Launching the Beyond ‘Anatomy’ Forum

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When I first read Anatomy of an Epidemic in 2010, something inside of me ignited.  I had no idea that such a sensation was possible to experience, let alone for someone like me, who hadn’t felt alive in a long, long time; who hadn’t felt hope in years; who hadn’t felt human, like everyone else around her, since becoming “bipolar” a decade earlier and conceding that I needed to take psychiatric drugs, likely for the rest of my life, at my doctor’s request.

In an instant, my eyes saw the world, and more importantly, my place in it, through a profoundly different lens.  My thoughts were suddenly centered around a feeling that was foreign, yet vaguely familiar, as though I might have felt it once, as a child, or in a dream— the drive to take action.  I was suddenly investigating, challenging, and questioning the way I’d come to think about my Self, connecting to a sense of purpose and determination that came from a place deep within me.  Years of stagnancy were gone in the snap of a finger, and I was moving forward— to where, I did not know— and coming into a new awareness of myself that was the beginning of what I see today as my full recovery from psychiatry— from psychiatric labels, psychiatric drugs, and psychiatric “treatment”.  It was powerful, beautiful, scary, and the turning point of my life.

I’m sure that many of you out there can relate to this, upon having read Anatomy.  The words I write here just don’t do justice to the experience, which I see as nothing less than a rebirth, an awakening, and an enlightenment.  I was left champing at the bit, energized and rejuvenated, and I wanted change, both within myself and in the way I related to the world around me.  At the same time I experienced these beautiful shifts, however, I was riddled with fear— fear of the unknown, of the future, of my emotions, of a life without psychiatric drugs, and of just who I’d end up being once I got off of them.  Can anyone identify with this, whether as a part of your past or as something you feel today?

For the last several months, I have been fleshing out a vision of a communal space here at madinamerica.com for people asking the same questions that I’ve been asking since discovering Anatomy:  Now what?  What can we do to take action?  Now that we understand the message of Anatomy, which clearly shows that the current system of drug-based “care” isn’t working, and that its long-term “treatment” is, in fact, making us “sicker”, how do we do something about it?

I asked Bob Whitaker if I could create a new space at madinamerica.com for investigating this subject, and he said yes, as long as it was understood by readers that Mad in America, Inc. was simply providing a home for such discussion, rather than advocating for any particular change.  As a first step, I have created a forum, called ‘Beyond Anatomy’, which I see as a space for dialogue, discussion, and organization around the question of how to take action, whether that means in your own life, in your local community, or in society at large.  Eventually, I envision ‘Beyond Anatomy’ to evolve into something much bigger, but by getting it started in the forum space, we can build a foundation and make a start. Topics in the ‘Beyond Anatomy’ forum include:

  • How do we help our broader communities and society at large understand this issue as one of human rights and civil rights?
  • How do we effectively spread the message of Anatomy of an Epidemic, as well as the greater message that the current biomedical paradigm of understanding intense emotional experiences is false, to communities beyond this one?
  • How do we effectively provide support in an inexpensive, accessible way for people who have decided to come off of psychiatric drugs, and what does that support look like?
  • How can we learn from past civil rights movements to see what will make ours successful?

I truly believe that reading Anatomy not only saved my life, but also set me on a path towards becoming the person I was always meant to be but had been blocked from by the diagnoses I was given and the “treatment” I received for nearly half my life.  In accidentally discovering it in a Vermont bookstore in 2010, I unknowingly began my journey towards the freedom I have today from believing I had a “mental illness”— from the hopelessness, the social marginalization, and the isolation that came with believing I was abnormal and different than everyone around me.  Today, I feel a deep drive to make change happen so that others can find their own paths to freedom, and I am hoping that ‘Beyond Anatomy’ will bring together others who feel the same calling.

Link to the Beyond ‘Anatomy’ Forum

 

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

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89 COMMENTS

    • Thanks Steve,
      I look forward to seeing what unfolds when this community begins to grow.

