’t separated from it?
Yes folks, people that aren’t for involuntary commitment and the nuclear bomb are against “https://www.facebook.com/peace negotiations” because they have never experienced what it’s like….
Sorry my clipbook added that fragment of an address there…..
Just a reminder: “Peace negotiations” are usually done by the people that started the war in the first place, and never listened to those who were non violent and had a different solution that would have prevent the whole war. “Cancer Treatment” for the most part has become a big business $$$$$$$$$ and many natural cures that have been proven to heal what “Cancer Treatment” has no cure for wouldn’t be allowed in “Cancer Treatment.” The countries with the least “necessity for jails” like Norway also have the least crime.
People defend commitment for different reasons. I believe that most people defend it because they see people struggling and/or suffering and they don’t know of any other way, and can not envision another way because of our current system and how media portrays mental health.
No one wants to see loved ones die from suicide. Most people would like to see reduced homeless rates. When our system has limited options, and often those options in any given area very coercive services, it leads to people having negative views on autonomy and ability to recover. I am not saying that this justifies forced treatment but I think it plays a role in why people defend and use it.
Those who can envision a better way have to stand up and create a vision for other and work to change current negative systems. Allowing people to have a variety of options in ways in which they can receive support. Letting people be able to retain their autonomy while supporting a person in increasing hope, feeling empowered in their life, taking self-responsibility, and developing roles within a community. If you work to engage people and are genuine people are more likely to be interested in receiving support/ service versus a system that takes away your right and ability to chose. If a person wants to try medication, having a system that offers a clear picture of what meds target and downsides to these medications.
The pharmaceutical companies spends millions of dollars to sell medications as the answer, as well as to lobby to make sure that they are an integral part of the mental health system. It is going to take people standing up and pushing to try different things new things, which show that medications should never be the foundation of a system, and that there are other ways to help people besides forcing people.
It’s always most be people, isn’t it Paul Duncan? I believe it to be one of the preponderant misconceptions of our society that most people care and want to help. It is little more than a diaphanously veiled anthropodicy, a vindication of humanity in the face of the overwhelming, nay, even ‘truly mountainous’ amount of evidence aligned against it.
Sadly, it is prescribed by custom these days to say that it is always the majority that are right and well-meaning. Yet the history books protest.
I think a lot of the staunchest defenders of this undefendable practice are just plain intolerant.
Many of the psychiatrists who lobby to consolidate the hold psychiatrists have on their slaves or to increase it are sick to death of being reminded of their crimes by survivors and the critics of psychiatric orthodoxies, pining for the days when they could just hack at your juicy, tender lobes, safe and secure in the knowledge no-one wants to listen to listen to the protests of a social leper.
Is outpatient commitment better than inpatient? Is that a relevant comparison?
Bob Whitaker, following in the tradition of psychiatrists like Joanna Moncrieff and Peter Breggin and others, has documented the very harmful effects of routinely prescribed psychiatric drugs.
The psychological effects are discussed above. But in addition in the book Bob documented numerous physiological problems. The effects of these drugs has become more toxic in the last couple decades because psychiatrists now, in an effort to appease their drug company reps, tend to prescribe “cocktails” of these drugs– typically 5 or 6or 7 drugs or more per patient–instead of 3 or 4 as was the practices in the 1970s. This causes “polypharmacy psychiatric drug illness.” which includes cognitive deficits, obesity, diabetes, cardiovascular
problems, thyroid dysfunction, respiratory disease, diabetes, metabolic illnesses, and
kidney failure, to name just a few. Whitaker notes “the physical ailments
tend to pile up as people stay on antipsychotics (or drug cocktails) for
years on end.” The drug consuming patient’s mortality rate is generally shortened compared to rest of the population by 20-25 years––the quality of her life emotionally spiritually and physically is miserable.
Considering the lack of evidence that their efficacy is greater than active placebos, and the evidence that alternative treatments are far superior when judged by quality of life criteria, the objective researcher can’t help but infer that the cost/benefit ratio of psychiatric drugs is one severely prejudicial against the interests of patients. The beneficiaries of the use of these poisons are mental health professionals, particularly psychiatrists, and the drug industry. The psychiatric-pharmaceutical industrial complex is like a parasite that gets into the bodies of their hosts and starts consuming like a flesh eating bacteria––body AND soul. Psychologically, as Bob points out above, the patients
rarely recover their autonomy.
Back in the mid -80s the State Supreme Court of New York in Rivers vs Katz held it was unconstitutional(State constitution) to force patients to ingest psychiatric drugs. There were federal appellate Court
judgments that also ruled forcing drugs on patients violated their constitutional right to liberty and autonomy––the liberty to have control over one’s own body.
What right could be more sacrosanct, Dr Moffic than the right to determine what one puts into one body––the right over one’s body? Would you trade yours away if you had a buyer? At what price? Because the price you offer “the mentally ill” is very cheap.
In exchange for professionals’ promise to look over them if they should become suicidal or homeless you want them to agree to the expropriation ( a fait accompli today) of their constitutional liberty-right in the event that professionals––the same professionals who have destroyed them body and soul over the course of the 20th century–– deem that they constitute “some danger.” And you tell them not to worry in regards to outpatient commitment because after all they might be under the control of a humane psychiatrist like you. You write, “I know I sometimes decrease or stop them[drugs], or recommend psychotherapy instead.” Well la di da. Let’s throw out our precious constitutional heritage and replace it with rule by Psychiatrists.
Maybe you do sometimes decrease drugs, but that is just not good enough. The threat to constitutional liberties comes today
from all quarters, including “liberals” like President Obama who signed the NDAA Bill vitiating due process for citizens suspected of aiding terrorism.He has also attempted to silence whistle-blowers. But my concern here is the rights and well-being of those labeled “mentally ill.” You ought to be supporting these rights Dr, instead of making excuses for outpatient commitment. And besides Dr Moffic
MOST shrinks will NOT decrease “medications.” I’ve known many people in fored commitment–and not one was offered the option of lowering their dosage, let alone getting off the poisons/ Once one becomes financially indebted to the drug industry, one’s practices begin to change–even if one hopes to resist. That is what the research shows. That is the problem with the FDA. Yet you urge people to support AOT because “of the homeless who die on the street when they don’t need to, the suicides in those who have never received any treatment whatsoever, and the violence that could be prevented” DR Moffat there are many people who could use decent housing but prefer to live in the street than take psychiatric drugs. I know another psych survivor who was an activist for psychiatric reform for 30 years. When her mother died she became homeless 5 years ago. She was too old to survive in the street; she moved into a half-way house where she is forced to take psychiatric drugs. She shakes like a person with advanced Parkinson’s–in just five years. That’s tardive dyskinesia. And suicide? What is shrinks’ prescription for that? Anti-depressants. The suicide rate is 5 times greater among patients on SSRI anti-depressants, like Paxil. Instead of speaking out for the right of patients to have access to reasonable housing without being forced to take psychiatric drugs, you tell activists here they should accept forced treatment because otherwise patients will be homeless. And besides they might get a good shrink like you who decreases their “meds.” Why can’t they have the services without the poison? They don’t need to be FORED into decent housing. Or a support group.
Are YOU standing up for their right to LIBERTY AND SERVICES. No instead you come here and urge patients to make a deal with the Devil. Or more
aptly with the Grand Inquisitor. (I suggest you re-read Dostoyevsky’s parable–it’s relevance has not faded, unfortunately.)
Even if the substance was vegan tomato soup instead of poisonous drugs, should not the
individual have the right to decide what to put in her body? The Courts in the 1980s were not convinced by the argument that patients were “mentally ill.” “Mental illness” is a “clinical” category that did not necessarily vitiate one’s competence to make decisions about one ability to own one’s own body. (As a student of Thomas Szasz I don’t believe in mental illness, but that is irrelevant to the point I’m making here.) These rulings were blows for the liberty rights of patients. There was just one problem. The lower Court judges ignored the meaning of the rulings.
Patients in civil hearings were overruled by judges who deferred to the determinations of hospital psychiatrists. According to the latter any patient who refused to take her “medication” was ipso facto incompetent to make her own medical decisions! As Bob argues there is no longer ANY rationale for that determination.
Once you take away the rights of individuals the power of parasitical industry grows. And this happened in the 1990s when state after state passed out-patient commitment Bills based on the argument previously rejected by higher Courts that psychiatrists could force patients into out-patient treatment. In many cases these Bills were rammed through State congresses in the name of public safety.
If public safety was endangered by a small subset of mental patients, this was not because they did not take their meds–– as argued by the APA, NAMI, and NAMI’s patron saint E Fuller Torrey with the backing of virtually the entire “mental health” system.
There were a variety of factors. In NY Kendra Webdale was the victim of a mental patient who not only failed to receive therapeutic treatment (not drugs) for his emotional troubles (they never do unless they can afford private treatment, or are near one of the support groups of TIP or Mind Freedom) but who never suffered any criminal penalty for his long history of assaulting innocent persons. So the message give to Andrew Goldstein was: “You can continue to assault people and you will never be held responsible because you are mentally ill, and incapable of responsible behavior.” Thomas Szasz had always cogently argued that “patients” should be treated like other citizens, and accorded the same legal rights and responsibilities as other citizens. Any other policy will have socially detrimental consequences. Any other policy is a violation of the principle of equality upon which our society is supposedly based.
The answer is not now, never was, and never will be to place power in the hands of the Psychiatric Grand Inquisitor. It is not to convince activists to trample on the constitutional rights that differentiate democracy from tyranny. We have witnessed the abuse of power that results from placing our trusts in experts and corporations. Have you learned nothing from Bob’s book?. Perhaps you should read The Myth of Mental Illness. But at any rate you should PUBLICLY as a psychiatrist oppose forcing citizens to ingest psychiatric poisons. You should heed the words of C S Lewis who famously wrote, “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”
Seth Farber, Ph.D., author of The Spiritual Gift of Madness: The Failure of Psychiatry and the Rise of the Mad Pride Movement
You need to know that I will suicide if I ever have such a commitment applied to me. Absolutely, 100%, and I will still do it even if it is rescinded. I will not live in that world. Your system will lead to my death, rather than prevent it.
I’m glad you admit that inpatient commitment is inhumane; that it most certainly is.
I would rather be homeless and die in the street, or by suicide, than take what you’re offering, and I am far from alone in that preference. You can prevent a lot more violence by imprisoning the entire population (just to be sure). Why not turn the whole world into a giant gulag?
Sadly, I think the whole world IS turning into a giant gulag…. If Trump or Bernie win, we’ve got hope…. But Cruz and the Hildebeast are 2 of the 4 horsemen of the Apocalypse!…. lol
I’m just glad that I don’t have children, because I have no investment in the future. I can see where it’s going. Of all the tools humanity has refined to a high art, the Cage has to be at the top.
Thanks for calling a spade, a spade. Your efforts to have helped to save my life.
At 16, I took these medications on the advice of experts. I believed they could help me. After 17 years of “treatment” I was left cognitively impaired, physically sick and dependent on these drugs. Over the years I plead for new solutions. Doctors responded to my concerns by reminding me of the severity of my “condition(s)”, upping doses and mixing new cocktails.
Two years ago I began to taper myself off of these drugs AMA. I am now beginning to recover speech, memory, muscle control and a kind of spirited will that I’d lost a long time ago.
I’m braced for the long haul as there is still lots of healing to do and the withdrawal process is indeed a challenge. But, thanks to MIA and the peer movement, I’m on my way.
With overwhelming gratitude,
You’re amazing Vanessa. Keep going.
I know exactly what you mean Vanessa. I have now been totally drug free for almost 5 months and the amount my body has managed to recover is beyond me. I am by no way healed, I have massive problems and struggle to know what to do, but at least I have my body now, something I did not have before. Like you I had to do it against medical advice, in fact my family doctor refused to see me anymore because I was lowering the dosages of my medication. This was despite the fact that i was remaining well, regaining functioning and the like.
What i can say though is don’t give up. Many of us have trodden this journey and we are thriving as a result. Like you I will be forever grateful to Robert for what he has done in telling the truth. It needed to be told.
Thanks for this Bob!
Let me share with readers that forced outpatient commitment is a current topic. NAMI Ohio has made the loosening of current outpatient commitment laws their “number one priority.” For the last few months their Director has been trying to gather support around the State for a “bill” that would greatly relax the standards around depriving someone of their civil liberties.
Some have said that outpatient commitment is just “another tool in the toolbox” I’ve responded that it’s not a tool I want or any of us should want. The outcome of this struggle in Ohio is still in the balance, but Bob’s post here will be helpful in the ongoing efforts to defeat such a horrible policy.
Sadly these brain rapists don’t know when to stop. Their cult of brain blaming, and their messianic faith in its unproven premises, is more important to them than the liberty of their fellow man. The reason for this is, they don’t even view the people whose rights they are trying to destroy as equal human beings. Arguing with these fundamentalists is like talking to a rock.
NAMI is one of the most insidious organizations in this country. It’s allied itself with the drug companies, biopsychiatry, and the government and is determined to keep all of us on those toxic drugs. And they do all of this so that they will not have to face up to the fact that the anguish that their family member experienced or experiences is due to something that’s not right in the family. They do not want to shoulder any responsibility for the possibility that their parenting wasn’t worth diddly squat and are willing to destroy the person rather than fess up to inadequate parenting. Sometimes I think that the people in NAMI are actually worse than the biopsychiatrists because they’re willing to sacrifice their family member to save their own reputations. How can anyone do that?
Thank-you, David C. Ross You know, it’s ironic. Now, almost 4 years after you wrote that comment, former Ohio Gov. Kasich is running for President. I have heard – and I’m hoping you can add direct observation – that Kasich “balanced” Ohio’s budget partly on the backs of so-called “mental patients”, by making it easier to commit them to private, for-profit clinics.
And that the plight of those deemed “mentally ill”, has in fact worsened.
I can TESTIFY, that NAMI has done far more harm than good here in New Hampshire.
The whole “community mental health center” SCAM has done far more harm than good.
Here, so-called “mental patients” are still used as pawns bargaining chips, and cash cows, by all the little 501(c)3 “agencies”…..It’s appalling. And, yes, it’s GENOCIDE.
In 1982, after eight years of unsuccessful psychiatric treatment for a condition diagnosed as schizo-affective disorder, I quickly regained my mental and physical health with orthomolecular therapy.
In 1984, I attended a meeting where E. Fuller Torey addressed a large audience of people concerned with mental health in the community. Representatives from the National Alliance for the Mentally Ill also spoke and encouraged formation of a local Chapter of that organization.
When Torrey finished speaking and called for questions from the audience, I started to relate my experience with orthomolecular therapy. Dr. Torrey became enraged and chanted over and over again, like a mad man, “The studies have been done! The studies have been done.!” Then he took another question from someone else.
After the meeting, a woman approached me and asked me to share with her what I was going to say before Dr. Torrey cut me off. I later visited her at her home and met her husband who had a long history of schizophrenia and her daughter who suffered from exposure to dioxin. The power company had sprayed defoliants beneath the high tension lines that ran next to their property and where many kids liked to play.
The whole family went on the orthomolecular diet and supplement program from the same lab I used. Within a few months the husband had had a remission from his schizophrenia, the daughter had recovered her health, and the mother, who had endured years of stress caring for the other two, became a new woman.
Since no one had started that local NAMI chapter yet, she and I decided to do it. We obtained a charter from the organization, secured a room in the public library and began to have regular meetings. Of course, we shared our experience with orthomolecular therapy with all who attended.
Soon, more and more parents and relatives of “clients” of the local mental health counseling center began to attend regularly and voice their objection to our sharing of information about orthomolecular therapy, and persisted in turning the discussions to the subject of psychiatric medications and involuntary commitments. The library then suddenly needed the room for other uses and the group moved to facilities at the counseling center were my friend was voted out of the presidency of the chapter, and our further attendance was pointless. However, we both learned a lot from the experience.
subvet416–I’m glad to read someone else heard him speak and witnessed that wild behavior of Torrey’s, unbelievable. I saw him speak to hear it for myself—
Congratulations on your success with Orthomolecular Medicine!
It’s good stuff!
This link has some information on Orthomolecular Medicine, for anyone interested –
Fortunately for me, I had been working for a government contractor doing weapons testing. An engineer once asked me why I was shaking so much and I told him I was taking lithium for a bio-chemical imbalance. He said that was crazy because lithium (a nuclear bomb element) was poisonous in any amount and to look it up in the US Chemical Abstracts and that the doctor who prescribed it for me must be a quack.
Another friend told me that if I really wanted to know about lithium, I should get Walter Russell’s book “Atomic Suicide?”. After reading it, I started a correspondence with his widow Lao Russell and visited her in 1982. She suggested I use the services of Analytical Research Labs in Phoenix AZ, which enabled my rapid recovery. http://www.arltma.com
I then learned that ARL was being used by the National Labs for security clearances as they had the ability to print out a personality profile from a hair sample. Even the Veterans Administration used ARL to detect self-medication by veterans seeking mental health care, but had no interest in the lab’s ability to design a diet and supplementation program based on one’s individual needs.
All of this seemed like unbelievable science fiction in 1982, but today you cannot be employed by many large companies without giving up a hair sample.
Reading Anatomy of an Epidemic helped me to find the strength to try tapering anti-depressants for the third time. I had given up hope of being able to restore my health but your investigative work motivated me to give it another go. I thank you for all that you continue to do to educate and most importantly for caring.
All the best,
You can do it Ruby. Good for you. And if you don’t, try try try again. You’ll get there.
Thank you anonymous for your kind words of support! Mr. Whitaker’s article on Psychology Today referencing research that SSRI’s actually reduce serotonin in the brain was another important factor in keeping me on the path to recovery. I fear a little for what will happen in the months following that last dose, but I believe and hope that through my extra slow taper I am giving my brain time to re-calibrate. If only there were such a thing as Miracle-Gro for seratonin receptors!
I’m with you Ruby! Don’t give up. I took my last dose 5 months ago and it is a challenge. However, I do feel like I’m healing. Are you connected with others in the taper/withdrawal/post med phase? This has been very helpful to me.
Thank you, Vanessa! And,congratulations on reclaiming body and soul! Wow–you finished five months ago. That must feel like a new birthday! From what you’ve shared here you’ve obviously been through quite an ordeal and must be very proud of yourself to have pulled yourself back up into the light.
I have done a lot of reading on the peer support boards and have communicated with a couple of very kind and knowledgeable people. I also have access to a great doctor should things get too hairy. It certainly makes all of the difference in the world to have others validate your reality and offer assistance when a medication throws your life into turmoil.
Best wishes and thanks for reaching out!
Don’t give up, and most importantly make sure you have other supports around you when you take the last dosage. There were times in my tapering when I stopped and stayed where I was as other things were going on for me. I knew and believe that you need to be in a good place each time you lower the dosaged. Once I got to the lowest dosage, i then took them every second day for a month as well.
Hang in there Ruby! All the power to you, go girl!
Thank you Stephen for taking the time to reach out and offer kindness and support and for being such a terrific advocate for us all through your writing here!
“If you would find freedom, learn above all to discipline your senses and your soul.”
A truly great man and a great pastor. As you probably already know since you used his statement, he stood up against Hitler and was part of the bomb plot that almost worked to take Hitler out. Unfortunately, it didn’t work and he ended up in prison. A man with principles, morals, and ethics and a person who wasn’t willing to compromise any of them to save himself.
If you haven’t seen it already, I think you would find the documentary Bonhoeffer very inspiring.
He ended up dead. He was imprisoned briefly, moved to a concentration camp, and then sentenced to death. He was executed by hanging.
Not only did he stand up against Hitler but Bonhoeffer had been a refuge who was granted asylum in the US. He went back to Germany, knowing his probable fate.
He wrote “I have come to the conclusion that I made a mistake in coming to America. I must live through this difficult period in our national history with the people of Germany. I will have no right to participate in the reconstruction of Christian life in Germany after the war if I do not share the trials of this time with my people… Christians in Germany will have to face the terrible alternative of either willing the defeat of their nation in order that Christian civilization may survive or willing the victory of their nation and thereby destroying civilization. I know which of these alternatives I must choose but I cannot make that choice from security.” He returned to Germany on the last scheduled steamer to cross the Atlantic.
His unusual and demanding theology was influential after his death. Martin Luther King Jr was among those influenced by his ideas.
I found that exchange with Dr. Torrey informative. I was impressed by the fact that Dr. Torrey pointed out the many things he agreed to in your book. I was surprised by the last paragraph of Dr. Torrey (saying it’s true that drugs are overprescribed by psychiatrists). The fact that a consensus could not be reached on many fundamental points was expected, given the starting points of view. While my beliefs are much closer to yours than Dr. Torrey, I am disappointed that you call him dishonest, the complexity of the human situations involved (often having to arbitrate between two bad solutions) make it possible for people to reach different conclusions without anyone being in bad faith. I do think that some of Dr. Torrey’s ideas are dangerous, but I don’t see the evidence for calling him dishonest.
Re-read Whitaker’s rebuttal then. He makes it quite clear where Torrey was dishonest.
I wonder if Doctgor E. Fuller Torrey was being “honest” when he came up with his theory of “schizophrenia” being caused by a cat virus (exposure in childhood to T. Gondi parasite) spread by cats.
Maybe he really believed it at the time.