      In my heart, I know what my solution is– any institution in which one person claims the right to be an “expert” on another person’s emotional, thinking, and spiritual existence is, in my opinion, oppressive and in need of dismantling. However, I understand that this vision I have of the future is one that is going to be many years away from taking place, as the egos and very existence of countless people are at stake– “mental health” professionals, “mental health” institutions, and, at the highest peak of the power structure, the pharmaceutical industry.

      I believe that once the mainstream begins to understand that (a) there is no such thing as “mental illness”, (b) the “treatment” people have been receiving for these “mental illnesses” is actually making people more “mentally ill”, (c) at the root of all of this (manifested in the DSM and in all of psychiatry and psychology) is a destructive sociopolitical paradigm of “normal” that, in my opinion, inherently oppresses and marginalizes, even when its application is well-meaning, then and only then can we possibly stand a chance at bringing human rights and justice to each and every person who has been deemed abnormal and broken by the “experts” in their lives, and to any person who’s ever wondered whether their intense emotional experiences make them “ill”.

      While I believe that your institution is inherently oppressive, Steve, I want to say that, as I’ve said before, I very much respect you for your presence at Mad in America– you truly help to stimulate very insightful debate.

      All the best,
      Laura

      • Thanks, Laura, and of course we disagree to some degree on some things. As to power, or at least potential power, I would put the politicians on top, and they are ultimately crucial for any human rights advancement. They influence everything from medication approvals to new laws.

        • Dr. Moffica,

          Laura put together a beautifully-written piece – a call for transformation, and the freedom to heal.

          She respects your participation on the MiA site, and has told you as much.

          I’ll do my best to be respectful, but I have a question:

          Do you believe a person diagnosed with a severe mental illness is able to have authority over decisions related to their treatment?

          I think it’s a fair question, as it pertains to your introductory post on MiA:

          From ‘Why We Still Need Psychiatrists!’ –

          “Psychiatrists know that deficits in the frontal lobes of the brain can cause a condition called Anosognosia, which leaves many prospective patients unable to even realize and accept that they have a mental problem in the first place.”

          Link –

          http://www.madinamerica.com/2012/04/why-we-still-need-psychiatrists/

          You have asked on numerous occassions to be part of this transformation… insisting that any good revolution requires a big-tent, and asking to be part of our movement.

          Do you believe in “Anogosognosia?”

          If so, do you believe in forced treatment for individuals who suffer from this condition?

          Duane

          • Duane,

            I would now say I essentially believe in what Dr. Steingard recently blogged about Anogosognosia, though I have also been informed by other commenters here. I probably should not have used the word “many” in the blog, but if psychiatrists work with upwards of a million patients, maybe a small percentage of that would still be “many”.

            For most situations, I would say that people diagnosed with severe mental illness do have the right to decide on their treatment, even if they have that “condition”, unless (and this is the very difficult decision) they seem to be of imminent danger to themselves or others without an obviously known good reason to be so. Another exception might be those who have conveyed in advance that they want a certain kind of help if they are ever is a condition where they can not decide as usual for themselves (including the much different Alzheimer’s).

        • Hi Steve,
          I would very much challenge putting the politicians at the top– at the root of this is the deep-seated belief that to feel intense emotions, think intense thoughts, or have a unique reality is to be “mentally ill” and thus lacking the ability to figure oneself out without the help of a “professional”. In my opinion, this is the core dilemma– the medical/social paradigm of “normal” versus “abnormal”– and it is driven by a health care system that perpetuates the power hierarchy of mental health professionals as “experts” on human experience, which in my opinion is nothing short of oppression.

          I think it’s safe to assume that most politicians have bought this model hook, line, and sinker– and even safer to assume that few have ever even heard of resources like “Anatomy of an Epidemic”.

          Thanks for the great dialogue!
          Laura

          • I put the politicians up there because ultimately if you want some human and civil rights laws to change, they will need to cooperate.