The more important question is how did this guy become the self-appointed advocate for the “severely mentally ill”?
And that’s a question that ought to scare the hell outta anyone!
“The great masses of people will more easily fall victim to a big lie than a small one.” – Adolph Hitler, Mein Kampft, 1925
Dr. E. Fuller Torrey on his cat virus theory –
But it’s certainly unfreakinbeleivable!
Either Torrey was dishonest (or more plainly, a liar) or he miss-read Mr Whittaker’s book, in which case he is stupid.
As he is a bit of an, “Expert,” who tries to use science to promote his ideas he has a lot to loose if Mr Whittaker’s ideas are seen as more truthful than his.
People resort to miss-reading things or lieing when their feel under threat. Mr Torrey, much like the rest of bio-psychiatry, built his reputation and his career on years of work and study. It is unlikely he, or many others will change their point of view without being seriously challenged.
The fact that Torrey agrees with Whittaker on just about everything except his own area of expertise suggests that he is using pride to defend his sense of self rather than reason.
Whether one politely suggest someone has got something wrong or whether one says they are either outright liars or just plain stupid is a tactical decision. It is unlikely that Torrey will change his mind so undermining his credibility in this case may be more useful.
“The great masses of people will more easily fall victim to a big lie than a small one.” – Adolph Hitler, Mein Kampft, 1925
Is that the truth, or is it a lie?
Sound pretty dishonest to me! I’ve never met him but he sounds like quite a whack job and probably needs some of the very drugs he wants to poke down everyone else’s throats!
In ‘The Insanity Offence’, he admits to prevaricating in court to obtain an order for civil commitment. The man’s a liar, lying at a rate of five lies per breath. His contempt for truthmakes him worthy of mention in the same breath as Hitler and Goebbels.
This review of Torrey is simply malicious and distracting. Robbers do this, they go into a store distract the person behind the counter and then rob them while they are distracted and can’t see they are being robbed. To have to mention just a few things from this “review” and take up more space than the review, and not have at all dealt with all of the untruths, discrepancies of logic; it becomes clear that it’s malicious. I admire Robert Whitaker’s patience in responding at all. But there comes a point when one shouldn’t have to play run and fetch with another person’s false accusations; especially when the intention is clearly a distraction and a provocation. And it seems that only those that can’t really see what’s going on and provoke others with their ineptitude are the ones that have such difficulty with plain simple fact and good reporting.
I agree that it is worth at least thinking about the fact Whitaker could have chosen not to give Torrey oxygen…
My guess is Whitaker wouldn’t bother with such a pathetic figure as Torrey if Torrey wasn’t an active threat to the liberty of every American.
The fact that Torrey is out there in society pumping legislators and the media full of total BS means if we just ignore him, his quack organization, the forced treatment advocacy ctr, could actually succeed in their desire to bring about forced drugging laws from Alaska to American Samoa, a forced drugging regime on which the sun would never set.
Since this pathetic figure Torrey is such an active lobbyist, it’s necessary to join the fray, and counter him. Whitaker could ignore him, but when Whitaker engages him, thousands of links to Whitaker’s rebuttal are posted all over the internet, and a few people are more armed for the fight for human rights.
Torrey wouldn’t have reviewed Whitaker’s book if he didn’t feel threatened by it. The fact he waited two years shows Torrey may have originally tried a strategy of ignoring Whitaker, but then Whitaker’s influence just got too much to bear so Torrey had to do a hit piece hatchet job on his little forced drugging website.
You are very right though, it is truly something to ponder. To engage the fanatics at the forced treatment advocacy ctr or not? I think the answer lies in what utility it has for countering the forced treatment advocacy ctr’s sickening lobbying tactics.
It’s very simple, if Torrey wasn’t in the business of convincing governments to pass laws that make it legal to forcibly drug people in their own homes, he would not be worth responding to, he’d just be another elderly, sad clown playing with his dead brain collection spewing crap about cats and viruses. A laughing stock.
In reality, he is a laughing stock with millions of dollars to spend on lobbying for laws that make it legal to forcibly drug us in our own homes.
Torrey likes to predict “dangerous” behavior in other people.
Torrey is Kevorkian-like in his ghoulish brain collecting, and just as much of a sociopath.
I hope this is not construed as a “personal attack”, since he has made himself a public figure.
I wouldn’t be surprised if it is revealed that he paints scary clown portraits as a hobby.
He is a danger to himself and others.
Now I hate Torrey as much as the next man, but there’s nothing wrong with drawing scary clown portraits.
If I were to give a zoological physiognomic characterisation of Mr Fuller, I’d say he looks like a rat. A rat in human form, with the eyes of Charles Manson, only Torrey’s are much more maniacal.
I’m not saying that Whitaker shouldn’t have written his rebuttal, it’s just baffling to see how much work it is to actually decipher the misinformation, to wade through the disregarding mumbo jumbo that replaces actual incisive insight with selectively taking certain findings and bringing them out of context to draw conclusions one couldn’t make when the totality of evidence is looked at — this is highly confusing. It’s an incredible challenge to have to keep all of that straight. It was enough of a difficulty to piece together the evidence in the first place, but then to have to deal with another person obfuscating that; have to keep track of his corrupt handling as well as then relating how this doesn’t really apply; that’s even more work. I’m truly happy Whitaker took all of this trouble; and it’s amazingly helpful. I just know from self experience that after it becomes clear that these people are going to continue to do nothing but corrupt anything you say, and that you would spend the rest of your life having to untangle their knots, go running after their false leads, play run and fetch with their polemics; there comes a time when you just simply have better things to do. And I just want to express my commendation for what Whitaker has done; and how clearly he deals with a very disruptive situation.
You are right. Whitaker seems to be a very patient man.
That, I can empirically validate.
It is essential that Whitaker is able to do as he has done here. The fact that he is not simply going to ingore such things and is instead going to back them up with evidence and show the truth, shows just how strong a handle Whitaker has on the sciecne and that it really is as he says it is. Those that have not read Whitakers books, but have instead only read that review, may see no need to read it. Having the truth on the internet for them to also see can give peopel another option to what is said.
I admire and am incredibly thankful to Whitaker for continuing to take the time to back up his work and to explain the science, to provide the proof, and of course to link to the actualy studies, so that people can read for themselves what they really say.
Of course what none of this does is to link to any of the research on forced treatment orders, which shows they simply don’t work. One would have to forcibly drug at least 20,000 people just to reduce one asult and about 50,000 to prevent one murder!! There are much more costly and more effective things that could be done with all the money that is spent on forced treatment than that.
One also has to ask why is it that psychiatrists are not capable of simply spending time with people are talking them into taking these treatments. They are supposed to be the experts at talking to people, and of reducing voilence and yet the only way they know to solve such issues is to use it themselves.
Thank you for fighting the good fight!
For fellow readers of MiA:
Robert Whitaker was kind enough to publish an Op-Ed which addresses forced outpatient treatment, along with several other issues.
If you would like to become involved in helping getting a bill passed through Congress, and putting an end to this mess, one-and-for all, please take a moment to read this Op-Ed –
Duane Sherry, M.S., CRC-R
As a group psychotherapist in a large hospital network in Pennsylvania for many years, Anatomy of an Epidemic quantified and described perfectly the ancedotal observations Ive witnessed across many years. Until the book I was easily dismissed by my peers. After submitting the book to our library I have become a target of ridicule and harrasment. This website has kept me going. I wrote to Mr Whitaker to thank him, and tell him what his book meant to me, and he was kind enough to write me back. When Mark Foster was fired for his position on meds, I sent him a quote from Ghandi “first they ignore you, then they ridcule you, then they attack you, then you win”. At that time I noted that our movement was largely in the “ignoring” stage. Only a year or so later, Id say we are making progress!
Ive had to buy two more copies of Anatomy, since the copy in our library went missing, and im refusing to argue with anyone who isnt willing to read it.
I think it is really important that practitioners who are familiar with Mr Whittaker’s work, and who are generally critical of mainstream psychiatry, stick together and support each other.
We need more informal and formal support for people like you. In the UK there is the Critical psychiatry network, but we need all parts of the psychiatric system, from talking therapists to housing support workers, who support Mr Whittker’s views to organise and support each other.
So I wish you well in all your attempts to resist the major ideology of mainstream psychiatry.
Bob I’m really glad you set the record straight about Torrey’s attempt to dishonestly portray you and your work.
I see Torrey as a political figure, as the Karl Rove of the alliance of pharma, bio-psychiatry and NAMI. In that light, everything Torrey does and says is a political move to hold ground or gain ground. His review of your book is like a negative campaign ad.
Over and over his talking points were repeated so his constituency, his audience- would be able to come away from reading his review, armed with a bumper sticker slogan about you.
He was shamelessly working to paint you as a radical man who believes anti-psychotics cause or worsen psychosis.
In the world of Torrey’s political base, that makes you about as wrong and dangerous as a person can be. According to him, not only do you believe that people may not need meds their whole lives, but you hold the most extreme position possible- that the indispensible meds are the cause of psychosis. That is how he wants to politically define you. As a political enemy who would do away with anti-psychotics if you gain power to do so. In that vein you probably also support the war on marriage, on Xmas and prayer in school!
Torrey is the essential political operative like Rove who will smear or swift-boat an opponent without hesitation.
The fact that he and the alliance he heads are responsible for forced out patient drugging in 47 states means we must defeat that political machine. You help arm everyone of us in that struggle with the power of truth. That is causing a daily election or referendum of sorts, as the public chooses what they believe and want for themselves.
Thank you Bob for everything you do.
Re: Assisted outpatient treatment
There are really two issues here:
1) There is no real science to justify this use of force
(as Robert Whitaker points out in detail)
2) There is no law to justify this use of force
(as Jim Gottstein point out in detail as well) –
Both of these need to be considered by Congress, when we demand a ban on outpatient treatment (mis-treatment), once-and-for all –
To most of you who have commented on Steve Moffic’s post: Although I too have grave concerns about outpatient committment (and it potentially affects someone very close to me), i think you’re being unrealistically hard on this doctor. He’s made it clear he is not in Torrey’s “camp” and is quite sympathetic to the points made in “Anatomy of an Epidemic”. If more of the psychiatrists i’ve had contact with were at least as open as he seems to be, the outlook would be more hopeful for those caught up in the mental health system. He seems to be more friendly than unfriendly, and it is these mental health professionals that give me some hope for positive change. This does not mean, of course, that we should accept the “good” in place of the “better”, or the “better” in place of the “best”. I think maintaining dialogue with such people is very important; otherwise we contribute to an increasing defensiveness and polarization that precludes positive change. But i realize this may seem too muted for someone who has been subjected to forced drugging or other detrimental “treatments”, such as has occurred (at least some of the time) with my loved one.
I agree, Dr. Moffic seems open to dialog.
I think many people here are looking for radicals when even being a moderate among psychiatrists is daring!
What is Radical about wanting/demanding humane care and treatment for those suffering emotional distress.
The evidence overwhelming shows that those still promoting these drug treatments & the status quo psychiatric establishment of today are the dangerous radical extremist that will continue to cause grave harm to the public until they are called out and stopped.
Moffic as editor of the “psychiatric times” still touts the APA and the biological/pharmacological psychiatry status quo of today.
That is hardly someone I would call a “reformist” in even the most kind & forgiving interpretation of the word.
I’m a pretty conservative guy.
Pretty open to dialogue, on most any subject.
Certainly, a very tolerant person.
When it comes to the subject of freedom, I’m proud to call myself a “radical”.
How can we “compromise” on issues such as forced treatment?
The answer is, “We can’t”
And the radical answer is, “We won’t!”
“Extremism in the defense of liberty is no vice” –
Senator Barry Goldwater (a conservative, “radical”)
If you prefer to talk to radical psychiatrists, find them and talk to them. (I wouldn’t mind knowing some myself.)
Pounding on a moderate is not going to make him a radical.
And appeasement will not work either.
Is that how we are to address conventional psychiatrist when it comes to stopping the use of force?
Do we stroke their egos?
Make them feel all “warm-and-fuzzy” inside?
Hold hands with them abnd sing “Kumbaya”?
Freedom is non-negotiable!-
Using your logic about appeasement, Robert Whitaker is one because he has mentioned that psych meds work for some people.
He also dialogues with many “conventional” psychiatrists.
There isn’t a human being on this earth who is 100% consistent on a position and that includes you. I am vehemently against forced treatment. But I can’t honestly say I am comfortable with letting someone stay out on the street and cut themselves.
And before anyone flames me, I am not advocating an exception in this case. But since the person can’t be sent to someone like Peter Breggin, what is the solution?
I am happy to talk to moderates but it irks me when they misrepresent themselves as radicals.
My comment was in reference to the use of force.
Re: Alternatives – Comments were left on the “Coercion’ post written by Sandra –
If you want to continue to say, “We’re stuck”, go ahead, but I refuse to believe it.
Just because someone comes across as friendly, doesn’t mean they are good. Camus once said of his age, to paraphrase, that the malefactors come now as benefactors. This is the problem you see, people can’t see past the manners and miens of these quacks. I’m not interested in what people say about themselves and the way they go about their sometimes criminal actions, it is what they do that concerns me.
I posted this on another article comment section at Mad In America: I’m reposting it here, now that Torrey is a topic.
“Here is part of Fuller Torrey’s Op-Ed that ran in The New York Post regarding Kendra’s Law:
“Kendra’s Law is proving to be what its authors designed it to be: A safety net protecting the severely mentally ill and the communities in which they live.
While they have yet to fully embrace the promise Kendra’s Law brings to the state’s most vulnerable, we hope these well-intentioned yet misguided civil libertarians eventually recognize that defending an individual’s right to remain psychotic is mindless.”
That’s who Fuller Torrey is, he is someone who believes schizophrenia is an airborne toxin that we all are subject to breathing in, and he said when I heard him speak in person that we are ALL exposed and some “get sz and some don’t”. He equated bipolar and SZ as being the same thing, and he called the antipsychotic Haldol an “anti-viral” and when I asked him how he could call Haldol an anti-viral? he said he did not know. Though from that POV, one can deduct that a virus born “illness” can be treated with an anti-viral…Schizophrenia and Haldol. The man gave me the creeps.”
Haldol (Haloperidol) is an ‘anti-viral’ med?
All these years, I thought it as an “antipsychotic”.
Not to worry, I’m gonna contact the National Institutes of Health and tell them to change the drug classification –
I’m glad to see Dr. Torrey’s got this all figured-out… This guy’s a freakin’ genius!
Yeah! and if I remember correctly (I can look it up) he and or his associates at Stanley Medical Research own the patent for…the under-the-skin HALDOL DISK. Now tell me that is not planning for complete control!
Unfortunately, like in his book, Mr. Whitaker engages in hyperbole which far from giving his arguments credence, detracts from them. In your opening paragraph, you state Dr. Torrey argues “people with “severe mental illness” lack insight into their disease and this is why they reject the medication.” That is not true. Dr. Torrey argues there are some people with serious mental illness who also have anosognosia, lack of awareness of illness and he goes on to argue there is a subset of this group who due to their anosognosia don’t take medication. That is far different than how you stated it. I thought your book was excellent at showing inbreeding in the pharma/mentalhealth care complex. Although it gave the consumertocracy which has a much more expansive definition of what a mental health issue is than the APA, a free pass. It was less honest or informed when it discussed medical issues . My review is here. http://www.huffingtonpost.com/dj-jaffe/book-review-anatomy-of-an_b_1071163.html
Actually what you’re presenting is innacurate. “The logic behind outpatient commitment laws is that antipsychotic medication is a necessary good for people with a diagnosis of severe mental illness. The medications are known to be helpful, but—or so the argument goes—people with “severe mental illness” lack insight into their disease and this is why they reject the medication.”
This is what Whitaker said. And there is no difference between saying a person has anosognosia, and saying that they lack insight into their disease. Not even when you start making sets and subsets.
For anyone ever forced to take psych meds, or committed against their will to a psych hospital this is why DJ Jaffe is a dangerous agenda projector:(in my opinion!)
How to prepare for an emergency
“Sometime, during the course of your loved one’s illness, you may need the police. By preparing now, before you need help, you can make the day you need help go much more smoothly. There are three things to do.”
“the fact is that some families have learned to ‘turn over the furniture’ before calling the police. Many police require individuals with neurobiological disorders to be imminently dangerous before treating the person against their will. If the police see furniture disturbed they will lusually conclude that the person is imminently dangerous.”
The bottom line is Fuller Torrey and TAC and associates are not Pro-patient, they promote articles and stories about violence in mental health patients, they feed the media hype and the stigma that mental health patients are violent, they back legislation that removes freedom of choice such as forced (court-ordered) medication compliance and more.
This is Mad In America where people who have been harmed and discriminated against, held against their will, forced to be strapped to gurneys, injected with antipsychotics against their choice can have a voice–and mine is from the perspective of seeing these atrocities happen to my child. Once you see a child strapped to a gurney with a spit shield attached, and the wrist’s being cut from straps too tight, you tend to have less tolerance for ppl like Jaffe or Torrey, and their agenda.
What is it called, lying to cops and fabricating evidence? A crime or something?
DJ Jaffe finds it offensive that Americans “could become free to go off their medications”
He has a long history of lobbying for laws that take away human rights. He is not worth taking seriously.
Just read this egregious piece he wrote to find out all you need to know about what sort of person DJ Jaffe is
DJ Jaffe THANK YOU for giving us so much ammunition to use against you, you’re clearly a man if given enough rope, will do the rest for your opponents. We can be thankful that you are so inept.
Anosagnosia is a neurological term usually associated with demestratable temropareital lesions. I think it is a misappropriation to start using it in schizophrenia where, there no definate, consistent lesion of the brain as ever been demonstarted. It is blinding people with science to start using long sciency sounding words, and all it really demonstartes that Dr. Torrey knows little about neuroanatomy.
It just goes to show you that you can give any crap a Greek name and call it science.
Aren’t you the mouthpiece for Torrey? Why do you feel the need to defend him and his very strange ideas?
“To support an ‘epidemic’ he compares the number of mentally ill hospitalized in past, with number on Social Security Disability Income (SSDI) today. ”
Maybe you’ve misunderstood something, DJ. I admit, I haven’t read the book – but I did get to hear this with my own ears and I personally transcribed it:
“If you look at the adult disability rolls in the past, they were largely populated by psychotic disorders; schizophrenia or schizo-effective disorder. There weren’t many mood disorders. If you look at the young population on the adult disability rolls, the 18 to 26, it’s being populated by children who are quote depressed or have bi-polar disorder, mood disorders. This is a new group, we didn’t see them. It rises in conjunction with this rise of medications.” ~ Robert Whitaker, 6/2010 (spoken presentation in support of the book)
I think your review’s attitude is a bit inappropriate for having suggested “lunacy”. But whatever.
“He compares numbers of individuals mentally ill in past with numbers today, without adjusting for population increases.” I always wonder about that, when I see reports of statistics.
You have misspellings and punctuation errors in your article.
For all of this ignoring you charge Mr. Whitaker with, I wonder if he would’ve needed to write a one thousand page book. You seem to cite every lack of mention of every fact you expected or wanted to read.
Oops! Now I’ve found a grammatical structure error: “Wouldn’t those ‘failures’ would lower the overall efficacy of medications.” Yones, they wouldn’t! (just playin’ with you. smiles.)
You say Torrey did not report on Hardings statement that lifetime medication use is not needed. In fact, Torrey credited you for recognizing that long-term treatment may not be needed. He also writes that as people age they can lower or discontinue dose. Facts do matter.
to make such statements as “long term care may not be needed” and that people when they age can lower of discontinue dosage is quite misleading when statistics show that the absence of what you call care is more helpful (see the open dialogue program and many other examples).
DJ Jaffe, for the readers of Mad in America, should know Jaffe was on the board at TAC with Fuller Torrey
“The Shortage of Public Hospital Beds for Mentally Ill Persons
A Report of the Treatment Advocacy Center
E. Fuller Torrey, M.D.*, D. J. Jaffe, B.S., M.B.A.*, Kurt Entsminger, J.D.**, Jeffrey Geller, M.D.*, Jonathan Stanley, J.D.**,
* Member of the Board, Treatment Advocacy Center
** Staff, Treatment Advocacy Center
This is why Jaffe is here to carry on the take down of Whitaker’s book via the Torrey Platform.
This is my opinion.
Oh great, is there comment censoring going on again? why do some of my comments go to moderation?
Stephany: If there’s more than two links, I found they go to moderation. You can post one link at a time and it’s fine.
Sorry! meant more than one link…
The point also was that Torrey labeled these studies as completely unremarkable. This is like saying that involuntary commitment isn’t about forcing people on medications, when this is such a likely scenario that in “developed” countries there is significantly less recovery.
And it’s quite an amazing statement to say that it’s generally known that when people get older that some of them don’t “need” anti psychotic medications anymore, when much of the rest of the evidence (which is extensive) is simply dismissed as being completely unremarkable. Something it certain isn’t! Reading the 8 points above certainly dispel any notion that it’s unremarkable.
One might also ask why so many elderly in nursing homes are put on antipsychotics: http://gaia-health.com/gaia-blog/2012-02-24/standard-treatment-for-noncompliant-elderly-increases-death-60-70/
Considering you are unable to accept an America DJ Jaffe where people are “free to go off their medications”(1)
So therefore, DJ Jaffe, why would we give a shit what you and Torrey think may or may not be needed and for how long, you’re not even willing to give us the human right of choice, and that is why we find you so appalling. That, and your dishonesty.
It is not D.J’ Jaffe’s or Dr. Torrey’s place to “allow” anyone any right.
Neither one of them, nor any judge in any mentl health court, with an expedited hearing, without adequate legal counsel for the person whose very liberty hangs in the balance.
Those rights are spelled out in the Constitution –
And any perso: aself-appointed “advocate”, a mental health judge or other who arbitrarily takes those rights away is a “law-breaker” in the worst sense. In fact, a “domestic enemy” of the Constitution.
How’s that for “radical”?
And here is the one you should correct: “We are embracing the increased use of outpatient commitment laws that force people to take antipsychotic medications” Neither Laura’s Law (CA) or Kendra’s Law (NY) allows people to be forced to take medications. Both bills specifically exclude it. As do most others. You should correct that mistatement. I know it is the argument used by opponents of AOT, but it is innacurate.
To insinuate that a law which supports involuntary commitment doesn’t also enforce drugging against one’s will is about as convoluted and inaccurate as I’d already expect given the other statements.
DJ Jaffe has a habit of telling people what do “correct”, when it comes to making sure Torrey’s agenda is projected the way they want it to be…he has emailed me to “correct” numerous article links to newspapers discussing Torrey’s illegal harvesting of brains from King Co Wa. for example.
Consider the source readers of Mad In America!
This comment may be erased.
I ask the moderator for some (a great deal) of latitude due to the subject at hand, and D.J.’s public role.
What is it about Constituional rights that you don’t understand, particularly the 14th amendment – the “due process clause”?
Several members of my family have served in the military, having taken an oath to “defend the Constitution against all enemies, foreign and domestic.”
When I think of those souls who have given their lives to do so, only to see people like you spit on the very Constitution they gave their lives to defend, I get sick to my stomach!
Take your tyranny somewhere else!
Take it back from where it came from!
Take it to hell!
Amen and pass the ammunition!
“… pass the ammunition.”
A great expression by the ‘Greatest Generation’, who had the spirit we are going to need to be successful.
We are not in a war, at least not in the literal sense, but we certainly are involved in a ‘revolution’ unlike any ever seen!
And it’s a pleasure to be part of the revolution!
“We are not in a war…”
For myself, it very much has been a real war.
Mr. Jaffe, you state that Laura’s Law & Kendra’s Law specifically exclude forced drugging. So I’m confused. If not to be drugged, what then (in actuality, not just hypothetically) do most outpatient commitment orders actually require of the person? Do you have any statistics on what percentage of people under involuntary outpatient commitment have NOT been required to either be drugged or receive ECT?
Exactly, the only so-called “treatment” for anyone is the toxic drugs! This guy makes no sense with his jabberwocky jingoism. Who is he trying to kid? I don’t know anyone who’s given the choice between good old talk therapy and the drugs; you get the drugs, period.
This is the lie that the forced treatment advocacy center shills often trot out. They pretend that the only meaningful thing the law does is make it mandatory to accept whatever the psychiatrist sets as ‘treatment’. Then DJ Jaffe hides behind an appallingly childish ‘two steps removed’ strategy and says the decision on what treatment to force is up to the psychiatrist, and that his forced drugging laws ‘rely on prior law’ to force incompetency status on people. It’s a shell game played by an increasingly desperate and cynical forced drugging lobbyist.
All of DJ Jaffe’s and the forced treatment advocacy center’s materials relate to a bizarre and speculative heavily ‘biological’ framework, always mention the need to take ‘medication’, and I think it is patently embarrassing for a full grown adult like Mr. Jaffe to come on here and say this when you look at this quote of his from 2010
“To help avoid a repeat, the state legislative leadership put politics aside and passed Kendra’s Law in August 1999. But the law sunsets this year. If the Legislature doesn’t make it permanent, 1,800 patients with mental illness — many of them with a history of violence — could become free to go off their medications.”
So it is clear this organization and its spokespeople are fundamentally dishonest in all their dealings.
DJ Jaffe what a disgusting dishonest claim.
In 2010 DJ Jaffe said “passed Kendra’s Law in August 1999. But the law sunsets this year. If the Legislature doesn’t make it permanent, 1,800 patients with mental illness — many of them with a history of violence — could become free to go off their medications”
And today he claims these laws don’t even ‘allow’ forced drugging. Yet that is entirely the crux of his lobbying.
Did you not publish those words DJ Jaffe? Did you not say those things? Did you not lobby for a law not to sunset because your concern was people could be in your words “free to go off their medications”?
No reader should take this person seriously. It is amusing that he’s all upset and coming here to do damage control.
That is just a matter of semantics and how you want to define force. Yes the laws may say that you can’t hold the person down and force them to take something but you have to know that coercive strong armed tactics are taken often regarding threats of negative consequences if if people do not follow suggested treatment. So it is just how you want to define force. With how those systems are currently set up I define that as coercive force.
DJ Jaffe, for the readers of Mad in America, should know Jaffe was on the board at TAC with Fuller Torrey
“The Shortage of Public Hospital Beds for Mentally Ill Persons
A Report of the Treatment Advocacy Center
E. Fuller Torrey, M.D.*, D. J. Jaffe, B.S., M.B.A.*, Kurt Entsminger, J.D.**, Jeffrey Geller, M.D.*, Jonathan Stanley, J.D.**,
* Member of the Board, Treatment Advocacy Center
** Staff, Treatment Advocacy Center
This is why Jaffe is here to carry on the take down of Whitaker’s book via the Torrey Platform.
This is my opinion.
Here are the court documents re the lawsuit of wrongful body organ harvesting
Fuller Torrey and Stanley Medical Research are in the lawsuit. Brain collecting, etc.
This is important perspective for readers to know the background of Torrey, before allowing his words from a book review to be taken seriously, in my opinion.
Civil liberties, and freedom are not part of his agenda.
DJ Jaffe was, and still today acts as the mouth piece for TAC and forced out patient drug treatment laws – He is a fear monger right out of the Torrey mold – these people are not just misguided touting fear/hate propaganda based in fantasy science/medicine; they also are dangerously entrenched in organizations such as NAMI & DBSA. They are active participants in the broad reaching political wing of the most extreme pharmaceutical indoctrination & modern eugenics movement going on in America today.
Get to know TAC & Jaffe – http://bipolar-stanscroniclesandnarritive.blogspot.com/2010/02/fuller-torrey-treatment-advocacy-center.html
Thanks for the good reading material exposing Torrey’s toady.
I am not sure that it is even necessary to debate past research results but rather Fuller Torrey should pay attention to the details from the people who have recovered from schizophrenia and the cocktails of poisonous medications. I would like to hear how he explains those results?
Did you read what E Fuller Torrey wrote in his review “Anatomy of an Epidemic” in which Robert Whitaker is responding back in his article? He provides a link. Though not really easy for some to possibly catch it or I could be wrong on that. I think the title to Whitaker’s article “E. Fuller Torrey’s Review of Anatomy of an Epidemic: What Does it Reveal the Rationale for Forced Treatment?” One it takes away the deserve for those completely against Torrey and AOT from wanting to read his article and two is that Torrey review just that a review. I found that it explained the results of some of the information on the studies the Whitaker used in his book. I still need to fully read Whitaker’s article to make for me to give a truly informed thought of my opinion.
Torrey does write of recovery and that it does happen.
I take medication because my manic episodes mixed with paranoia was too disruptive to myself and others around me.
That’s great but you know what? Others prefer not to label their experiences as “manic paranoia” or whatever psychiatric buzzword you’ve internalized that has no objective meaning in real science. Others also prefer to live in freedom without fear their government will forcibly drug them.
Good for you! Psych drugs have been awful for me but I’m pro-choice and pro-informed consent. One size fits all solutions don’t exist.
M0re power to you if you freely chose them and was given true informed consent. Pro-choice is what I am about and I want all the alternatives for recovery as possible to be placed on the table. I don’t want the drugs to be the only things available.
Thank you for a couple of the supportive comments about what I am trying to do and say. I don’t think many know there is a “radical” psychiatry group that wants to be supportive of the concerns of many here.
At the risk of being hit with negative comments again, and some of the above do seem to still be uncivil, let me share my experience with committed patients (though not committed by me). Believe it or not, many are thankful afterwards and feel there lives have been saved, not destroyed.
The argument from selective thankfulness ladies and gentlemen!
Most psychiatrists use this argument to justify smashing the eggs (lives) of everybody to make a few omelets (thankful people).
A fundamental weakness to the argument is that the people ‘thanking’ the psychiatrist inherently understand that everything they say can and will be used against them and will be written down in the file. They aim to please their coercers and not give any impression of resistance because they know resistance is futile.
Then there are those whose ‘thankfulness’ stands and falls solely on their tenuous belief that this person who has locked them up and drugged them is a legitimate brain disease doctor, and that they have a legitimate brain disease.
This ‘thankfulness’ often erodes when they come to discover the truth about what has been done to them.
Finally, the psychiatrist who points to his cadre of ‘thankful coerced’ is immoral, because he by definition ignores those who had to have their lives destroyed in order to create the cadre of ‘thankful coerced’.
Like a system where everybody had to hand over control of their bank accounts, because a few were ‘happy’ and ‘thankful’ that someone came along and took control of their finances. Everyone has to be treated like a child, because some adults who were coerced wound up claiming to be ‘thankful’.
A psychiatrist saying this is essentially saying ‘hey! you gave me carte blanche to mess around in various random peoples’ lives and half of them thanked me so I’m a great guy’. Forget those who were destroyed. Only the obsequious good little mental patients who say ‘thanks’ are the ones who people like Dr. Moffic tend to mention.
Comment deleted by administrator.
I have heard of people being thankful that they were detained against their will too, although I have not met them. However that does not mean that other systems of help that do not rely on forced detention would not leave people in similar circumstances feeling just as thankful.
We would have to compare two such systems and their outcomes and peoples experiences of them to find out.
I personally do believe some people do need detaining, or at least restraining. But that leaves open the whole question of how long that should be for, what happens when they are detained and on what grounds and how they should be released.
Others think that detaining people against their will should be left up to the criminal justice systems. Either way there are large areas of debate on why and what for. Agreeing that involuntary commitment is sometimes necessary does in no way mean the present system needs to be in place.
Each deserves a fair trial.
In a real court room, with an attorney who has had adequate time to prepare; with a list of alternative treatment options; with a jury if called for by defense counse.
It matters NOT that a few people swear they were “helped” by having their freedom taken away!
Constitutional rights are not decided upon by referundum, by votes on the APA Convention floor, or at NAMI National, or the majority rule of “doo-gooders”!
Exactly. Well stated.
And statistics are moot.
And the fact that x-amount of people swear they were helped, while x-amouunt of people appear to be harmed.. Those statistics matter NOT.
Because, at the end of the day, this is not about referendums OR statitstics; science or lack thereof; testimonials or medicine; black-and-white thinking, or many shades of grey…
This is about freedom!
Duane Sherry, M.S.
Wow amazing. You take away someone’s liberties, you take away their freedom to disagree with you; and then you tell us that they say this saved their life. Of course, them not even being allowed to disagree with you would have nothing to do with their choice, right? That’s why their free will is taken from them so that they “or their own free will” can agree with you!?
Exactly. If someone with a psychiatric label says no to psych drugs, that is a symptom of a brain disease according to these messianic brain disease cult members.
If someone with a psychiatric label complains about being subjected to human rights abuses, that is a symptom of a brain disease according to these messianic brain disease cult members.
If someone sings the praises of someone who coerced them, that’s not labeled a symptom at all. That’s embraced as good PR for the brain disease cult.
Do you consider yourself a “radical” psychiatrist? This is not an attack–I am genuinely curious about what this means to you. Please dialog with me and help me understand where you are coming from.
Are you a member of the APA’s radical caucus? I would like to learn more about that group. How does your public call for psychiatrists to retake their diagnostic and treatment power and your advocacy of coercion make you a radical? Is it because you believe that forced treatment should be used less frequently than mainstream psychiatrists? Is it that you support limited forced drugging instead of widespread forced drugging? Is it that you oppose forced electroshock but not forced drugging? Do you oppose forced electroshock? Are you radical because you support limited instead of widespread reinstitutionalization? Why do you use terms like “antipsychiatry”? Do you consider yourself radical because you support single payer health care? I am a long time advocate of single payer and I rejoice that we can agree on this!
Maybe I am misinterpreting you. Are you saying that there are “radical” psychiatrists that we may are unaware of, but not that you are one of them? Were you referring to radical psychiatrists along the lines of Peter Breggin or Daniel Fischer?
Because this is written communication you cannot hear my tone of voice. I am not hostile and not attacking you. I am not being sarcastic. If this were face-to-face communication you would be the seeing the body language and facial expression of an empathic listener. I am genuinely curious as to your radical views. Please share.
Answering these specific and sincere questions directly would go a long way toward establishing credibility and trust between yourself and those who are struggling with your presence here.
Reflections on the 2012 Radical Caucus Meeting
May 8, 2012
Thank you for stating what you did. I to am interested in hearing his answers to your questions. I keep trying to point out that many survivors/ex-patients, whaterever, have no reason to trust any psychiatrist or member of the present system, even if you are one of the good guys in a white hat. You have to not only talk the talk but you have to walk the walk.
I like what you said about trust. I, too, am interested in hearing his answers to my questions, but I am starting to suspect it may be a long wait.
This is something that troubles me quite a bit.
My own opinion is, for example, that antidepressants should not be prescribed at all, they deliver far more harm than good.
Yet there are people who swear the medications have saved their lives. Same with antipsychotics and ECT, and in-patient treatment. (Do NOT accuse me of promoting these interventions. I do NOT.)
Is it possible for the vast majority, psychiatric interventions are not appropriate, but for a tiny minority they may be helpful?
Should not the experiences of these patients, one of whom may be Sigmund David above, also be honored?
We all err when we generalize from our own personal experience. Not everyone has the same opinions and results that we do. Rather than jumping all over someone who doesn’t display a required orthodoxy, can we allow for a multiplicity of experience and opinion?
“Is it possible for the vast majority, psychiatric interventions are not appropriate, but for a tiny minority they may be helpful?”
I’m surprised that I have not yet seen one mention of the insiders’ joke: hospitalizations are “vacations”.
It is quite likely that *some* people who say a hospitalization was good for them is because of the benefit in the temporary respite or “escape” (even though hospitalization very often *is* a form of imprisonment), and in addition to whatever valuable social interactions they experienced while in “vacation-land”.
I was one of those people who initially spoke very well of Effexor XR. I had never felt the way I did while on that drug. It effectively reinforced a belief that there really was some chemical problem or genuine disease with my brain, and that the drug was working. At long last, I’d found the right one!
But the positive effect was very short lived. While I did have some positivity, initially, I couldn’t deny that something was very seriously wrong. The last time I took that drug, I stood in front of a mirror while doing so.
I began doing some research about a year after I stopped taking the damned drug. I was homeless at the time. I truly “went out of my mind” at what I read; stories from other people who had taken that damned drug. The “brain zaps” – OMG I had those! The loss of memory – OMG I had that! The hellish nightmare it was in less than 24 hours of a missed dose – OMG I had that! And more.
I got to know just how bad things really were, in seeing my reflection … in others.
When people lack insight that they’re TAKING A DEADLY POISON, is it because the drug itself inhibits cognition or because of the mental abuse and belief system brainwash? Or worse – a maddening combination of all of the above.
One “doctor” wanted to prescribe a “medicine” for my eyes after I complained that risperdal was blinding me and causing me to pass out. I was LIVID.
Ya’ll are mad scientists and you’re murderers.
To try to defend taking away people’s rights, by saying that those who have no right to disagree anymore, or see it any other way that they are being treated for their own good, consequently say by all amazement that is was for their own good. This is no defense of anything. And then to also disregard that the kind of healing that is not only the most effective, but in the worst cases the only kind that is effective, isn’t really allowed in the places a person is incarcerated in, when their rights have been stolen; when their freedom to disagree has been robbed, this then becomes an issue to call people’s responses “uncivil.”
To do barbaric things and call it a service to others, and thus alleviate yourself of questioning what you’re doing (because it’s a service); and then dress this up with false kindness (as if something that’s not fixing the situation is fixing the situation, so you can act like you’ve done something despite the results. The results being that a person believes that there is inherently something wrong with them, although there is a whole population of people who have been through the same thing and worse, people that can help those like him with better results, and beyond that not make him think there’s something inherently wrong with him.
Well, thank you for pointing out how hollow the word civil is. Sort of like those savages that needed to be civilized. The ones that don’t make machinery that spoils the whole earth, that aren’t happy with disabled minds.
What’s truly completely clear, and operative is this: What does it say about someone who advertises that it’s something when others have had their freedom taken away from them and have no choice but to agree that their life has been saved and that they are being healed?
And it’s not even mentioned in this context by this person that these people have no choice but to have such an opinion.
What does it say about someone that needs to hear such things?
How does it make another feel to have no choice but to deal with a person who needs to hear such things?
I would be nothing but happy to hear that someone’s life has been saved. But given that they have no real choice in how to see what happened to them, and that this “viewpoint” they are said to have is reported by someone enforcing taking away their right to have a dissenting viewpoint; it really in no way can be considered “objective” by any standard of what sanity or reason is.
And there are quite a few people that completely DON’T have such a viewpoint, despite that they aren’t allowed to see themselves as sane would they express their viewpoint.
Nijinsky, I agree that coercion can cause some people to behave like they’re okay with the coercion, in order to escape that coercion sooner. And it can sometimes influence people toward actually being okay with the coercion, just to reduce the cognitive dissonance about what they’ve been through (becoming a form of Stockholm Syndrome).
But to paint an entire group of people with certain viewpoints as ‘can no way be considered “objective” by any standard of what sanity or reason is”…. Aren’t there already those who insist that we can’t possibly be objective or sane, because our viewpoints disagree with theirs? Does it really help us to similarly dismiss others as not objective or not sane, because they disagree with us?
Or is this more that you were declaring the viewpoint (as opposed to the person) as not objective and not sane? I still don’t think that invoking judgments involving the word “sane” is a helpful tactic here. Let’s vehemently disagree with the content of certain viewpoints, but skip making dismissive judgments about the people who have them (especially if they’ve been through some of the same trenches).
(Oops, just to clarify, philroy & phil59 are both me.)
Excuse me, what are you going on about!? I’m simply stating that you can’t take it as objective fact when people who force others to agree with them or lose their freedoms say that those that WOULD lose their freedoms when they disagree with the psychiatrist, magically agree with them, and their statements can be used as evidence of the efficacy of their treatment.
It makes no sense to base any “objective” data on such information.
And no, not everyone when they use the word sane, makes references to whether you have the right to deprive someone of their freedoms. I thought that would be clear! And it’s the psychiatrists that are touting these viewpoints as being “objective,” not the people who are forced to say whatever they say to the psychiatrist!
Ha, that’s funny, many slaves used to be happy slaves, grateful to their oppressors and disdainful of their potential emancipators, still doesn’t change the fact that slavery was an immoral institution, just as psychiatric slavery is.
Some people identify with their aggressors and oppressors; some internalise the rotten way people treat them, thinking they deserve it and showing gratitude; some feign thankfulness, dissembling their real feelings because of the insuperability of their opponent and fear of punishment. This is only beginning to unravel the skein of different reasons why a person might be thankful for being the object of someone’s despotism and iniquity.
Conspicuous by their absence are the ingrates, chafing under the yoke of the tyranny they are somehow supposed to be grateful for. The tacit assumption is that these people are actually unpeople, lives expendable in the pursuit of psychiatry’s goals.
Dr Moffic, with all due respect, I don’t think I’d classify you as a “radical” psychiatrist.
This was my initial response. Upon further reflection I posted the above invitation to dialog and I am hoping that that Steve responds directly to these specific, sincere questions so that I can understand what this means to him.
So far, I don’t see him as a radical psychiatrist either. It will be important for him to respond so that the dialog can continue. Some of the comments directed at him are very pointed and I suspect some of them even sting, but this is what you open yourself up to when you enter the debate or discussion here. The problem, as I think Sonia pointed out, is that this type of communication is limited since you can’t see body language, facial expressions, or hear tone of voice. It’s tricky to get across what you want and need to say. But, he shouldn’t expect people to trust him simply because he thinks of himself as one of the good guys.
It frustrates me that Moffic will not answer specific, civil, and sincere questions, but instead only responds with general complaints that this is not a “safe space” for him and that he’s being attacked because he’s a psychiatrist. I think it’s more accurate to say that he’s being challenged because of his problematic statements, not his profession.
Instead of responding directly to those of us who have critically engaged his positions (not ad hominen attacks) he suggests we need to be kinder, forgive and move on. In my opinion, this is not dialog.
Yeah, I get tired of doctors whining here too.
It’s called manipulation.
The vast majority of psych docs are good at it!
Interesting. Maybe Dr. Moffic is “radical” when compared to (or in the viewpoint of) the majority of psychiatrists? Radicalism is often in the eye of the beholder, so it depends on which beholders are being referenced.