            Supporting your view may be how so-called “primitive” and historical cultures and societies do so much more to accept, support, and value the more extreme emotions and thoughts you mention. “Cultural psychiatrists” understand this.

        • Dr. Moffic,

          The questions were pretty cut-and-dry…

          I found your respone to be hard to follow, to say the least…

          IMO, it appeared evasisve (again).

          It’s frightening that others’ freedom hangs in the balance by what it is you psychiatrists believe about someone’s civil rights at any given moment; on any given day.

          If Consitutional rights were being upheld, the opinion of a psychiatrist (such as yourself) would be moot.

          We’ll get there one day…
          We’re workin’ on it!

          Duane

          • For example, what did you mean by this? –

            “… they seem to be of imminent danger to themselves or others without an obviously known good reason to be so.”

            What’s a “good reason” to be in danger to themselves or others?

            How is it that our society made the HUGE MISTAKE of giving so much power to a group of people like psychiatrists?

            … When I think of the young men and women who have given their life to defend the Constitution of the United States (including the 8th and 14th amendment)…. only to read reponses such as yours as to when and how you would deem forced treatment is necessary… It honestly make me want to throw-up.

            What can I say?

            Duane

  2. Good stuff Laura. My blogs are pretty much all about bringing about these reform efforts from a county-wide policy and funding level. We can’t do it all, but we can certainly have an effect and make a difference. We’re in this for the long-term. We have a very supportive Board and a dedicated Exec.

    As several folks have already mentioned, changes need to happen at different “levels” at the same time. Your forum should be a nice place for all those efforts to be discussed.

  4. I have been thinking about this post a lot since yesterday. I am eager to see what the forum will look like because I too am chomping at the bit to get more involved and get the word out. I hope this helps to move that objective forward. There is a lot to do (and, of course, a lot already being done). I think your bullet points get right to it and are a daunting and necessary agenda. Your voice speaks to the newly enlighitened (or at least I can speak for myself when I say that…) and I think could do a lot to bring people together who feel a growing sense of urgency. Thanks for your courage. I am looking forward to hearing more!

  5. Hi Names,
    I am so glad that you share the energy I feel, and I know that there are more of us out there who are feeling the same way. While it is so important to continue talking about what needs to change, I think building a forward momentum towards that actual change, however slow-going it may be in the beginning, is just as important.

    When I sit with my thoughts around all of this, I find myself going down so many different paths– the loudest, most idealistic part of me believes that the entire mental health system needs to be dismantled (which in my heart I believe is the only true way to rectify this human rights dilemma). On the other hand, the more realistic part of me recognizes that this is not something that will just happen overnight– rather, it will be a slow and persistent chipping away at the system from the outside, as well as making our best attempts at creating change from within. Regarding that “change from within” part– the biggest change I believe I can create in my work as a peer specialist (a title I take numerous ethical issues with, and that my heart really struggles with having, although that’s a conversation for another time…) is to help a person connect to a sense of inner-agency and hope that he/she has forgotten exists inside of him/her. The more that I can work towards helping people connect to that (especially people who’ve been in the system for a very long time), the higher the odds that people will realize there is life beyond being “mentally ill” and reliant upon the system to be taken care of and given “answers” by (a position that is by no means the fault of that person– but rather an enforced disabling by the “treatment” and “care” that they’ve received).

    At the end of the day, like you’ve said, there really is a lot to do. I believe that the more we speak publicly about the fact that being a human being means feeling intense feelings, thinking intense thoughts, and having unique realities, and that the only definition of “peer” that is true and real is that we are all HUMAN peers, the more that labeled and system-dependent people will reconnect with their own humanity and begin to yearn for their own freedom and believe that achieving it is possible.

    Names, I look forward to fighting together to make change happen! See you over in the forum :).