This is a great post by Mr Whittaker which I think could be of use in negotiations with practitioners, especially when people want to challenge the terms of involuntary community treatment.
Or maybe not, but I might see if some of my friends want to give it a go.
This is incredible. I need to share this with our Hidden Thoughts Press readers on our facebook page.
Thank you, Robert
Removed at the author’s request.
Anonymity is not a crime. Or would you prefer it if I just wrote a fake name in there like a large percentage of the other posters who are also anonymous. I could point to a dozen ‘screen names’ in use on this page alone. There’s nothing wrong with that. I don’t see anybody checking photo ID on the way in.
If any of my comments broke the rules they’ll be deleted. Care to point one out you disagree with? I’m happy for any of them to be deleted but they haven’t been.
You’ve typed the first f-bomb I’ve seen on here, yet you call me uncivil.
Hei, I’m in Finland. Can you point me in the direction of the conference in Finland in late August as I would love to attend. I am puzzled because if Open Dialogue is so effective why isn’t the rest of the country embracing it? The rest is hopelessly biological and medication orientated.
thanks for taking the time to post this. I find it very helpful and informative. I think your two books gave impetus to the survivor movement in ways that nothing else has. I am grateful for this more than you will know. You’ve given us invaluable tools to use in the sturggle to find freedom and respect. Have they labeled you as a Scientologist yet?
Re: Forced Treatment
When it comes to the subject of forced treatment, much of the dialogue centers around those who have been diagnosed with either “schizophrenia” or “bipolar disorder”.
I think there are those who consider these “rare” cases.
I would remind anyone reading that this involves a very large segment of the population. Historically, one percent (slightly higher) in the case of “schizophrenia” diagnosis; historically, one to two percent of the population for those diagnosed with “bipolar disorder” – however according to more recent statistics from such places as NIMH, now are in the 3 to 5 percentage area.
So, we are talking about anywhere from 12,000,000 to 18,000,000 souls.
For anyone who has not received such a diagnosis, who may be tempted to think, “Oh well, this doesnt’ effect me.”…
A few thoughts:
1) A person diagnosed with “severe depression” can lose their rights in a heart-beat.
2) A person diagnosed with “anxiety” should take heed as well; accoriding to Andrew Saul, Ph.D., anxiety is the most costly mental health condition in this country.
3) With all the attempts to “control medical costs” by the federal government, many may find themselves in the predicament of being forced to take psychiatriic drugs – by do-gooders, along with state/federal boards.
When the Nazis came for the communists,
I did not speak out;
As I was not a communist.
When they locked up the social democrats,
I did not speak out;
I was not a social democrat.
When they came for the trade unionists,
I did not speak out;
As I was not a trade unionist.
When they came for the Jews,
I did not speak out;
As I was not a Jew.
When they came for me,
there was no one left to speak out.
– Martin Niemoller
“… nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.” – 14th Amendment, U.S. Constitution
Keyword, ‘ANY’ peron.
Alternatives would be far less expensive, but the government will continue to say they are not “evidenced-bassed”, and that “untreated” conditions have too high a cost, too large a burden on the taxpayer, and law enforcement….
Unless we are pro-active, and begin to demand freedom in health care, mental health care.
I would like to echo some other comments above regarding the laborious reply that was necessary to write regarding E. Fuller Torrey’s review. As I read Robert Whitaker’s reply carefully, a few facts became obvious.
1. They (pro-drug, pro-forced treatment elite) across the board really are not that smart after all.
2. If it is necessary (and I agree it is) to carefully defend the truth this way, it seems there is a light at the end of the tunnel in terms of successfully challenging the powerfully corrupt.
3. They really aren’t that smart. Even Jaffe failed to understand a simple fact when he tried to criticize again on the same point Torrey failed to achieve, which was that Harding’s conclusion was Harding’s, and not belonging to Whitaker. Here is what Jaffe wrote on May 16, “You say Torrey did not report on Hardings statement that lifetime medication use is not needed. In fact, Torrey credited you for recognizing that long-term treatment may not be needed. He also writes that as people age they can lower or discontinue dose. Facts do matter.”
But that isn’t the point that Robert raised in his reply to Torrey’s review! Robert’s reply stated, “I did not attribute the 34% recovery rate to the fact that they had ‘all long since stopped taking their medications,’ as that would indicate that I had drawn that conclusion. Instead, I repeated what Dr. Harding had said in an interview with the APA Monitor about the recovered patients”.
Jaffe and Torrey BOTH missed the detail about the Harding conclusion. If this is the level of intellect we are required to challenge as a movement, I am REALLY hopeful for our future.
I am finding this inability to use logic and reason is actually evident in other powerfully corrupt people across the entire industry as they make claims or provide Swiss cheese explanations for their actions…I cant help but wonder, is this inability to present a coherent argument a residual effect of one’s brain when they enjoy too much power and become too comfortable and secure?
Finally, I think Robert let Torrey off too easily. The 4th dishonesty moment in my opinion, counted when Robert wrote, “Equally revealing is what he omits from his discussion of Dr. Harding’s study: he does not mention her conclusion that the conventional wisdom regarding the need for schizophrenia patients to stay on antipsychotics all their life is a ‘myth'”…but that’s just me.
Thankfully Robert takes the time to critically examine what these powerfully corrupt are actually saying; and as a reader, for me, that’s when the horizon suddenly appears. As Robert’s example has shown it becomes necessary to forensically examine each sentence, each article, each lecture, so that we can see even more so, among other things, just how sloppy and a little too comfortable they really are.
Thank goodness for Robert’s ability to stay with this kind of tedious replying, and defending. There is no doubt his attention to the truth has helped advance this cause by light years.
I wouldn’t worry about Jaffe. He tied his own fate all those years ago in 1999 when he foolishly somehow believed the internet wasn’t forever when he wrote the infamous ‘turn over the furniture’ article. And many more.
He’s stuck with that for the rest of his life. He hates it I’m sure, but it’s there, it decimates his credibility. It’s on Google forever, and hundreds of times over.
For those of you who haven’t seen it yet, here it is, I’m always happy to share the truth about DJ Jaffe:
In this article he advises parents on the most slick strategies to try when you’re trying to get another person locked up and forcibly drugged by psychiatry:
DJ Jaffe showed his true colors forever with that article and presumably much to his chagrin he can never remove it from circulation. He has done dozens of articles that are just as ridiculous but why bother pasting them here? It’s a waste of space, just like he is.
He’s a joke.
Here’s another classic sample:
DJ Jaffe, propagandist for forced treatment:
“Realize that you & the cops are at cross purposes.
You want them to take someone to the hospital. They don’t want to do it. You need to get on common ground with the cops to gain their cooperation. Say, “Officer, I understand your reluctance. Let me spell out for you the problems & the danger. I understand that if you take my son to the ER involuntarily, you’ll have to wait with him until the doctors make a decision on whether to admit. I also understand your concern about litigation if you take him involuntarily. Therefore, why don’t we work together so my son goes voluntarily.” Cops will often change their attitude dramatically if you say this. If a person goes voluntarily, the cops don’t have to stay in the ER. They don’t have to use handcuffs. If a person goes involuntarily, they go the same way, except in handcuffs. This can often be used to convince a person to go voluntarily. You can say, ” I know you don’t want to go, but I think you need to go.” The cops can say, “You’re going to go one way or another, cuffs or no cuffs.” Usually the person will go voluntarily when faced with this choice.”
I laugh every time I read it. How could a serious propagandist for forced treatment actually leave this kind kind of crap littered all over the internet and expect to be taken seriously?
He clearly is a man in his late 50s, who was outsmarted by the internet. He may have believed in 1999 when he wrote this, that he was living in the world of early 90s forced drugging propaganda newsletters, which he also inhabited.
And then the big bad internet came along and made it easy as all hell to dial up every misstep he ever made.
I picture him squirming every time this embarrassing lapse is mentioned. He has tightened up his propaganda in his old age, clearly he was shaken by this hard lesson.
DJ, remember, there are more links on google to your ‘turn over the furniture’ article than from any other thing you ever wasted your life writing.
And the people you seek to coerce are laughing all the way.
You’re a joke.
I can just picture it now. This clown thinks this ‘internet thing’ is just a fad. And here he is, even after he is long gone people are going to be reading the hundreds of copies of the ‘turn over the furniture’ article.
In the annals of internet history, DJ Jaffe will be forever remembered as the ‘turn over the furniture’ guy.
And we laugh.
Another sugar hit from DJ Jaffe’s hit parade:
“While AMI/FAMI is not suggesting you do this, the fact is that some families have learned to ‘turn over the furniture’ before calling the police. Many police require individuals with neurobiological disorders to be imminently dangerous before treating the person against their will. If the police see furniture disturbed they will usually conclude that the person is imminently dangerous.”
More, I just can’t stop the hit parade:
“NAMI/NYC is a non-profit dedicated to improving the lives of people with neurobiolgical disorders (“NBD”, formerly known as ‘mental’ illness) through education, advocacy, support, and research. If this has been useful to you, PLEASE JOIN US. Send a deductable contribution of $30 (or more)”
Formerly known as? huh? Classic.
You’re a classic DJ. Keep on spinning those gold records DJ!
TURN OVER THE FURNITURE.
ANNUALLY, IN ‘NEUROBIOLOGICAL DISORDERS AWARENESS WEEK’ WE ARE ALL CALLED UPON TO TURN OVER THE FURNITURE.
ANNUALLY, IN ‘NEUROBIOLOGICAL DISORDERS AWARENESS WEEK’ WE ARE ALL CALLED UPON TO TURN OVER THE FURNITURE.
You should be used as a source of treatment. At least one dose of you per day would make me a very glad person. I love reading anything you write.
“Readers should know that Dr. Torrey’s viewpoints do not have much favor with most psychiatrists, and certainly not with me. He is viewed as being on the fringe, though he should be given a chance to try to prove his theories about whether something biological causes certain problem”
” Now I realize that many will not agree that any sort of commitment is needed at any time, but think of the homeless who die on the street when they don’t need to, the suicides in those who have never received any treatment whatsoever, and the violence that could be prevented.” Dr Steve Moffic
One of the many replies: “Dr. Moffic I’ve never broken into your home, I’ve never violated the bodies of you or your family members. Why do you seek to violate my body?
If not you, then why do you seek to allow the government to empower your colleagues to violate my body? Don’t you see how violent the actions of your profession are?”
It was good you let us know how you felt about forced ‘treatment’. However it would be better if you answered the many comments people who live in fear of coercive psychiatry addressed to you. It is outrageous that the very people who have the power to ‘diagnose’ others if they think they violate themselves or others are prepared to violate them when they perceive it is for their own ‘good’! Bio psychiatrists have not got the skills to help the homeless or those in severe distress. An ounce of kindness and support is much better than forced psychotropic drugs.
Psychotropic drugs defiled my body, mind and spirit for almost 20 years. I know they have harmed many people as I am actively involved with helping others now. Even though I believe psychotropic drugs do much more harm than good I would not advocate to forcefully stop people taking drugs! I believe people should know the truth and chose for themselves. This is why Robert Whitaker’s book ‘ Anatomy of an Epidemic’ is so important!
Of the topic of the “Fuller Torrey’s Review,” I know, but interesting and perhaps worth a look at a recent mainstream view of the issue of a mental illness epidemic? Specifically;
“Robert Whitaker uses such data to conclude that psychiatric disability rates are now around 6 times what they were in 1955. But SSI/SSDI determinations are unreliable measures of the actual incidence (new cases) or prevalence (basically, total cases at a given time) of psychiatric disorders.”
The following blog post appeared on the website “Psychiatric Times”.
Is There Really an “Epidemic” of Psychiatric Illness in the US? By Ronald W. Pies, MD | May 1, 2012.
If claims in the non-professional media can be believed, there is a “raging epidemic of mental illness” in the US1, if not world-wide—and, in one version of this narrative, psychiatric treatment itself is identified as the culprit. There are several formulations of the “epidemic narrative,” depending on which of psychiatry’s critics is writing. In the most radical version, it is psychiatric medication that is fueling the supposed burgeoning of mental illness, particularly depression and schizophrenia. More subtle variants suggest that there is a “false epidemic” of some psychiatric disorders, driven by dramatically rising rates of “false positive” diagnoses.
It is not my intention to examine each of these arguments in detail. Nor am I primarily addressing the question, “Is there sometimes over-diagnosis, or over-treatment, of certain psychiatric conditions, such as ADHD or bipolar disorder?” (In brief, I believe there is both over- and under-diagnosis of most psychiatric disorders, depending on the clinician’s experience and the thoroughness of the evaluation). Rather, I want to address the claim that serious psychiatric illness is dramatically increasing in the US—not simply that it is being “over-diagnosed,” but that the number of genuinely “sick” individuals has skyrocketed in recent years. If we limit our analysis primarily to the adult population—the focus of my commentary—I believe the evidence for this claim is very thin. The matter becomes somewhat more complicated when we look at children and adolescents—but in that arena, the concept of the “false positive” must be carefully scrutinized, since the term is often misused or misunderstood.
Some who argue that actual psychiatric illness is on the rise in the US point to increasing rates of disability determinations—for example, increased numbers of those “disabled” by mental disorders who qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Thus, journalist Robert Whitaker uses such data to conclude that psychiatric disability rates are now around 6 times what they were in 1955. But SSI/SSDI determinations are unreliable measures of the actual incidence (new cases) or prevalence (basically, total cases at a given time) of psychiatric disorders. First of all, disability determinations by the Social Security Administration (SSA) are subject to a myriad of socioeconomic factors that have no direct bearing on how widespread a disorder is, in any given year. For example, many applicants for SSI/SSDI have already been turned down by their regular (private) disability insurer. These unfortunate individuals often present in desperate financial straits and may—quite understandably—come well-prepared to make their “case” to the evaluator (see, eg, the websitehttp://www.ultimatedisabilityguide.com/disability_hearing.html). This is not to impute malfeasance to anyone; it is merely to note that disability determination rates may increase as a function of increased preparation by petitioners.
Nor can “disability determination rates” be equated with medically-determined disability. The initial SSA determination is made by a two-person adjudicative team consisting of a “medical or psychological consultant” and a “disability examiner.” (see http://www.ssa.gov/disability/professionals/bluebook/general-info.htm). Appeals may ultimately reach the level of an administrative law judge. Though psychologists or psychiatrists are sometimes involved in the initial stages of SSI or SSDI determinations, it is simply not clear to what extent these adjudications adhere to the standard (DSM) diagnostic criteria for mental disorders. Thus, valid inferences regarding the actual incidence or prevalence of disorders—or changes in these measures—cannot be made on the basis of SSA disability determination rates.
Other proponents of the “mental illness epidemic” narrative point to rising rates of antidepressant prescription in the US. Let’s be clear: this is no myth. Researchers Ramin Mojtabai and Mark Olfson found that the rate of antidepressant drug treatment in the US increased more than 4 times between early 1990s and early 2000s. Of special note, the rate of antidepressant treatment increased more in the group of less severely ill individuals than in those with more severe psychopathology. These findings are certainly cause for deep concern, and may reflect disturbing trends in the treatment of depressed patients—for example, the declining use and availability of psychotherapy among psychiatrists, and limited access to psychiatric physicians. However, rates of antidepressant prescription —largely prescribed by general physicians—cannot be used to compute or infer incidence or prevalence rates of depression. Indeed, many prescriptions for antidepressants written by non-psychiatrists are for the treatment of pain, insomnia, or other non-psychiatric conditions.
That said, when we look at rates of diagnosis and treatment of bipolar disorder, particularly in younger patients, the statistics are quite sobering. Dr. Mojtabai’s group, for example, has found that the number of visits to a doctor’s office that resulted in a diagnosis of bipolar disorder in children and adolescents has increased by 40 times over the last decade. Over the same time period, the number of visits by adults resulting in a bipolar disorder diagnosis almost doubled. But what do these figures really mean? For one thing, the survey examined the number of office visits, not the number of individual patients, so some patients may have been counted more than once. Also, it is not clear whatdiagnostic criteria the treating physicians used, or how closely the doctors adhered to the “official” criteria for bipolar disorder, used in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Indeed, as then NIMH Director, Thomas R. Insel MD, observed in 2007, “We do not know how much of this increase reflects earlier under-diagnosis, current over-diagnosis, possibly a true increase in prevalence of this illness, or some combination of these factors.”
The issue of “over-diagnosis” brings us to the thorny problem of the “false positive” in psychiatry. Some critics are fond of arguing that rates of bipolar disorder, major depression, and other psychiatric conditions are being inflated by “false positives.” For example, they argue that children who are merely “temperamental” are being falsely diagnosed as having bipolar disorder; or that “bored” and overactive children are being misdiagnosed as having ADHD. There may be some validity to these claims, in certain clinical settings—but the claims themselves must be carefully scrutinized, with respect to the notion of a “false positive.” In general medicine, the term “false positive” usually entails 2 requirements: first, the existence of a reliable and valid set of diagnostic criteria; and second, the availability of adefinitive confirmatory test. The definitive test for syphilis, for example, depends on the direct or indirect identification of the causative organism in the blood or cerebrospinal fluid. It is a truism that, at present, the field of psychiatry does not have such “lab tests” for its principle diagnoses, and even the criteria for these conditions are in a state of flux. When critics of psychiatry argue that there are too many “false positives” for a particular diagnosis, what they usually mean is that, in their considered opinion, too many patients are being diagnosed with the condition; or that there is excessive “medicalization” of “normal problems in living.” These are certainly arguments worthy of debate—but in no way do they constitute scientific proof of increasing “false positives” in psychiatric diagnosis. Rather, these claims are vestiges of the Platonic notion that in our diagnostic criteria, we are fully capable of “carving Nature at its joints.” But the nature of human disease often eludes such precise articulations. Much depends on the degree of suffering and incapacity we, as a society, choose to consider “normal” or “disordered”—and ultimately, this is an existential decision, not an objective determination.
With respect to the incidence and prevalence of (unipolar) depression among adults, the best epidemiological studies do not support the “epidemic” narrative. For example, a study of the Baltimore, Maryland catchment area between 1981 and 2004 was recently carried out. Participants were selected from the household population in 1981, and interviewed in 1981, 1993, and 2004. Diagnoses were made via the Diagnostic Interview Schedule according to successive editions of the DSM-III and IV. There was indeed a rise in the prevalence of depression in the prior quarter century among 1 subgroup: middle-aged females. However, overall depression incidence rates (new cases) in the period 1993-2004 were actually lower than the period 1981-1993, suggesting that the rise in prevalence is due to increasing chronicity. In other words, previously depressed patients were continuing to be depressed—there was no evidence of an “epidemic” or “surge” of new cases of depression. (It’s important to point out that, in principle, rising or “accumulating” prevalence of an illness may drive up treatment and/or disability determination rates, without signaling an increase in “new cases” or incidence of the condition).
Similarly, most epidemiological evidence gathered since the beginning of the neuroleptic era (ca. 1954) does notsupport the claim that schizophrenia is significantly increasing in incidence or prevalence, either world-wide or in the US.11 To be sure, rates of schizophrenia vary considerably from country to country, and from rural to urban settings (eg, showing increased incidence in South London from 1965-1997). Rates of schizophrenia are also critically dependent on methods of detection; eg the use of lay interviewers versus clinicians, and the use of open versus structured clinical interviews. Nonetheless, a recent study of the incidence of schizophrenia and other psychoses in England, 1950-2009, found essentially “no evidence to support an overall change in the incidence of psychotic disorder over time, though diagnostic shifts (away from schizophrenia) were reported.” Since antipsychotic medications have been used for decades in the UK, this finding argues strongly against the notion that these drugs are markedly increasing new cases of schizophrenia.
Dr. Peter Buckley, an international expert in the area of schizophrenia, wrote in an email that “There is no evidence of a shift in incidence or prevalence discernible over recent years” with respect to rates of schizophrenia. Consistent with this view, a study by Cowan et al15 evaluated patterns of initial hospitalizations for schizophrenic disorders among US military personnel for 2000-2009, and found “no consistent changes in rates over time.”
Another useful way of assessing claims of an “epidemic” of psychiatric illness is to examine measures of psychological “distress” in the general population, as a function of time. The Substance Abuse and Mental Health Services Administration (SAMHSA) of the US Department of Health and Human Services recently reported on a measure they call “serious psychological distress” (SPD). SPD does not represent a specific psychiatric diagnosis; rather, it measures the presence of mental health symptoms that may negatively affect a person’s ability to participate in family, community, and work life. SPD is measured by a symptom scale designed to assess psychological distress within the past 30 days. The most recent report from SAMSHA, Mental Health, United States, 2010, reached an important conclusion; namely, that “National levels of psychological distress in adults have remained relatively stable for more than a decade.”[http://www.samhsa.gov/data/2k12/MHUS2010/MHUS_2010_part1_508.pdf].
The report also assessed another dimension of psychiatric impairment called “serious mental illness” (SMI). This is defined by both symptoms and their resulting serious functional impairment in the past year. According to the SAMHSA report, approximately 11 million US adults had serious mental illness, representing 4.6% of the population. There is no credible evidence to suggest that this represents a dramatic increase from previous determinations of SMI. For example, the 2001 National Household Survey on Drug Abuse (NHSDA) estimated that about 15 million adults aged 18 or older—7 % of the US population—experienced SMI during the past year.17 While the SAMHSA and NHSDA studies used somewhat different methods of calculating the SMI rate, the estimates from 2001 to 2009 do not point to a burgeoning increase in serious mental illness in the US.
Furthermore—and contrary to some widely-publicized claims1—there is little evidence showing a dramatic increase in mental health treatment in the US. The most recent SAMHSA report actually found that “. . . since 2002, adult use of outpatient mental health treatment has declined slightly, while inpatient treatment use has remained stable.” While this finding is not unalloyed “good news”—after all, there is evidence of significant under-treatment of serious mental illness in the US.18—it hardly supports the claim that this country is witnessing a new “epidemic” of mental illness. Nor does it support the hypothesis that psychiatric treatments, including medication, are fueling an “epidemic” of serious psychiatric illness. If this were the case—and even allowing for more restrictive admission policies–we should be seeing a “signal” in substantially rising rates of psychiatric hospitalization.
In sum, there is little credible evidence that the US is experiencing a huge spike in serious psychiatric illness, at least among adults. This does not mean that psychiatrists should be complacent regarding markedly increased rates of diagnosis—for example, of ADHD or autism—nor should we minimize the potential side effects of psychiatric medication. But while carefully attending to these issues, we should not lose sight of the bigger picture. Uninformed fear-mongering about an “epidemic of mental illness” only distracts us from the sad reality of mental health care in the US—namely, that tens of millions of uninsured or impoverished individuals are unable to avail themselves of the best available psychiatric treatments. Now that is an “epidemic” worth worrying about.
Given that David Bates’ long comment denying the facts presented by Robert Whitaker in ANATOMY OF AN EPIDEMIC is based on the typical fraud, lies, junk science and corrupt “experts” in bed with BIG PHARMA/BUSINESS and equally corrupt government hacks, I’ll take Whitaker’s word any day of the week.
Bates does exactly what he accuses Whitaker of doing by acknowledging the huge increase in bogus bipolar stigmas to push the latest toxic drugs on patent per Dr. David Healy in his enlightening book, MANIA, and many others while pretending it is an unknown mixture of “possible” past underdiagnosis and other lies. Studies have been done by those like mainstream Zimmerman showing a huge number of adults stigmatized with bipolar did not have it, but rather had Complex PTSD often given the deliberate insult stigma of borderline per Dr. Judith Herman, trauma expert.
There are so many self serving lies in this BIG PHARMA/PSYCHIATRY ad, it is futile to try to address them all. One of the main problems is the author uses the junk science DSM and its bogus stigmas VOTED in by a white old boy network with huge conflicts of interest and ties to BIG PHARMA/BUSINESS. Dr. Paula Caplan now protesting the damage done by DSM stigmas exposes the stunning lack of science and evidence that goes into the bogus medicalization of normal lie known as the DSM. The DSM is known as psychiatry’s “bible” because it is based on revelation known only to those key opinion leaders (KOL’S) serving as hacks for BIG PHARMA/BUSINESS as they cocreate the latest stigmas or expansion thereof to push the latest toxic drugs and other tortures like ECT. This makes for a very dishonest, corrupt enterprise just like all the lethal drugs and other tortures it forces on those in distress in the guise of treatment for nonexistent “illnesses.”
Phone surveys using bogus check lists are not bona fide studies like those cited by Whitaker.
And contrary to what the author says, the worst thing that ever happened was forcing health insurers to grant parity for psychiatry’s right to destroy people’s health, lives, livelihoods, reputations, families and social lives with their bogus stigmas and lethal drugs. Of course, no surprise Ted Kennedy promoted this given his sister was given a lobtomy by his great father so she wouldn’t interfere with the boys’ great future careers.
The best thing that could happen is that the economic crisis forces the government and others to admit that the massive harm and disability caused by psychiatry/the mental death profession in bed with BIG PHARMA is no longer sustainable even though it does contribute huge wealth for the 1% and its fascist cohorts in crime by preying on the vulnerable and/or protesters and destroying their health and lives with impunity.
Robert Whitaker exposes the corruption that occurred when psychiatry adopted the so called “medical model” of psychiatry that had nothing to do with medicine or health of anyone but the APA and psychiatrists whatsoever!
Interesting “reaction” Donna:))
This is not my comment at all and I posted the Pies article only as an example of the current mainstream stance on the perception of an epidemic of mental illness.
The use of SSI/SSDI statistics is interesting because it speaks to a deeper issue in the debate about mental health. Another comment on this thread points to the cultural differences in recovery rates in countries where there is no social security safety net?
Here in South East Asia, the safety net is still the extended family and points to the validity of the human centered approach, compared to a statistics & ratios attempt to understand of the human condition.
If there is an epidemic of mental illness in America, is there a deeper issue of a society in distress, beneath the obvious corruption in the predatory nature of capitalism?
There are few other experiences that challenge the very nature of what it means to human, like madness does? Yet we seem to prefer an “us vs them” debate about “treatment” rather than face up to what lies within each of us, as the root of the mental illness experience.
As long as the focus stays on the treatment of illness and the logistics of health care, we will conveniently dodge the underlying issue and fail to address Michael Cornwall’s potent question, “if madness is not what psychiatry says it is, then what is it?”
Do we all avoid deeper self awareness, by scapegoating “them?” Consider Murray Bowen’s notions of our emotional projection processes;
The societal projection process: The family projection process is as vigorous in society as it is in the family. The essential ingredients are anxiety and three people. Two people get together and enhance their functioning at the expense of a third, the “scapegoated” one. Social scientists use the word scapegoat , I prefer the term “projection process,” to indicate a reciprocal process in which the twosome can force the third into submission, or the process is more mutual, or the third can force the other two to treat him as inferior.
The biggest group of societal scapegoats are the hundreds of thousands of mental patients in institutions. People can be held there against their wishes, or stay voluntarily, or they can force society to keep them there as objects of pity. All society gains something from the benevolent posture to this segment of people. A fair percentage of people are too impaired to ever exist outside the institution where they will remain for life as permanently impaired objects of the projection process.
The conventional steps in the examination, diagnosis, hospitalization, and treatment of “mental patients” are so fixed as a part of medicine, psychiatry, and all interlocking medical, legal, and social systems that change is difficult. There are other projection processes. Society is creating more ‘patients” of people with dysfunctions whose dysfunctions are a product of the projection process. Alcoholism is a good example. At the very time alcoholism was being understood as the product of family relationships, the concept of ‘alcoholism as a disease” finally came into general acceptance.
There might be some advantage to treating it as a disease rather than a social offense, but labeling with a diagnosis invokes the ills of the societal projection process, it helps fix the problem in the patient, and it absolves the family and society of their contribution. Other categories of functional dysfunctions are in the process of being called sickness. The total trend is seen as the product of a lower level of self in society. If, and when, society pulls up to a higher level of functioning such issues will be automatically modified to fit the new level of differentation. To debate such a specific issue in society, with the amount of intense emotion in the issue, would result in non-productive polarization and further fixation of current policy and procedures.
The most vulnerable new groups for objects of the projection process are probably welfare recipients and the poor. These groups fit the best criteria for long term, anxiety relieving projection. They are vulnerable to become the pitiful objects of the benevolent, over sympathetic segment of society that improves its functioning at the expense of the pitiful. Just as the least adequate child in a family can become more impaired when he becomes an object of pity and over sympathetic help from the family, so can the lowest segment of society be chronically impaired by the very attention designed to help. No matter how good the principle behind such programs, it is essentially impossible to implement them without the built-in complications of the projection process.
BTW, Bowen is one the father’s of the family therapy movement, like the Milan family systems approach, which open dialogue is based on.
Try to FEEL the impulse of your reaction Donna, you come to know the source of your reason?
I am familiar with Bowen, family systems THEORY, the Karpman Triangle and lots of other mental “health” theories. Dr. Stanton Peele’s THE TRUTH ABOUT ADDICTION AND RECOVERY is a good book exposing the fraud of the disease theory of all so called addictions as have others. They made little headway but lots of enemies because fraudulent addiction “treatment” is too lucrative too. You might also like Dr. Patrick Carnes’ THE BETRAYAL BOND. I find these theories tend to blame the victim too much though parts of them can provide some insights like those into abusers. Are you in the mental health profession and if so, what is your role?
I do not appreciate being psychoanalyzed by you since you dont’t know me or anything about me.
Since most of your comment was about mainstream psychiatry’s take on why there is an epidemic of so called “mental illness,” that is what I focused on when responding. I have done tons of research on what I now call the mental death profession, so I have little patience with the self serving lies of main stream psychiatry and its cohorts in crime.
I am a big fan of Dr. Peter Breggin’s and get his newsletters. I recently sent a protest to Dr. Breggin because there was a similar dishonest, self serving article by Dr. Pies on Dr. Breggin’s web site. Of course, I made sure to tell him that I hold him in the highest esteem since he helped me save some loved ones from the typical fate of those destroyed by psychiatry. Since it was presented along with the noble Dr. Fred Baughman’s usual exposure of the fraud of biological psychiatry, I assumed it must be there by accident since it certainly did not represent the type of views typical of Dr. Breggin or Dr. Baughman. I recently got a response from Dr. Breggin’s wife promising to remove the offending article there by accident.
Dr. Thomas Szasz calls psychiatry THE SCIENCE OF LIES. I believe those in mainstream psychiatry lie quite knowingly for very self serving purposes in bed with BIG PHARMA, corrupt government hacks like themselves, BIG PHARMA front groups like NAMI and CHADD for greed, power and status by destroying their victims with impunity. Therefore, I don’t see much point in trying to win with such psychopaths because Dr. Robert Hare, the world authority on psychopaths, can assure you that there is no winning with psychopaths. See Dr. Hare’s WITHOUT CONSCIENCE and SNAKES IN SUITS. The book, POLITICAL PONEROLOGY, is an excellent explanation of how these intraspecies predators or psychopaths highjack relationships, groups, countries, religions, governments, professions and all other organizations to corrupt them from within. The only hope of taking back our country is for people to wake up and see through this horrific menance, which will take a great deal of maturity and sacrifice on everyone’s part.
I’m returning the favor and giving you my take of some psychological principles at work here.
Consider your own reaction.
David, I do regret if I made it appear that you wrote the article by Pies. Frankly, I am all too familiar with mainstream psychiatry’s views ad nauseum, so I found Pies’ article revolting to say the least. I’ve gained much knowledge from tons of research on the latest fraud fad of bipolar disorder in psychiatry along with psychiatry’s sordid history with past and present bougus eugenics theories to destroy others in the name of science.
Other interesting books on psychopaths include Dr. Hervey Cleckley’s THE MASK OF SANITY (THE CLASSIC), Dr. John Clarke’s WORKING WITH MONSTERS, Dr. Martha Stout’s THE SOCIOPATH NEXT DOOR and PUZZLING PEOPLE by Thomas Sheridan. Tim Field’s BULLYONLINE is a great web site devoted to all kinds of abuse and bullying by the pathological including psychopaths. Sadly, a majority of those who appear mental cases are victims of abuse/bullying by the pathologicals including psychopaths and malignanat narcissits in society at large. I urge everyone to educate themselves about these human predators since everyone will encounter them sooner or later, so it is critical to be able to recognize them.
Thank you for drawing attention to Dr. Ronald Pies’ Psychiatric Times blog post “Is there really an ‘epidemic’ of psychiatric illness in the U.S.” (link above)
In the comments section after the blog post Pies links to E. Fuller Torrey’s review of “Anatomy of an Epidemic,” calls it “excellent” and states that it “lucidly debunks” Robert Whitaker’s claims and conclusions.
Any healthcare professional (but only healthcare professionals) may make comments at the Psychiatric Times. I hope that someone with this professional status will post a link to Robert Whitaker’s response to Torrey so that Psychiatric Times readers who are unaware of Robert’s careful and diligent response to Torrey might learn from it.
Some people just can’t handle any thoughts that Robert Whitaker might ever be wrong. He is their new prophet for the wrongs of psychiatry and psychiatric medications. Geez, he is just a man who wrote a book on what started out a journalistic report. And now he makes more money from all of you when pay him to speak at your conferences and whatever else he does for “the cause.” I read two books and won’t buy anything else by him. I only bought one of those books. Other one was loaned to me by a friend. If I hadn’t read them, I wouldn’t find myself here writing, ugh!
You did not read them. Who are you trying to fool? Maybe you read the text on the flaps but that’s all. You could not even summarize the thesis of Anatomy of an Epidemic. For example how does Whitaker explain the enormous increases in bipolars-=–specifically. Of course you can’t.
Seth Farber, Ph.D.
Yes, I did read the book – both of them. I chose to read the books due to the interest of many people I know that think highly of Robert Whitaker. I had no preconceived notion about him when I read the first book. After reading “Mad in America” I has some concerns and talked with my friends. I then read “Anatomy of an Epidemic” still concerned.
I understand that we all have our own opinions on things, including this topic and other subjects. To add on the subject I don’t believe in forcing someone to taking medications if the don’t want to take them. Anti-psychotics take a hard toll on a most person body.
Does Torrey have the perfect solution? No he doesn’t. Many psychiatrist don’t have a perfect solution even those who don’t prescribe meds. It is a hit and miss kind of thing. IMHO. There is no ideal solution for anyone who deals with a mental health disorder.
I did read more than just the texts on the flap and currently I would need to re-read the book, actually both books, to summarize the thesis. I didn’t realize I needed to know it by chapter and verse to be able to give my thoughts on it.
I don’t think that I have to believe everything thing he writes in his books. I have a right to think for myself. I refuse to follow the thinking of the Robert Whitaker’s and the E. Fuller Torrey’s of this time. Both have good and bad points.
The more Torrey is discussed the more power you are giving him.
I’ll get back to you on summary the thesis of the book and the enormous increases in bipolars – specifically. And of course, I can. I have both books are ready to be re-read, articles on hand and to let you know. I shall take this as a challenge. Is it easier to post it back here or do you have another place for me to get back to you on this?
Thank you for giving me the idea to challenge myself. I know what I believe. I’m just doing this because I enjoy researching and becoming more informed on all subjects. Even if it proves me wrong.
Oh god, not Torrey Fuller, please god spare us any more of this man’s merciless nonsense. I detest the man. When is this odious rabble-rouser going to spare humanity of his pestilential presence?
Why would anyone, apart from the people who find his backwards views amenable to their own interests, take a man seriously who has such a long and ignoble history of lying? If his psychiatric subjects were to tell the kind of lies he does, they’d say it was a symptom of their illness. The guy has less regard for truth than Hitler and Goebbels put together.
Apropos of the supposed logic being for forced treatment that they get people better, there can be no justification for drugging innocent people. Such people who perform these acts, are socially and legally sanctioned rapists (as well as the worst kind of drug-dealers), regardless of whether or not they force purrulent chemicals into your body with caring manners and mien or not, proclaiming themselves to be the supreme arbiters of what is in your best interests, and regardless of what linguistic ornamentation they prettify their morally despicable acts with.
Whether or not the drugs can be shown to benefit the indivdual (bearing in mind that the criteria for this are extremely nebulous) is ancillary to the matter of greatest import, which is that forcing drugs into a person’s body is somewhat consubstantial with the phenomenon of rape, in that both inflict immense psychological damage as well as damage to the ego and your sense of self-worth; both involve sticking something into a person’s body against their will; and both implicate a power differential, with the stronger availing himself/herself of their power. Also, just like has been common with rape victims, psychiatric rape victims have a tendency to internalise the despicable way other people treat them and come to see themselves as deserving of such treatment, which is the why whole argument about psychiatric rape being tenable on the grounds that the patient sometimes is grateful is about as absurd as defending chattel slavery on the grounds that manny slaves are happy, grateful slaves.
The sine qua non of relations between a medical practitioner (or nominal medical practitioner as with psychiatrists) and a patient is consent, not whether or not the patient can be shown to improve or not, to paraphrase Thomas Szasz.
I was asked to do a presentation last November, before the Orange Co. Homelessness Commission and Board of Supervisors, on my opposition to “Laura’s Law,” California’s outpatient commitment laws. A paid TAC representative, citing no research and mostly Torrey/TAC rhetoric presented the opposite view. In my prep. I discovered one of Jaffe’s (co-founder of TAC) reported quotes from Stigma Clearinghouse: “from a marketing perspective it may be necessary to capitalize on violence” to pass laws compelling psychiatric outpatients to take psychotropic medication.”
I was given five minutes, hardly enough but presented this PowerPoint summarizing the extant research establishing outpatient commitment as ineffective, including some samples of the search:
It would help if the link worked
The link does work. sf
ran across this quote today while working on a piece. “The main advantage of depot antipsychotic medication is that it overcomes the problem of covert noncompliance.”So, you doped them into doing what YOU said they should do. I have known people with schizophrenia. It’s a horrific disease with a more horrific treatment. With just what I’ve seen, I find it ridiculous to claim that noncompliance is based on a selfish bid for personal gratification. From what I saw, these people live in perpetual anxiety and fear. You only choose that life over treatment, when the other option is too horrific to consider. Also, the idea that we lack insight is absurd. There’s a constant level of anxiety as you walk through the office that someone might know. Then, you slip up and say it.. and they look at you like they’re ashamed for you; like you don’t know enough to be ashamed of yourself. I worked in a position for four years before my medications had to be changed and I went on LOA. When I returned, they refused to train me on what I had missed passively. Then, took me out of good standing with no bonuses for not having the training. In four years, I had always kept it together, but I was told I couldn’t take my meds on the floor anymore. This led to a panic attack. I excused myself to the bathroom, and had only been gone about 5 minutes when my supervisor slammed the door open, ordered me out of the stall and gave me the choice of going back to my desk or being fired. I wasn’t even allowed to wash the mascara off my face before she marched me the long way through the office. That’s what this type of view of mental illness and treatment has gained us. I don’t pretend to be as bright or educated as Dr. Torrey, but a simple retort, ” Tell me how this medication helps to treat the cause of my disorder otherwise you’re arguing a moot point because you are avoiding tackling the the truly important question, why would you risk human lives for a medication that you can’t even show to be scientifically and medically valid.
His tone and clear resolve to treat you as insignificant regardless of your findings from the start. His ego won’t allow him to mask his bias, but he did contribute one thing to psychiatry, and it was probably his only contribution. He vividly outlines the methodology used in psychiatry to skew the findings, regardless of their clarity, to reflect anything he wants.
I forgot to mention. No one has mentioned the irony of the fact that E Fuller Torrey started out as s student of Thomas Szasz. His first book was a critique of the expansion of psychiatry in the tradition of Szasz. He became increasingly fixated in meddling in his sister’s life whom he insisted was schizophrenic.
The sacred symbol of psychiatry became an idee fixe in Torrey’s mind, and some how he gradually gae up all the principles he originally believed in. SF
I heard that Torrey’s sister has schizophrenia which is one of the reasons he became interested in research for it. Is there some where that you can point me towards that states that he “increasingly fixated in meddling in sister’s life whom he insisted was schizophrenic” because that doesn’t sound right.
Maybe the irony of E Fuller Torrey starting out as a student of Thomas Szasz was that he figured out that Thomas Szasz was wrong about he theory of mental illness. That sounds plausible to me.
I don’t need studies. I am the simple proof, I was cured of schizophrenia thirty-five years ago.
I’m just glad that no one like Torrey or is act-alikes got their hands on me. And I’m glad it was in the old days- If it was now in the time of a very aggressive CTO program (Community Treatment Orders), the DSM and and the apparent triumph of the Biomed Psychiatric Industry, I would be living dead meat or a ‘walking dead’.
I am quite active in my community and I know many of the living dead, and I know their minders who are helping to keep them dead. The whole industry is regimented in an almost military-like structure -I never see even a glimmer of hope, protest or awareness there. It is exactly as if I was a lone neutral observer at Auschwitz watching ‘the Beast’ at work.
The world the Torreys have created is a totalitarian horrifying machine that is sucking the life out of all it’s members both prisoners and keepers and like a predator ever searching for more victims and even more populations of victims.
That is a powerful statement. I think you are right. There are certain procedures that once implemented gradually produce a “chronic mental patient.” The drugs play a major part but so do the various rituals of degradation. What you then see—as you describe–is a de-spirited human being, a victim not of “schizophrenia” (which is a spiritual crisis usually) but of the “mental health” system.
I am a dissident or renegade psychologist. Are you aware of my latest book? One could call it a neo-Laingian approach to madness and social transformation. It is The Spiritual Gift of Madness: The Failure of Psychiatry and the Rise of the Mad Pride Movement [Paperback]
Seth Farber (Author), Kate Millett (Foreword)
Seth Farber, Ph.D.
Plugging a book, eh? I’m curious to know are you total against medication? Or is reading books a cure all? I just don’t get this movement is it that: meds – bad, books to tell me how to be well – good?
What is best????
You have very naïve ideas about publishing. You make little or negligible amounts of money for a book of this kind. Even Bob’s books–which sold fairly well for a book of this kind–would not pay his rent for a year. Had money been his concern he would not have picked this topic. The enormous amount of effort is not commensurate with the meagre financial rewards.
My books make virtually nothing since if you sell less than 10,000 copies (as I do) the author only makes 5% of the profits–enough to pay the rent for a month if you include the advance.