    Onwards,
    Laura

  6. Hi Steve,
    Yikes, the ‘comment’ thread wouldn’t let me reply to your most recent response about “primitive” cultures and “cultural psychiatrists”, so I’ll respond here:

    I’m curious– if you put the word “primitive” in quotes, why did you even use it at all? Is it because you see those cultures as “primitive”, but are aware that that word is considered oppressive, racist, and elitist? I am asking this question from a complete place of curiosity, in case the question is coming across otherwise. I decided to look up the word because I was curious, and its anthropological definition (which I assumed you were using) says:

    “of or pertaining to a preliterate or tribal people having cultural or physical similarities with their early ancestors: no longer in technical use.”

    The fact that “literate” society is considered the pre- and post- marker for the human race aside, I’m both slightly confused about your comment and also wondering if you’re somehow missing my point. You bring up “cultural psychiatrists” as exceptions to the psychiatric institution who understand these “primitive” people– and me, according to your comment– and our tendency to “do so much more” (do you mean “do too much of”?) accepting, supporting, and valuing human experience. I don’t see how a psychiatrist, even a “cultural” one (still not sure what that means exactly), could possibly believe in the validity of his/her profession if he/she truly understands the vast expanse of possible human experience, and that none of it has anything to do with having a condition treatable by an “expert” (psychiatrist in this case). It’s a fundamental paradox, in my opinion… Any clarification would be most helpful.

    -Laura

  7. OK, Laura, let me try to respond as a “cultural” psychiatrist (and I never use the word primitive because I think it is derogatory, but others do so I put it in quotes). A cultural psychiatrist is interested in how the cultural values of other people influence how they view variations in emotional expression and thinking. Of course, this can verge on stereotypes and needs to consider individual variations. Cultures can include ethnic groups, religious groups, economic groups, countries, tribes, refugees, etc. We know that in some cultures around the world historically and currently, such variations are much more accepted into the wider society and medication is much less used. In a so-called Western or industrialized society, Gheel is the best example I know. One could say that we would need less professionals if there was better societal acceptance of variation in emotional expression, thinking, and some behavior. Many cultures have there own “healers” to go to first; I talked about some of that in my last blog, ranging from shamans to curanderos to clergy. Sometimes these within-cultures healers will refer onto cultural psychiatrists. There is an organization called the Society for the Study of Culture and Psychiatry that focuses on all of this, mainly from a research perspective.

    I greatly appreciate the tone of the discussion and questions. It makes me think we can learn from each other.

    • Hi Steve,
      Thanks for the response. I am really enjoying this dialogue!

      I still believe that a true, open acceptance of the subjectivity of human experience (as manifested by the variety of cultural, religious, social, political, gendered, ethnic, etc. environments in which a person can grow up) is inherently paradoxical to the belief system connected to psychiatry, which implies that there is an objective, medical, and scientific Truth to human experience.

      In my opinion, a person either does believe in the inherent subjectivity of human experience (you’ve put it as taking a “cultural” approach to things), or doesn’t. There’s no middle ground. A psychiatrist’s very identity is defined around the assumption that there is an inherent biological condition (even if you’re a person who talks about the “biopsychosocial” model… “Bio” is still there, and “psycho” too, which carries it’s own Truth, but that’s a topic for another time…) determining the emotions/thoughts/beliefs that a person has. This makes believing in the subjectivity of human experience impossible, doesn’t it? In other words, if one believes that there is an underlying scientific, medical, objective basis to a person’s emotional experience of the world, at the end of the day, doesn’t that imply that that person’s subjective experience of the world (which you’ve defined as “culture”) is only secondary? And if you don’t think it secondary, why does your institution treat it as such, focusing its energy almost solely on the diagnostic, clinical, and biochemical paradigm?