I write out of moral conviction. The reward is not financial. Your idea that we are writing these books to make money shows how little you understand about the motivation of people with strong convictions. Take Thomas Szasz– he spent half his life writing and probably made little money on his books.
I would have to sell about another 5,000 books to make more money beyond my advance. I don’t “plug” my books to make money (which I don’t do) but because I want people to read my books and wrestle with my ideas.BecAuse I want to save people and recruit them to the Mad movement.
If you want to post you summary of Anatomy you could do it here, or on my FB or both. (I’ll confirm you on FB.) I have 2 FB pages. Here’s my personal one. https://www.facebook.com/SethF1968
Seth Farber, Ph.D.
Actually I do understand that publishing is not a money maker for most authors. I know people who have written book and self-publish because of they very reason you do and their own personal reasons. They are still working at their jobs which is their source of income. I wrote the thing about plugging a book as a jab. Didn’t you notice after that I just asked what your thoughts on medications? I was you if asking about reading books being a cure all (referring to the other authors you posted about.) I was being rhetorical which may not have been the best time to be rhetorical.
I admire those who write their first hand accounts of what has happened to them because it isn’t easy. I don’t even know how to start to try to write down my account of what happened to me within the mental health system. It hasn’t been all roses and skipping through those rose pedals. I have my share of experience of horror within the that system. How I have chosen to handle has been how I manage and continue to survive. Many of us are like that, we survive. I just don’t associate myself with the Mad movement, a personal choice and/or lack of information on it.
It is obvious that writing isn’t one of my best areas. I don’t have a Ph.D. I have a lot of life experience. I have made changes and I’m known in my community for what I have done. I have ruffled the feathers of officials and I still show up for state meetings. I sit on advisory committees. They don’t have to like me. I not there for them to like me. I’m there to advocate for myself, others and to know what is going on. Anyway I don’t need to go on any further. I’m great where I stand. Just as you are where you stand.
I own many books by authors I realize that don’t make the in mainstream media. One of the first ones I read was “The Center Cannot Hold” by Elyn R Saks. An amazing woman! I have read Loren Mosher’s book on Storia House (I’m sure spelled something wrong in that last sentence.) Being able to write is a talent and if you have it then that is great. FYI, I looked at your link provided for your book after I posted. The book looks interesting. You think I’m naïve and maybe in some areas I am naïve. I don’t mind having still being naïve in some areas because it allows me to know that I’m not jaded it every part of my life.
Thomas Szasz is an interesting fellow. I happen to own two of his books. There is a documentary that is out on him “The Last Interview of Thomas Szasz” which on DVD for sale. I’m thinking of buying it because I have started reading “The Myth of Mental Illness.” I find myself frustrated by him and amused at the same time.
As for my summary of Anatomy, I can only imagine what fun you might have tearing me apart on it. I’m not sure I’m ready for that in a public arena. I’m not afraid to write it and at the same time I don’t feel like been torn up in front of others if what I write isn’t consider up to others liking. I suppose no one does likes it. I realize that you pointed out where I go just go read it in another post. I would have a different perspective because we each have different ways of thinking. If we all thought the exact same way then it would be awful boring. I get that you want to save people and recruit them to the Mad movement.
I have noticed a lot of talk on Torrey and AOT lately. I reading a blog that I subscribe to and he was following a discussion of Facebook and found it strange in the fact that from what he could had something to do with new “mental health reform” law. He gathered maybe “..it was as it they thought E Fuller Torrey was God’s judgment on the recovery movement.” I find his blog well thought out. He admits he still confused by the discussion on Facebook. Of course they was more written. Perhaps I jumped in a discussion on this site that well discussed a year ago and started throwing out my thoughts and opinions.
If you really care about what I come up with after re-reading both of Whitaker’s books, the rest of the other discussion and want to see what I come up with then privately read I’m willingly.
I’m open to learning new idea and thoughts. I have good and bad days. The last few days have not been my good days. I sometimes like to say things to stir the pot which is my bad. I’m old enough to know better. I’m allowed to a few moments at times or do I need perfection? joking – on the perfection.
Robert Whitaker has good points and Torrey has a few. AOT isn’t one of them. Maybe this will show my naïve thinking in this next thought. Isn’t it sometimes time consuming to spend arguing on who is right or wrong when we should work together, not against each other, as a whole collectively? Not putting Whitaker or Torrey in the picture? They put out the information so now we can figure out what we can do with it.
AOT is something that needs to be dealt with in states that have it. I know that it isn’t used in state I live in. We had three state hospitals and now we have one open that has beds have almost been eliminated, expect for one that has about 90 beds for those committed, it houses more beds for civil commitment of adult male sex offenders (personally they can stay in there forever that is just how I feel about them), an area for young tweens to teens sex offenders, and drug & alcohol treatment for male teens and a forensic unit. They are working on lower those 90 beds those committed for at least a year. It is not easy to get into a psych unit in the community either.
I’m rambling now. Signing off.
AOT exists in all but 2 or 3 states. But you are focusing on superficial changes. More people are on psychiatric drugs than ever before and the most rapidly expanding market is children–they don’t have much choice. Kids who end up in foster care or other institutions are far more likely to be placed on drigsd–cocktails of drugs. AOt is just the tip of the iceberg. The real problem is as I stated the existence of a psychiatric-pharmaceutical industry that markets drugs and markets diseases.Just this past Sunday there was article in NY Times on the selling of ADHD.
You don’t need coercion when those whom you trust the most (doctors, psychiatrist) are pushers for the drug industry who systematically mislead you. THAT’s where you make money–not writing critiques.And those you expect to protect you–the FDA– are controlled by the drug industry itself.
I suggest you begin with Anti-psychiatry 101
Which would be Breggin’s book Toxic Psychiatry.It is the simplest and the best introduction to the topic. My first book Madness, Heresy and the Rumor of Angels with Foreword by Szasz)is much more elementary than my current book. You need to start at the beginning.
Seth Farber, PhD.
PS The questions you ask are answered in any of my books.
I agree about the drugging of children is rapidly expanding. I can’t believe the amount of medication children are put on. Given medications for ADHD during the week and then off them on the weekend. I know how much children are on drug cocktails because of the high rate of foster care in my state. It seems that once a child is in foster care they are put on medication, as well as seeing therapists and doctors. Children are too young to be taking any of those medication.
After I posted last night I did go to your website. I did bury your book “Madness, Heresy and the Rumor on Angels” without any prompting before this post. I think I will wait a while before getting “Toxic Psychiatry.” I need to balance my reading with other things. I don’t exclusive read these types of books. I also read fiction, political biography and memoirs, and on my faith. I tend have least two books that I’m reading at most times.
I think that I have read more books on this than you think I have. I think this is why my position tends to be hard to define at times even for me. I have strong feelings at times about one things then later my feelings about the same thing changes.
I’m working on what changes that I hope to obtain. If they aren’t obtained by me then hopefully I will have set up something that someone else will feel as passionately about it as I do.
I’m so gratefully that there wasn’t much
about ADHD when I was a child or I might have been on drugged up kid. Though I doubt it because my mom even now would not says she would not allow it. She knows that a young persons mind has yet to fully develop and that medications won’t and don’t help the situation.
I look forward to reading your book when it arrives to my home.
I am honestly terrified of Torrey, but today, having stumbled on TAP’s facebook, I was so disgusted I couldn’t stop myself. I find the random diagnosis of movie stars that have neither sought their help or even spoken with them repugnant. It is professionally and morally unethical.
Haven’t taken anti-psychotic drugs or any psychiatric meds for over 7 years now. My mind functions better than it EVER did on those drugs. There is no delusional/hallucinatory thinking as what I experienced ON the medication. I had a “serious diagnosis” and if I have not experienced the criteria of that for many years, I’d wager to say it is gone. I believe some doctors used to manipulate the diagnostic labels to fit the criteria of disability forms without telling the patient, this label is going to be hard to shake once it’s applied. Unsuspecting patients become pawns of the Pharmaceutical industry this way. A very sad sate of affairs, indeed!
Robert Whitaker is similar in away to E. Fuller Torrey. Hear me out before reacting. Both have an agenda. Both of them write books and both want to make money from them. They write articles and now challenge each other. Robert Whitaker is reporter who really has gained fame from a book he wrote that if it had not been noticed by those who are anti-psychiatry and/or psychiatric anti-medication. He said in his second book that when asked if he had he wrote the books because he had family members effected by psychiatric problems. He said no and that he was doing research for medical articles (or of that sort.) So now he is famous in certain circles because people have a need to believe in the “evil” of all medication especially anti-psychotics. Mr. Whitaker has only what he has chosen to use in what he printed. What happens when medication has made all the difference in a person life? E. Fuller Torrey knows something about that and he actually has a medical degree. Whitaker does not. I don’t agree completely with E. Fuller Torrey’s AOT thinking. It stems from a failed mental health system. When a person is begging for help and not getting any then pushes a women in front of a subway train then get help, all the wrong kind of help, then a law comes into place “Kendra’s Law” so where does this not helping and helping someone become a non-issue in which is trying to be addressed?
I wanted to note that Whitaker mentioned that name of his book as much as he could. I’m sure that while he caught all of Fuller’s mistakes, someone could go to what Fuller wrote and find Whitaker’s mistakes.
/b>I suppose we can just take all anti-psychotics off the market and all people on them off of them. I just want to ask, who will be willing to care for them and also who will take responsibility for them when something horrible goes wrong?/b> I’m certain Robert Whitaker will take a huge step back and act as though he had not one thing to do with it as well as his “followers.” Is this were E. Fuller Torrey and others like them step in to help?
I wish I had not heard of Robert Whitaker’s books. I read E. Fuller Torrey’s book over 30 years ago when I first given the diagnoses of schizophrenia. It helped me and my family gratefully. Robert Whitakers books would have made great for my family to add to the fireplace.
The world is a HUGE place. What serves some via Torrey obviously won’t align with what serves others via Whitaker.
How about one of these ?
1. Rebecca Riley Law
2. Gabriel Myers Law
3. Emilio Villamar law
The argument “but psychiatry helps some people” is a tough one.
I am very selfish I guess , if help for someone else means I myself will be brutalized in the name of help I would rather the next person not be helped.
Thanks but no thanks, I got to be the collateral damage from Torrey’s ideas already.
“Were I to invoke logic, however, logic clearly dictates that the needs of the many outweigh the needs of the few few or the one “
That’s what this is about the is treatment harming more people than helping.
Torrey is responsible for putting hundreds of thousands of people in chains– whether legal or mental. Some people embrace their chains, not knowing any other way. Bob Whitaker is responsible for liberating 100s of thousands of people, and bringing light into their lives. There is no equivalence in service between the two. mjk ought to know that. In the past she witnessed to it.
Seth Farber, Ph.D., author of http://www.amazon.com/Spiritual-Gift-Madness-Psychiatry-Movement/dp/159477448X/ref=sr_1_1?s=books&ie=UTF8&qid=1387425617&sr=1-1&keywords=farber+gift
“The medications are known to be helpful, but—or so the argument goes—people with “severe mental illness” lack insight into their disease and this is why they reject the medication.”
There is a contradiction in this statement to begin with. Here’s why:
1) let’s assume I’m so psychotic that I don’t know I’m psychotic
2) I am getting coerced to take an anti-psychotic – a wonder drug which makes me better, right?
3) drug works and I’m getting back to normal
4) because I am normal again I can see that the drug helped me and I am grateful and happy and want to take it
Oh, wait… I don’t want to take it? Why if it’s working so well in making me better? It works so I’m not psychotic anymore so I can understand I need the drug, right? This is so much bs that reading through this one sentence only should make your bullshit detector into alarm mode.
Gee thanks for stealing what I was going to say !
Seems to me there’s at least one huge defect in the Harrow study which, for Whitakers thesis, is so axiomatic. It is this unquestioning assumption that ‘prognostic types’ are scientifically valid and reliable indicators. If we take this assumption out of the equation, then all we can conclude from the Harrow study is that severe schizophrenia and the tendency to use medicine correlate, whilst milder schizophrenia correlates with a diminished tendency to resort to medicine. That is of course exactly how it ought to be – one should only take medicine if one can’t manage without it. To assume that the poorer outcomes are actually caused by the medicine is, to put it mildly, jumping to conclusions. Because obviously, the alternative explanation is that it is the severest grade of schizophrenia which is causing the severest problems for a certain percentage of the sample, and quite naturally this subgroup is much more likely to attempt to solve the problem with medicine.
Harrow tries to correct for this ambiguity by dividing his sample into good and bad prognosis, and weighing the relative merits of medicated and non medicated in each of these groups. But there is absolutely no guarantee whatever that these group matchings are reliable. Prognosis in physical health is often inaccurate – in mental health inaccuracy is notorious. Bleuler was already aware of this a hundred years ago and warned that his categories of schizophrenia only gave very approximate prognostic guidelines.
Whitaker’s summary of the Harrow study is not consistent either as far as i can see. In 2. (Spectrum of outcomes in the schizophrenia group) he says that 39 of the 64 shizophrenic patients who remained had been continuously on medication whilst 25 stopped taking medicine. (We don’t get to know at what point.) In 7. (Sustained periods of recovery in the schizophrenia-spectrum group.) he writes that only 24 of the 64 patients continously took medicine. The difference could perhaps be explained by the first figures being the 15 year follow up and the second the twenty year follow up. Perhaps. If so then a reasonable conclusion would be that after twenty years the 24 most chronically ill were still taking medicine and, regardless of whatever prognosis they were given at the start, with hindsight it should have been these 24 who received the poorest prognosis.
Again Whitaker is very unclear when in 7. he writes “In contrast, there were 15 in the group of 70 who were off antipsychotics by the two-year follow-up . . .”. Which group of seventy is that? The remaining group was 64, so does that mean we lost 6 along the way? What happened to those 6 could be statistically very significant in such a small sample as this.
All in all, as far as I can make out from Whitaker’s incomplete summary, at least 17 of these schizophrenics could be counted ‘recovered’ at some point in the twenty years. 17 of 70 is . . . well . . . 25%. I have to agree with Torrey Fuller that this study does no more than confirm what has already been known for 80 years, and certainly does not succeed in shedding any light on the perplexing issue of whether chronicity in schizophrenia follows the course of taking medication or whether taking medication follows the course of chronicity.
And talking of dishonesty I have to say that I suspect Whitaker’s account of the role of eugenics in getting people committed to psychiatric asylums in the mid to late 1800s to be largely a product of his own fantasy. I’ve never read this elsewhere, and in spite of Darwin’s genius, neither the scientific community nor the population at large had, at this point in history, any clear idea of the biological workings of inheritance. Horrific as the asylums no doubt were in many cases, they were nevertheless from a humanitarian point of view, a huge improvement on what went before them, and the building and direction of them was motivated by Victorian ideals of morality; indeed what we now call schizophrenia was widely thought to be a condition of moral inadequacy, which could and should be corrected by the careful application of moral treatments in a protected environment. Few, if any scientific or political administrators would have cherished any notion of this moral inadequacy being biologically inheritable, and we can be reasonably certain that the huge amounts of money spent in building and running these institutions was not motivated by the need to ” . . keep them from breeding.” as Whitaker so charmingly phrases it. The notion is reprehensible and dishonest.
“all we can conclude from the Harrow study is that severe schizophrenia and the tendency to use medicine correlate, whilst milder schizophrenia correlates with a diminished tendency to resort to medicine. That is of course exactly how it ought to be – one should only take medicine if one can’t manage without it.”
This is a self-serving explanation that is clearly at odds with the facts. It is often the persons who manifest the most symptoms who refuse to take their “meds.” They are not eager beavers. Out-patient commitment was based upon the idea that many “sick” patients will refuse to take “anti-psychotics.” The last figure I read was 70%–70% of “schizophrenics” were “treatment-resistant.” If all those patients have such mild symptoms why must they be forced to take drugs? And if they have severe symptoms how come they are resistant? People don’t like to take “anti-psychotics” because they have such virulent “side-effects”–one might as well argue that “sicker” have even less tolerance for side-effects. Considering the wide-spread phenomenon of “non-compliance” as shrinks call it, the idea that the difference in outcome can be explained b y the likelihood that “sicker” patience are more likely to take neuroleptics
is unpersuasive. Furthermore it does not explain the results of the WHO studies, or the more recent studies Whitaker surveys in articles on this website.
The fact that you so easily dismiss the impact of eugenics only testifies to you own ignorance. Read The Mismeasure of Man by Stephen Jay Gould or The Legacy of Malthus by Alan Chase,
Seth Farber, PhD.
Colin Bradley, since you claim to be such an expert, and stated, “I have to agree with Torrey Fuller that this study does no more than confirm what has already been known for 80 years, and certainly does not succeed in shedding any light on the perplexing issue of whether chronicity in schizophrenia follows the course of taking medication or whether taking medication follows the course of chronicity.”
How do you explain away the fact that the neuroleptic drugs can create both the negative symptoms of ‘schizophrenia,’ via neuroleptic induced deficit syndrome:
And, “This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to ‘improve’ what he perceives to be negative symptoms of schizophrenia, rather than antipsychotic side effects.”
And adverse reactions to the neuroleptics also can create the positive symptoms of ‘schizophrenia,’ via neuroleptic induced anticholinergic intoxication syndrome, the central symptoms of which are as follows, from drugs.com:
“memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”
And these symptoms are indistinguishable, to today’s doctors, from the “classic symptoms of schizophrenia,” or positive symptoms of ‘schizophrenia.’
And, given the reality that neither neuroleptic induced deficit syndrome, nor neuroleptic induced anticholinergic toxidrome, are actually listed in the DSM as potential causes of the “classic symptoms of schizophrenia,” meaning doctors can’t bill for creating these disorders, unless they misdiagnose them as one of the DSM “psychotic” disorders, in order to get paid. How do we know most, if not all, “schizophrenia” today is not completely iatrogenic?
I am aware there are lots of causes of “psychosis,” that are not “schizophrenia,” by the way. And just an FYI, there are some patients who took drugs prescribed by doctors, not because of really serious symptoms, but rather because the patients used to believe doctors were ethical and respectable people who’d promised to “first and foremost do no harm.”
And it’s pretty sad today’s number one, seeming etiology, of ‘schizophrenia’ does appear to be psychiatric misdiagnoses of child abuse symptoms as ‘psychotic.’
Especially, given the above medical evidence that the “gold standard” treatment for ‘psychosis’ can, indeed, create both the negative and positive symptoms of ‘schizophrenia,’ all by themselves. And, no doubt, especially in non-brain diseased children, dealing with a real problem, not a theorized “mental illness.”
As one Chicago special victims unit police officer stated to me, as he was refusing to look into the medical evidence of a child abuse cover up by this religion:
Read the chapter on evil, and I’m merely one of the, apparently many, “widows” who dealt with “the religious authorities that devour the widow’s purse, while hell bent on making sure the church suffers such agonizing theological carnage that it is no longer recognizable,” mentioned in the Preface. The police officer did concede, that if my medical research was correct, “we live in a truly disgusting world.” I agree, but did not agree with his lie he was a part of the solution, rather than part of the problem.
I do so hope the psychiatric industry will get out of the business of profiteering off turning child abuse victims, into ‘schizophrenics,’ with the neuroleptic drugs. Which according to Read’s research, does seem to be the likely reality in 2/3’s of all ‘schizophrenics’ today.
Cognitive dissidence is difficult to overcome. My best wishes to you, in your struggle to mentally comprehend how many patients you’ve likely harmed. No doubt, it will likely be difficult for you to overcome your delusions that the neuroleptics are “wonder drugs,” being used for good, rather than evil.
Bless your heart, “Someone Else”!…. I just saw this by comment by accident, and what to support what you say. The abuse I had as a kid wasn’t ritual, or horrific, or too sexual, and was mostly verbal, emotional, and psychological. And, I was well into adulthood before I FINALLY worked it all out, with some excellent psychologists, and a heckuva lot of reading on my own, and self therapy. But, my parents had taken me to a psychiatrist in high school, and I was “diagnosed”, labelled, and DRUGGED for 20 years! The drugs made things much worse than they needed to be. Same with the labels, and STIGMA. My issue here, is that even the label “schizophrenia” ITSELF is, -let’s be honest- an imaginary label for an imaginary disease. Look what they’ve done with “schizoaffective personality disorder”. More B.S., wrapped up in pseudo-science, word games, head games, and manipulations. All to $ELL DRUG$, and act as agents of social control. And, as you suggest, cover up child and sexual abuse. Thank-you! I feel better now!
You make quite a lot of assumptions on my part, which I won’t spend a lot of time on. I don’t claim to be an expert, and I don’t believe Robert Whitaker is either. I have no delusions that neuroleptics are wonder drugs, nor am I in any way trying to agitate for any acceptance of neuroleptics as the best or only treatment of schizophrenia. These drugs are dangerous, just as many thousands of other drugs used in many other fields of medicine are, and should be used with great care. I know of no other way to explain the fact that the neuroleptic drugs can create (or mimic) the negative symptoms of ‘schizophrenia,’ other than from existing research which suggests that excess dopamine activity in the brain’s limbic system has some relation to, (but is by no means an exclusive cause of) the phenomenon of psychosis in human beings, among others the so-called positive symptoms of schizophrenia, and that a deficit of dopaminergic activity in the frontal cortical area is implicated in the so called negative symptoms of schizophrenia. A good psychiatrist is of course well aware of these pitfalls in treating psychosis with medicine, and takes suitable precautions. The bad psychiatrists must vouch for themselves.
To get back to the point – and the only point – of my comment in this thread; Robert Whitaker replies to Torrey Fuller’s very pertinent critique of Whitaker’s reading of the Harrow and Jobe longitudinal study of the progress or otherwise of 70 schizophrenia diagnosed patients over a twenty year period. Fuller claimed that Whitaker was reading conclusions into the study which the study in fact does not bear out, and which apparently Harrow and Jobe explicitly denied were to be found in the study. Whitaker’s reply is really no reply at all other than a very brief summary of the study with a link to a more or less completely uninformative slide show, and the comment “I’ll let readers of this blog decide whether such findings are—as Dr. Torrey writes— ‘completely unremarkable.’ ” As a reader of the blog my conclusion is that the findings are indeed – as Fuller says – completely unremarkable, for the reasons I wrote of in my previous comment. However good or evil anyone may want to argue psychiatry to be, the study provides no evidence one way or the other to support any conclusion of the kind. Schizophrenics continue to recover today in the days of modern psychiatry, at a rate of about 25% just as they did a hundred years ago before medicine came into the picture, and another about 25% become chronically ill. I don’t know if that part answers to a similar figure for chronicity pre 1920s. I would imagine this would be a much more difficult comparison because of differences in mortality rates and patterns. And as Fuller notes there may be up to a million unmedicated chronically mentally ill on the streets of the USA. (Strange that Whitaker has absolutely nothing to say about that.) The 6 (or 55 if we include all the other none schizophrenic patients ) who disappeared from Harrow and Jobe’s study over the twenty years, may today be among the million out there. Anyhow the part of Whitaker’s argument that recovery rates for schizophrenia have not improved despite the heralded scientific and pharmacological advances, seems to be vindicated. But his implicit and explicit conclusion to which end he is trying to misuse the Harrow and Jobe study, that schizophrenia incidence today is attaining epidemic proportions, and is doing so because of the use of antipsychotic medicine, remains the same nonsense it has been from the start.
Sorry, but discussing Torrey as though he were some sort of serious scientist rather than a totalitarian demagogue is like discussing the finer points of medicine with Mengele.
Funny how these ancient discussions get resurrected though.
Colin Bradley, I might respect your arguments if you had not written, “A good psychiatrist is of course well aware of these pitfalls in treating psychosis with medicine, and takes suitable precautions. The bad psychiatrists must vouch for themselves.” After decades of being involved with mental health serivce users I have yet to meet many good psychiatrists – ie those who take into account a distressed persons experiences of the drugs when prescribing, is ok about not prescribing if the patient does not want them and has a serious interest in the persons life.
You then raise the spectre of homelessness and mental illness without mentioning the huge disparity between rich and poor and other social factors that give rise to the large number of homeless people in the states – and now in the UK. Once again psychiatry is used to avoid all the messyness of life.
You then raise the spectre of homelessness and mental illness without mentioning the huge disparity between rich and poor . . .
Not quite sure what point you’re making here John. Nobody is trying to say that mental illness causes homelessness other than those political parties who have made it a habit to blame the victims for so long that they take such things as self evident truths. Homelessness is created by bad and cynical governments which prioritize the cleansing of the backsides of the superstars of rapacious global capitalism, instead of raising and spending taxes on maintaining and improving social safety nets, for those in society who are not well enough equipped to compete for a decent living in the fashion most of us are expected to compete.
I gather from some of the comments here that some people choose homelessness to escape psychiatry in the US and that is truly shocking if it is a widespresd phenomenon. This is unknown in Denmark where I live, even though community treatment orders, something I’m vehemently opposed to, were recently introduced in a restricted form for about “100 especially difficult cases nationwide” (as the political blurb phrased it in the attempt to make it palatable.) I’m pretty sure that “100” will soon become 2 or 300. But I live in hope that at some point it will become clear that it is a stupid law without any real effect, and be repealed.
In Denmark it is illegal to live on the streets, and local authorities are bound by law to house homeless people. Being mentally ill and homeless will increase your chances of being admitted to a psychiatric ward about tenfold I’d guess. Not so in the US it seems. It was Fuller Torrey who raised the spectre of homelessness in his critique of “Anatomy of an Epidemic” and he seems to know quite a lot about the American side of things. His point was pretty clear I thought: Do you want to know about how people with an unmedicated mental illness fare? Then don’t just read about the few cases in the Harrow and Jobe study, but instead get out onto the streets in the big cities of America and talk to the vagabonds rummaging for food in the waste bins, and then come back and tell us whether schizophrenia is caused by medicine. Nobody has taken him up on it and I wonder why.
I don’t know who would assess the quality of psychiatrists, or how it could be done fairly. I’ve met some I regarded as good and some exceptionally so, including some who would fit your definition. If patients and relatives subjective opinions are the best measure then there are endless surveys in DK which point to 60, 70, 80 and even 90% satisfaction levels with the treatment received. I’m sick to death of questionnaires and quality controls and neither take any interest in nor believe very much in them, but they are there. It’s the critical 10 – 25% who make most noise in the debate, and that’s OK of course, as long as the quiet majority don’t get forgotten.
You’re right to point out that it’s a self serving argument to say that the only scientifically reliable prognosis is one made in hindsight. Of course. But that’s the whole problem with trying to use the Harrow and Jobe study the way Whitaker does. Because every individual person is precisely an individual, with individual personality, individual neurophysiology, individual pathology if they fall ill, and individual responses to the variety of potential treatments, it is only meaningful to conclude that medicine worsens schizophrenia outcomes if you have rock solid 100% reliable prognoses for each individual, based not alone on diagnosis but also on each individual’s individuality. Because taking or not taking medicine is far from being the only factor which can influence the course of a psychotic illness. Personality for example has a huge bearing on how well a person can mobilize the resources necessary to counteract the debilitating effects of a schizophrenic relapse. Manifestation of symptoms does not necessarily always equate with “most sick.” Schizophrenia is an ego disintegrating experience; medicine can only help the re-integration process if it’s used wisely in conjunction relational based ego rebuilding therapies. And this is surely why Harrow and Jobe wisely caution that their study cannot be used for what Whitaker wants to use it for. There are too many unknowns, and because each unknown has the potential to interact with each of the other unknowns to disturb the predictive certainties which one might seek from the study, uncertainty rises exponentially in proportion with the number of unknowns.
At the end of the day the only thing which can be concluded with certainty is that around 25% of the subjects experienced a recovery, and that of this twenty five percent (17 persons in all), 25% (4 persons) had managed it because of or in spite of the use of medicine, and 75% had managed it because of or in spite of staying off medicine. This is unfortunately simply not enough to able to conclude that more of the group which stayed on medicine would have experienced recovery if they had gone off it. They might instead simply have disappeared with the other 6 who disappeared. Who can tell? Not I and not Whitaker either. The study is therefore unremarkable other than that it does allow the general conclusion that the use of medicine statistically makes no difference to long term outcomes of schizophrenia, which remain stable at about 25%, in case there might be some drug companies that are trying to claim that drug use does make a difference to long term outcomes at the macro level. I don’t know if there are.
Colin, Alright, you make a more modest case, and acknowledge that the study at least shows that “anti-psychotics” don’t make a difference in long term successful
outcomes. It certainly was claim of psychiatric industry for years that unless “schizophrenics” remained on neuroleptics they would decompensate and get worse. (Now many psychiatrists claim that neuroleptics are “neuro-protective.” )
For example, in 1992 the APA published a book length Task Force Report on tardive dyskinesia. They acknowledged that a prevalence rate of 30–57% of tardive dyskinesia of patients who were on “anti-psychotics” (the range was great because many cases are masked by increasing the dosage of the neuroleptic) but still insisted long term administration of neuroleptics was the treatment of choice because “schizophrenia” was so devastating. Just showing patients got better without drugs debunked APA’s rationale for using drugs–to prevent patients from getting worse..
There were other studies that were ignored.
David Cohen wrote in special issue of The Journal of Mind and Behavior (1994, Vol 15 No’s 1–2))”Considerable evidence from controlled random assignment studies clearly shows that GIVEN THE PROPER SOCIAL ENVIRONMENT, most newly identified schizophrenics can be treated successfully with little or no psychotropic medication”(p144). Yet the APA and almost all psychiatrists ignored this evidence and continued to inflict TD and other disabling disorders on “schizophrenics.”
How many million people people developed TD over the years because of the APA’s policies is anyone’s guess but TD reached
I deon’t know how you define “less sick” but you originally claimed sicker clients took more “medication.” If your statement is not a tautology–meaningless–you need an operational definition of less sick–basically it comes down to appearances. My point is that many patients–no matter how “sick”– stopped taking the drugs not because they were less sick but because they did not like the side effects. Its side effects were as troubling to “severe” cases as
to “mild ” cases. Also even mild cases were exhorted by their shrinks to take neuroleptics. Therefore there is no basis for your original contention that the phenomenon of undrugged patients getting better can be explained away with the claim that they were mild cases who needed less drugs and therefore took less.
My own experience brought me into touch with many persons who were given prognoses of life-long illness who became activists and in conventional terms could be said to have recovered from “severe schizophrenia.” The Establishment’s response to high functioning activists was if they got better they were not really that sick to begin with. My point is this claim was used to justify long term use of drugs that were unnecessary and extremely harmful. Your original claim seemed to be that kind of apologetic: Patients who get off the drugs were obviously mild cases. It’s just not so. You wrote that ” severe schizophrenia and the tendency to use medicine correlate, whilst milder schizophrenia correlates with a diminished tendency to resort to medicine.”
Yes there could have been other unknown factors that explained recovery in Harrow’s survey. By 1990 there was sufficient evidence, taking the TD epidemic into account, for the APA to recommend against long term use of neuroleptics.. Yet they continued to do the opposite, breaking the Hippocratic oath.
Furthermore subsequent studie to Harrow’s discussed by Whitaker on this blog
were randomized controlled studies–they showed that long term use of neuroleptics impeded the recovery process. I know that recovery was also impeded by self-fulfilling prophecies like “You have a life-long illness for which there is no cure.” This “prognosis,” repeated over and over by psychiatrists destroyed many patients lives. The ones I knew who got better got off the drugs and away from the mental death system.
Your own practice may be more like Bert Karon’s or the Sullivanians than like the typical psychiatrist who followed the APA party line: “There is no cure for schizophrenia yet patients must take brain damaging drugs or they will get much worse.” I hope it is.
Seth Farber, Ph.D.
long term outcomes of schizophrenia,
That should read “successful” or “positive” long term outcomes . . . !!
As I’ve mentioned elsewhere, I’m no fanatic druggist, and I’m with you all the way in advocating minimal, professionally responsible and best possibly informed administration of these medicines. I know of several who successfully quit them, and I have recommended others to try it. On the other hand I know of people I would never have recommended trying and who nevertheless do try regularly, sadly with predictable and sometimes tragic results.
If your statement is not a tautology–meaningless–you need an operational definition of less sick–basically it comes down to appearances
which is also my point precisely. In order to promote his wild thesis that schizophrenia in our time is really an iatrogenic epidemic of drug induced side effects, (at his most shamanistic he seems to hint that schizophrenia might not even have existed before the introduction of neuroleptic medicine) Whitaker misrepresents a sober enough study to back up a theory, which the authors themselves never intended.
We have known for the past two or three generations that schizophrenia remits spontaneously in some cases without help from drugs, sometimes partially sometimes completely. And we know that for some it never remits. Medicine or no medicine. The great problem is that we don’t know at the
early stages how to identify who will experience remission and who will not. Harrow and Jobe understood that their study was potentially open to a bias in that it would be a natural tendency that anyone who could go off meds without relapsing too harshly probably would do so with time, whilst those who experienced insurmountable problems whenever they tried, would probably remain on medicine either by choice or by coercion. Under these circumstances it would be futile to postulate that medicine hinders recovery from schizophrenia, on the background of a study showing that after twenty years those still on medicine were doing worse than those who had gone off meds. Notwithstanding that we are speaking of tendencies here, to which there could, of course, be exceptions. There are simply too many possible causal unknowns to make any direct cause effect connection between medicine and poor performance. The best we can say is that we have a correlation.
One of these unknowns is why and how schizophrenia manifests in individuals in such idiosyncratic ways, as to make most attempts at prognosis, little better than a lottery. Nevertheless the only option open to Harrow and Jobe to attempt to eliminate this unwanted potential bias, was to make use of these very uncertain prognoses (presumably authorized by a doctor) and see if prognosis made any difference in sorting medicated from non medicated outcomes. If the results show that regardless of prognosis nonmedicated outcomes are better then that would strengthen the case for saying that medicine hinders recovery, in as far as one could say prognoses are reliable. But if prognoses are not reliable then the wished for conclusion also runs the risk of ending as a tautology. ( Medicine prevents people getting better –> therefore people who give up medicine get better –> therefore medicine prevents people getting better) To their credit I think Harrow and Jobe understood the weakness of this part of the study, and confined their conclusion to pointing to the correlation and saying more research was needed.
Not so Whitaker who uses the study as definitive proof that we are witness to a rampant epidemic of medicine induced mental illness in our society. And that, even though he himself says it is the only study of its kind, which you might think would prompt any serious researcher to take a pause for reflection, and realize that quite a few more studies of the kind would be needed to make any kind of definitive statement of the kinds he is making.
I note however, that Whitaker turned up at a NAMI conference where he surprisingly delivered a very moderate speech acknowledging along the way that long-term use of antipsychotics is sometimes necessary and appropriate, and that open-dialogue treatment in Finland is still – for 20% of patients – supplemented by longer term psychopharmacological treatment. So maybe his position is not so far from mine.
“I note however, that Whitaker turned up at a NAMI conference where he surprisingly delivered a very moderate speech acknowledging along the way that long-term use of antipsychotics is sometimes necessary and appropriate, and that open-dialogue treatment in Finland is still – for 20% of patients – supplemented by longer term psychopharmacological treatment. So maybe his position is not so far from mine.”
Really? Is this true? I’m very confused about what this online community is about, then. I thought that the very least we were starting with the premise that psych drugs are high priced toxins that were being fed to vulnerable, trusting people looking for help, and that they do more harm than good, unequivocally. And that, as a result, people were being rendered disabled through a combo of these drugs used to ‘manage’ a mythical “chronic” illness, and social prejudice which only serve to undermine individual and social health, as well as basic human rights and dignity. I thought that was ‘the cause.’ Otherwise, I don’t see the cohesion or focus here.
Alex: Consider the source (and maybe reconsider your dismissal of the possibility of “plants”). 🙂
Alex, Read Whitaker’s articles, not Colin’s summaries. There arfe sa range of opinion on this blog, all critical of mental health system.
Colin writes” One of these unknowns is why and how schizophrenia manifests in individuals in such idiosyncratic ways, as to make most attempts at prognosis, little better than a lottery. ” I don’t know what world you lived in Colin but I talked to 1000s of mental patients in the 1990s when I was most active. Virtually all were told they had a life-long disease from which tyhey would never recover. But your criticism are never of mental health professionals. YOu even concluded that patients got better without drugs,
and yet when I told you that the APA party line said drugs were necessary just to keep patients from getting worse, you have nothing to say. The evidence of TD and brain damage from the drugs don’t bother you. YOu cheery pick what suits your fancy and have no criticisms of the harm inflicted on patients by APA policies. You assume the good will of shrinks when all the evidence points to opposite conclusion. You live in a bubble–and refuse to admit that your statement is insulting to patients. Again ” One of these unknowns is why and how schizophrenia manifests in individuals in such idiosyncratic ways, as to make most attempts at prognosis, little better than a lottery. ” NO NO NO. It’s not a lottery. The party line has always been that no schizophrenic can recover. It manifests in an idiosyncratic way because “it” is not an illness. It is a spiritual crisis that gets labeled schizophrenia. There is no mystery.
YOu leave out all the relevant factors. You write “it would be a natural tendency that anyone who could go off meds without relapsing too harshly probably would do so with time, whilst those who experienced insurmountable problems whenever they tried, would probably remain on medicine either by choice or by coercion.” This is because the drugs are addictive. IT is also because some people are more trusting of their psychiatrists than others. The latter is what those of us critical of the system are trying to change. AS they lose their faith in psychiatry,patients have a better chance of getting off the drugs, rejecting the no hope diagnoses and getting better. You don’t even bother to read the randomized experiment which provide evidence the drugs undermine recovery/
In 2013 Bob looked at new studies.I directed your attention to them buT you ignored them. Bob writes,”Wunderink has now provided psychiatry with a randomized study of long-term outcomes. In his study of adults with a first episode of psychosis, all patients were stabilized on antipsychotics for six months (n=128), and then they were randomized either to a “drug discontinuation/drug reduction” arm (the DR group), or to standard drug maintenance (the MT group.) In other words, this was a randomized study designed to see which treatment protocol produced better outcomes: tapering first-episode patients from their antipsychotics (or down to a low dose), or standard drug maintenance, at usual doses.” At the end of 7 years the low dose or no dose had a full recovery rate of about 40% vs 17.6% for the medicated group
Since this study was randomized it leads to interpretation that the drugs impede long term recovery as the author concluded, ” “Antipsychotic postsynaptic blockade of the dopamine signaling system, particularly of the mesocortical and mesolimbic tracts, not only might prevent and redress psychotic derangements but also might compromise important mental functions, such as alertness, curiosity, drive, and activity levels, and aspects of executive functional capacity to some extent.”
Bob also discusses Open Dialogue.http://www.madinamerica.com/2013/07/harrow-wunkerlink-open-dialogue-an-evidence-based-mandate-for-a-new-standard-of-care/ No matter how you slice it there is no justification for long term use of “anti-psychotics.” Bob concedes that there are a small subset that might require them–20%–but I have argued that is because we don’t have a more flexible treatment model and sufficient resources in social and financial support.
Seth Farber, Ph.D.
I had an idea that I would focus my energy narrowly just on Whitaker’s liberal exploitation of the Harrow and Jobe study without taking other aspects of the general discussion of psychiatry’s failings into consideration. The remark on his claim that eugenics played a major part in the building of asylums was an afterthought. Polemical discussions have a habit of branching out and thereafter quickly losing their way; hence my avoidance of answering some of your points. But you insist and so I’ll try to reply to your latest piece point for point, without branching deeply into other areas of discussion too much.
What strikes me from your presentation of your arguments is that you have painted yourself into a corner where nothing other than strict orthodox adherence to the pure antipsychiatry path will be tolerated. Anyone who is not 100% with you is against you. It is almost as if it’s a kind of religion. That’s a great shame because I feel that there would otherwise be a good deal of fertile common ground where we could meet. I’m not American and don’t know much about the APA and the American approach to mental health. I’m not dependent on them for my own ideas and and opinions about schizophrenia; where I work the APA party line of which you speak has long since been abandoned if it ever really took root in the first place. If you are working to overthrow this kind orthodoxy then I can only say you have my best wishes, but if it means that you just end up replacing one set of dogmas with another set, then I don’t think any real progress will have been made.
A little like Whitaker, who in spite of the fundamentalist tendencies exhibited in his book, actually says that he can see that psychopharmacological treatment is in some cases both relevant and necessary, my position is one which espouses minimal use of medicine and especially in the long term, since it seems to me quite a reasonable proposition that long term antipsychotic use caould be harmful to the body, even though I don’t believe the H & J study can be used to prove it. Again I’d have to say that I also know of persons in long term treatment for whom the harm is not immediately apparent, and it would not be difficult to imagine that much greater harm might have occurred had they attempted to manage their illness without drugs. That does NOT mean that I subscribe to a blanket philosophy of drug treatment for anyone with the slightest hint of a schizophrenic illness for the rest of their lives. Please understand that. And please explain why that would equate with “living in a bubble” and “insulting patients.”?
Yes, patients get better without drugs – some patients anyway. That’s old news. Side effects and possible brain damage bother me a great deal – sorry if I forgot to mention it. Whatever the ‘party line’ is, what I’m interested in is reality. The reality is that prognosis is notoriously unreliable in psychiatry. Well you know that. You miss no opportunity to remind me that patients get better without medicine, and some even get better even though they take medicine. If the APA wants to give all these people a uniformly bad prognosis without any nuance whatever then yes of course – the APA is talking out of the part of the anatomy which is highest over ground level when one is plucking strawberries. But APA doesn’t actually make prognoses; it only sets guidelines. Doctors make prognoses. We are not at all in disagreement there as far as I can see, and prognoses were variable in the H & J study and most probably wildly inaccurate. So I don’t quite see the problem with comparing setting prognoses with picking a number from a hat, although obviously I exaggerate the case for the sake of emphasis.
Schizophrenia is not a spiritual crisis in my view. If so it would certainly be a mystery. Few of the people I know with schizophrenia would think so either. Spiritual crises do not run in families as far as I know. Just what schizophrenia is, is of course a truly fascinating question, a question many people, myself included have given many years of thought to. We cannot cover that here, but I’m not so pigheaded that I would not be willing to read a learned dissertation on the subject of schizophrenia as spiritual crisis if there is one. My antipathy to this standpoint does not of course mean that I cannot accept that it is possible for a person with schizophrenia to experience a spiritual crisis, any more or less than the next person.
” . . . the drugs are addictive”. Hmmm. Well, what about an experiment? Take a bottle of Risperidon or Quetiapine tablets down town. See what you can get for them on the black market. You’ll still have your bottle of tablets with you when you eventually head home. No-one will want to buy them even if you cut the price to a loss making minimum. They are apparently not so addictive that anyone ever gets desperate to get hold of them. So I think you have to qualify that word ‘addictive’.
I know of the Wunderink study but have not studied it in enough detail to judge it. I read that Wunderink was very ethically minded so he would not allow a blind study where patients went completely off medicine without their knowledge or that of their clinicians. If they did go off medicine then it was their own choice, but does that not then mean the study was not completely blind? And also if patients who were reducing started to get psychotic symptoms then they might be increased again or reduced more slowly. I’ll get round to studying it sometime. But I cannot comment on it yet.
“Bob concedes that there are a small subset that might require them–20%” – again old news. We have known for many decades that up to 25% of people diagnosed with schizophrenia or 20% if broader diagnostic criteria are used, develop a chronic form of the illness, whether they receive medicin or not. You may well be right in this last point – if there were sufficient resources then it may be possible to look after these people in some way without the use of medicine. Here at any rate is an incidence of one chronic patient for whom an alternative program succeeded. But he was exceptional and no – sadly even in the richest countries resources are not so abundant that such a program could be supplied for the whole chronic population.
I cannot discuss treatment of “schizophrenia” in England or Australia. But your discussion of prognosis is irrelevant in America. THe APA position was throughout the 1990s and before that “schizophrenia” was a chronic illness from which n o one recovered. (I’m not sure what it us today–probably the same.)I know this from working in clinics throughout the 1980s, from reading the literature, and from talking to persons who had been diagnosed as schizophrenics.
I do not accept a medical model. For deconstruction of such a model read Thomas Szasz–too many books to pick a couple. For the defense of a crisis model, read R D Laing (I’d recommend The Politics of Experience and Sanity, Madness and the Family) and John Weir Perry ( Trials of the Visionary Mind is a good place to start) and my first book (probably my first book , Madness, Heresy and the Rumor of Angels–1993 and my 2012 book, The Spiritual Gift of Madness). And read Leaving Home by Jay Haley. And Psychosis and Spirituality edited by Isabelle Clarke.
Let me clear up a few points. People don’t stay on neuroleptics because they make them feel good, like cocaine. They stay on them because psychiatrists tell them they will be rehospitalized if they don’t. I say they are addicted because after being on neuroleptics for, say, a year or so, one will in all probability have intense withdrawal symptoms if one tries to get off. (This will of course be interpreted by the shrink as the return of “the illness”) These confounding variable vitiate your ludicrous claim that only “severe” schizophrenics will stay on the drugs. People who trust their psychiatrists, or are scared of rehospitalization, often are hooked on the drugs–even if their schizophrenia is “mild.”
\ No no no! I said Wunderink was a randomized study. THe majority of people who were taken off the drugs were chosen randomly. There was a small subset who CHOSE to get off the drugs later. To quote Whitaker”this was a randomized study designed to see which treatment protocol produced better outcomes.” Randomized studies are considered gold standard–of course with neuroleptics’ awful side effects such a study cannot be blind. But that fact only strengthens our arguments because non-drugged clients did not have the advantage of a placebo effect.
Our main differences are philosophical. My paradigm is not medical–as stated. It is nonsense to interpret a spiritual crisis as a medical problem–and proclivity to being labeled schizophrenics proves nothing. For 2 reasons 1) Some persons re more sensitive than others–that MAY be genetic trait 2)) Joseph Jay shows in Mad in America that the studies that claim “sc hizophrenia” is genetically transmitted were flawed. But even if Joseph was wrong it does not prove as potential shaman is REALLY a schizophrenic., See “Shamans and Acute Schizophrenia” by J Silverman in American Anthropologist, 1967.
As to prognosis, it cannot be separated from behavior. This is just like quantum physics. How the person behaves depends upon how he/she is observed. Observation influences behavior–which you could argue explains better than drugs in Harrow’s survey why some patients don’t recover . Please see my article in 1990 but still relevant–and reprinted online http://www.academyanalyticarts.org/farber-institutional-mental-health
I will quote from it.” This is the fundamental hermeneutical insight. Objectivism obscures this reality, it pursues the illusory Enlightenment ideal of the “detached’ scientist, unmindful of the historical roots of this ideal, unmindful of the social consequences of the futile attempt to realize it. Gadamer wrote, ‘In this objectivism the understander is seen.., not in relationship to the hermeneutical situation and the constant operativeness of history in his own consciousness, but in such a way as to imply that his own understanding does not enter into the event” (p. 28). … Institutional Mental Health acts as if its own understanding does not enter into the event. It focuses its lenses upon the Others, the deviants, and professes to possess objective knowledge about their situation and their destinies. It fails to see how its own way of understanding the Other enters into the event. It is as if its particular way of understanding has no historical or social ramifications. It is as if psychiatrically labeled individuals are deaf to the discourse that Institutional Mental Health articulates through a variety of media, institutions, groups and individuals. Mental illness is a cultural artifact, the end result of a particular kind of highly structured dialogue between socially empowered experts and socially disenfranchised, psychiatrically stigmatized individuals. ”
Well I’m pleasantly surprised to hear that you were one of the people who proved the mental health Establishment the APA, wrong. I assumed you were working for the system. Hopefully if you are you are encouraging clients and telling them long term use of neuroleptics is unnecessary and harmful.
I can dicuss the UK situation and it an’t that different from the USA: diagnose, drug for life, pressure people to take the drugs, use CTO’s and depot injections for those who try to escape the chemical cosh.
It a disease like any other, it’s like taking insulin for diabetes are two common mantras.
There are a few good clinitians and a few good clinics, who see things differently, but they are few and far between. Any psychiatric survivor or critical psychiatrist will say the same.
I perceive that dialog doesn’t interest you very much. At least not dialog with me, as someone who potentially could be treated as one with thoughts and ideas equally worthy to your own, even if different. You work/think within an extremely narrow framework of ideas, and as long as my ideas don’t fit that framework you will patronize me if possible, instruct and teach me, help me see the error of my ways, but you will not enter into a real dialog with me. This is the impression your tone gives me.
We would not be able to work together in any treatment/care setting, because good psychiatric care requires a robust flexibility, in order to be able to respond to sometimes very bizarre and even grotesque situations that can arise at the drop of a hat, a good sense of humour and an empathic understanding which does not preclude the responsibility for taking charge, setting limits, and imposing codes of behavioural etiquette. Intellectual rigidity and the discreet supercilious arrogance of one who ‘knows better’ does not work in these settings.
I have not proved the APA wrong – I just haven’t taken any special interest in their dogma, because experience teaches one not to rely on dogma of any kind, if you want to be any real help to anyone. You are welcome to your interpretation of schizophrenia as spiritual crisis; I’ll continue to work with and develop my multi dimensional understanding of the illness.
I’ve read both Szaz and Laing. They’re both very interesting though they apparently were professionally sworn enemies. I don’t presently have time for the other works you mention, but as I said a learned dissertation on schizophrenia as spiritual crisis I’d be willing to try.
As for prognosis – no, in psychiatry prognosis cannot be predicted without consideration of behaviour. Quite true. In general a schizophrenia which manifests early in life with overwhelming negative symptoms, with severe ambivalence, loss of drive and motivation, anhedonism, and very pronounced social withdrawal, will receive a worse prognosis than a schizophrenia which first surfaces in the late twenties and is characterised by sudden and spectacular onset of positive symptoms, and fewer negative.
I am indeed assuming that the APA has a similar function to similar bodies in other countries. It produces guidelines and standards for diagnosis and prognosis, but does not itself diagnose and give patients their individual prognoses. If there is just one prognosis for any and every schizophrenic patient as you seem to be suggesting, and no room for independent professional interpretation by doctors at the level of the individual patient, then how on earth could Harrow and Jobe have divided their schizophrenic groups by varying prognoses?
But these prognoses are not guarantees or something proscribed by any human or natural law. The actual progression of a patient’s condition can completely make a mockery of prognoses and frequently does. The analogy with quantum physics is lost on me I’m afraid, but I concur naturally that observation infers a degree of subjectivity. And this is why prognostic differentials cannot give a study such as Harrow and Jobe’s the authority to pronounce a verdict on the influence of medicine on outcomes adjusted for prognosis. We cannot discount a factor of human error in setting a prognosis, and therefore we cannot eliminate the risk that such a study ends up merely demonstrating that less severe cases of schizophrenia open better chances for reducing or quitting medicine than severe cases. That’s not to say necessarily that it’s untrue that longterm medication hinders recovery, it’s just saying that the H&J study is not enough to prove it. Which is about all I ever intended to communicate with my contribution to this thread.
Colin, I don’t have time for such a dialogue. Besides as you say I am not interested in having discussions that I already have had hundreds of times with other people who were acolytes of the medical model. Indeed I WOULD like to “help [you] see the error of [your] ways,” but I know it’s a hopeless task. Thus you and I, Colin, are like two ships passing in the night. The difference is I hear you on deck singing a song that I’ve heard a million times before. Whereas I am shouting at you something unfamiliar: “Abandon your leaky rotten vessel! There is room for you on ours.” I’d even send you a life boat. But alas since you are perched somewhere comfortable and safe you have no desire to abandon the old ship.
It’s odd you see me as narrow-minded and rigid because I see you and others who espouse the medical model as narrow-minded and rigid and imprisoned within the parameters of a paradigm that ought to have been abandoned long ago. All I can say positively about your position is that you defend it eloquently, very smoothly with perfect command over syntax and an unusual amount of color. What you defend is mostly an unimaginative colorless paradigm that continues to serve as a rationale for an oppressive mental health system increasingly dependent(at least in America) on the pharmaceutical industry
You missed my point. I am not advocating better prognosis. I am advocating no prognoses. I am saying as long as professionals make prognoses and encode expectations in their writings, their discussions, their pronouncements, these expectations will continue to act as self fulfilling prophecies except by those who rebel against and reject their prognoses–all of them. For example over and over you keep saying “less severe cases of schizophrenia open better chances for reducing or quitting medicine than severe cases.” It has been branded on the cells of your brain that there are more severe cases and less severe cases of “schizophrenia”—INDEPENDENT of the way these “cases” are regarded by professionals. Horsesh–t! AS I wrote years ago “Yesterday’s shaman is today’s chronic schizophrenic.” It was the craziest people, the maddest of the mad, who became shamans in another age.
Today many become activists. I am bored by the studies but they confirm my spiritual development and hermeneutic paradigm. http://www.sethHfarber.com Furthermore there are numerous activists in the “mental patients liberation movement” (as it was first called) who were labeled ‘schizophrenic” and told they had a life long illness. In fact these were the leaders of the movement, not the “mild cases.” The APA always took the position that “schizophrenia” was incurable. (To answer your question the different groups in the Harrow study had different labels, such as “bipolar” which was always considered less severe than “schizophrenia.)
You have no way of determining who is the “most severe.” You declare those least severe who get off the drugs—it’s merely a tautology. When mental patients rights leaders attacked the Establishment, neo-conservatives wrote books and claimed these activists can’t speak for “schizophrenics”, because they were not schizophrenics–they were misdiagnosed! Of course they had to be–the tautology must be preserved: Those who get off the “meds” and get “better” were not severe cases.
. No one has ever established that psychiatrists diagnoses have any reliability, nor any predictive validity except insofar as they are self fulfilling prophecies. That is they have only seemed to be reliable because professionals have suppressed and oppressed and destroyed the brains of “schizophrenics” throughout the 20th century and beyond. You missed the point of the the essay I quoted. It is not the prognosis should be based on behavior. It is that the behavior of “the mentally ill,” the deviants, is influenced by those very prognoses. I wrote, “[Institutional Mental Health] fails to see how its own WAY OF UNDERSTANDING THE OTHER enters into the event. It is as if its particular way of understanding has no historical or social ramifications. It is as if psychiatrically labeled individuals are deaf to the discourse that Institutional Mental Health articulates through a variety of media, institutions, groups and individuals. Mental illness is a cultural artifact, the end result of a particular kind of highly structured dialogue between socially empowered experts and socially disenfranchised, psychiatrically stigmatized individuals. ”
In the medical model there are no “problems in living.” Every such apparent problem is really a symptom of a disease. In your country (UK?) the medical model allows somewhat more room for change but it has the same ideological functions. In America millions of people are being destroyed by the medical model. I developed a developmental model based on Laing and others. All the data or most fits within my paradigm. http://www.sethHfarber.com
“There is room for you on ours.” Really? Somehow I doubt it. There’d first be room for me on the day I reformed my thoughts to fit yours. Until then MIA would prefer not to see or hear people like me on their site. Even though I’m actually not so radically removed from some of the points of view, – actually I’m pretty moderate and not at all a slave of the pharmaceutical industry. But because I’m not 100% against then as far as the extremists at MIA are concerned I’m as good as 100% sold to the APA and the Big Pharma. I don’t at all seem to be able get through with any kind of nuanced message.
It’s not only I who is saying that there are schizophrenias that are relatively mild and others relatively severe. Regarding just the 70 people in the H&J study who had the schiz label: H&J themselves used differential prognoses because they had to try to qualify their point. And exactly therefore the tautology you’re trying to accuse me of, and which I agree 100% is a problem. enters into their analysis, and disqualifies it, from being any kind of valid proof that medication “causes schizophrenia”
But, your responses smack of being the “expert” about everything that pertains to “mental illness” and this is what is so aggravating to those of us who have been in the system and managed to disentangle ourselves from its tenacious grip. Humility gets peoples a long way but many clinicians in the system know absolutely nothing about that at all.
Colin Bradley, there are people, one being emeritas professor of psychology Mary Boyle, however I think we can all agree there are various degrees of mental distress.
I guess your other point is that drugs, ie the major tranquilisors, can help some people, sometimes. It seems Whittiker and some others who blog on this site agree with you. Some think that if enough support is offered they are unecersarry. Most think that the drugs should be optional and not forced on anyone. Some think the drugs should be banned and never used.
All agree these drugs have dangers – as all drugs do, though these ones are perticularly nasty.
There is evidence that these drugs impede recovery for many. That maybe something you find contentios and worth debating. This position is not just from the Harrow study.
This website has a wide range of viewpoints expressed by the people who blog and comment. They probably do include your opinions. However your manner has got some people’s backs up for a variety of reasons – probably the embedded psychiatric language which is used so often by clinitians to ignore people’s experiences and opinions and then to ride rough shod over thier wishes. This may not have been your intention.
dear me, I need to proof read my comments before posting them.
that should hve read:
“Colin Bradaley, there are people, one being emeritas professor of psychology Mary Boyle, who think schizophrenias does not exist as a valid disease catagory, however I think we can all agree there are various degrees of mental distress.
We don’t mind you on the site. In fact we’ll be following your progress as you gradually move closer and closer to “getting it.”
You have no way of determining who is the “most severe.”
No, I don’t. But that is just my point. Harrow and Jobe had no way of determining it either. Therefore the only certain conclusion to be drawn from the study is that about 25 % of people diagnosed with schizophrenia experience recovery whilst 25% remain chronic and the rest experience partial recovery. We simply cannot know if the people who took medicine and did badly would have done better if they had gone off medicine.
@ John Hogget
Nicely summed up. Thank you. I too think that it is a reasonable proposition that drugs can impede recovery for many.people, but I also think that it is a reasonable proposition that they can prevent catastrophe for some people. I only wish people would take care to err on the side of caution before rushing off to tell the world that ‘science has proved’ their point of view. That should apply to both sides of the debate of course. I do hope my manner has been decent and civilised. I have tried my best to argue my points in a sober and scientifically neutral mode, without insulting or speaking condescendingly to anyone.
This seems to me to offer a potential third way out of the impasse.
Everybody is the way they are due to their brain and environment interacting, but this doesn’t prove the existence of scrhitzophrenia. I think he kind said that at one point. However, too much time talking about what he didn’t mean, then what he was did mean. Yes, the way our brains interact with the world shapes us. Can’t think of anybody who wouldn’t believe this, and don’t think it’s a matter of believing in DSM labels, or finding psychotropics helpful. However what I would ask is if it’s adaptation, then who’s to say it’s not for a valid reason? Why should we start off trying to change the way people thinking before understanding the reason, or if this will lead to something better? He talks about needing new ways of thinking, so what? We can all think the same correct way? The worlds pretty messed up, so how is failing to adapt to it a disease?
I think you’ve got a good point there, and in some ways I agree. The existence or otherwise of ‘schizophrenia’ is a moot point really. There is a well described phenomenon of mental disturbance recognizable across different cultures and historical periods; calling it schizophrenia is really just a convention which is supposed to enable therapists and carers to have a common understanding of what it is – and just as importantly what it is not – we are talking about when we use the word.
For example in Denmark before the coining of the word schizophrenia it used to be called “ungdoms sløvsind” which means mental lethargy or bluntness, in youth. This is very descriptive of what the problem is and why indeed it is a problem, because it provides an immediate contrast with the normal state of affairs; youth is the time of our lives when mental alertness, drive, and development of ideas and interests are at their peak. Yes, we’re all different all unique all individuals, yet certain things we all have in common enable each one of us with all our uniqueness, individuality and differences to be woven into the social fabric. To become, at this point in life, disinterested, demotivated, reclusive, anti social, and to just allow friends, family, studies, employment, pastimes, personal standards of care and hygiene to drift away and instead become completely absorbed in some inner world of experience quite impenetrable to onlookers, is abnormal and a legitimate cause for concern. Call it schizophrenia or by any other name, any person so entangled is not going to be able to live an independent life, while in the grip of the spell. I do not see it as failing to adapt so much as being maladaptive. We can quickly agree that society is ‘a mess’ but that, for me, does not make schizophrenia a ‘relevant or understandable response’.
The point Kwame McKenzie is making about the epigenetics of the problem, if I understand it correctly, is that while we cannot simply ignore that there must be a genetic involvement in these very serious types of psychosis, the hope might be that human environmental influences (socially engineered) not only might compensate for negative effects of biological disadvantages, they may in fact hold the potential to modify the negative effects themselves at the biological level. This is for me a truly exciting prospect – one I often have tried to grapple with in abstract modes without ever having had the science to be able to articulate it in a way which could be accepted in any academic fraternity. It explains admirably for me why recovery is possible and why for example Open Dialog works.
Which – after all – is partly what Whitaker is trying to tell us. There are in many cases alternative possibilities to medication in the treatment of schizophrenia which we – through laziness, ignorance, false economy, ideological dependence on models of treatment behind which there lie strong vested commercial interests, – are not exploiting fully. It is the other part of what he is trying to tell us – when he turns these sage observations on their head and in doing so tries to argue a ridiculous case for schizophrenia being an “epidemic” of medicine induced madness – which alienates me from his campaign, and prevents me from taking him seriously.
Yea, so it’s typical for psychiatrists to feel they are above the truth. Often they will say something like they were just doing it for the best. Sometimes it’s others people aren’t smart enough to understand their reasons. In fact a doctor openly lied to get me to legally take an antipsychotic. He said he didn’t think it was psychosis, but since he couldn’t legally take a mood stabilizer he would say it was. Me not taking a mood stabilizer was “not giving him any other options, because I didn’t want to accept help”.
Another doctor diagnosed me as intellectual disability. I said no doctor thought I was retarded in the past. He kept denying it was the same thing, when I clearly knew it was. He often blatantly lied like this, or an explanation for being caught in a lie, would be just, why he was right, but not acknowledge the lie.
Thank-you, “kayla”, let my words here validate and substantiate your TRUTH….
Your experience is sadly too common. I’m glad you are speaking out.
The types of headgames you describe are common from the lies of the pseudo-science
known as “biopsychiatry”….
You might like the >beyondmeds<website. i recommend it, if you don't already know it,
or Dr. Kelly Brogan's site….Thnx!
Thanks! This system has worn me down, and the only thing that makes me feel it wasn’t totally in vain is to hopefully spread awareness. It’s helps to hear people say stuff like that. A therapist said I was playing the victim story, for stuff like not wanting to see that doctor, out of fear he would threaten me again. I was apparently ‘playing the victim story’, ‘fortune telling’ and ‘mind reading’ For wanting to distance myself from an abuser?
Thanks for replying! there’s one point I noticed in your first comment, but I didn’t say anything about it. What used to be called “retarded”, or “mentally retarded”, was briefly called “mentally challenged”, or some such nonsense, then it became “intellectually challenged”, then “intellectual disability”. That’s what all the so-called “agencies” around here did. So, I think maybe you & that Doc. were caught up in playing some kind of word game, or head game. It either IS, or IS NOT, “the same thing”, depending on what you call it! And, what “it” are we talking about again!? See what I mean!? No wonder everybody is confused! But, that’s how “biopsychiatry”, and the DRUG INDUSTRY works. Psychiatry runs on advertising DRUGS, and pushing DRUGS, and selling DRUGS, and telling people that they have a “chemical imbalance” that they can “balance” with some DRUGS! And, I just recently found “beyondmeds.dot.com”, from Monica Cassini, who also writes here. You will LOVE that site! Have a great weekend!