      I have a couple of questions for you, that I’m really curious to hear your answers to:
      (1) Do you believe that there is a biological basis to a person’s emotional/cognitive experience of the world? I understand that biochemistry drives every single little thing that we do— every breath we take, every thought we think, every time we interact with our environment— so I’m not asking that as much as I am, if a person is experiencing intense emotions and/or thoughts that are considered by the mainstream to be outside of the “norm”, do you believe this is because there is something abnormal with their biology?
      (2) Do you believe that your Western training as a psychiatrist is more legitimate than “primitive” understandings of human experience?
      (3) If you don’t believe that the psychiatric paradigm is more legitimate than “alternative” paradigms, why do you think psychiatry has all the power it does to act as experts on human experience?

      There are so many more questions I’d like to ask, but I’ll leave it with those for now ☺.

      -Laura

      • Laura,

        By cultural, I meant just one influence on our subjectivity.

        For your first question, I’d answer no. Certainly, many of our leaders in politics, new movements, and religion had intense emotions and/or thoughts outside of the norm. I suppose we could also add the recent example of Steve Jobs in his inventiveness and leadership. Of course, many everyday people too. Different on a spectrum, perhaps, but surely not necessarily abnormal.

        The answer to the second for me would be no also.

        I think psychiatry has whatever power it does from a societal political decision akin to what Nathan wrote. As I answered Nathan, I would add that psychiatrists, when they are trying to work with people, would like to have more power to have the time to get to understand the subjectivity you mention. Although this is being eroded, we always talked more about the “art” of psychiatry than the “science”. I know others will say, well, just take the day and take whatever pay you can. That is one solution, but for now the demand to see us is great and when insurance is involved (and that will only increase under Obama’s plan), those companies have more power in many ways (? like the real power behind the throne??

        Steve

        • Decision is not the word I would use, but I think I understand what you mean. By systemic, I mean that we really don’t have much decision or say in how things happen. Psychiatry has been entrenched with law, morality, health, capitalism, that it’s quite difficult to avoid its influence, like it or not. It is a regulating force enmeshed with those other system that creates a sense of what emotions/thoughts/behaviors/people are healthy/legal/good at the expense of pathologizing other emotions/thoughts/behaviors/people as sick/criminal/evil, with consequence of losing the privileged status punitive enough for folks to work hard to limit their emotional/cognitive expression to seem more “normal” while feeling righteous and fearful enough to need to control those who are regulated to the ill category. Being “ill” becomes a stigma that can never really be eiliminated, but only mitigated by taking steps to attain a semblance “normalcy” by acting in proscribed ways (constantly reaffirming one is sick, taking/buying medications to show compliance, paying for mental health services to avoid “relapse”, not working jobs that are too stressful [read: high-paying and/or meaningful], hanging out with people who are healthy or want to be “healthy,” avoiding protesting injustice as the injustices seen by such people are actually delusions and delusions mean you are sick, etc.). This sick folks who engage in this understandable mitigating process creates an interstitial buffer between the “healthies” and the “sicks.” Who would blame them? However, this buffering supports the paradigm in that in gives credence to the regulators that people are actually sick (“look, they even say they are sick!) and want their help, and makes folks who don’t engage in this process seem scarier, more distant, and hopeless, which would legitimize more coercive monitoring and control of them.

          Psychiatrists, insurers, politicians, or whatever, everyone does their jobs hoping to do some good, but they have to play the part in the systemic forces they are involved with, as the punitive consequences for not doing so is too great (lose livelihood, prestige, professional connections, etc.) and often overrides any concept of personal morality people have.

          Not to have another discussion about art and science in psychiatrist (I don’t believe there is much of any), the hope of many psychiatrists to have more “power” and time to engage with peoples subjectivities comes back to other fundemental questions we’ve talked about. What makes psychiatrists qualified to have this power? It certainly isn’t taught well in med schools. Why not pay clinical anthropologists or clinical social theorists if skill in understanding unique subjectivities is important to mental health? Why pay psychiatrists more than any other mental health professional then?

          “As individual psychiatrists, most of us wanted to have enough power to do more than just med checks, a quest most of us have lost.” Many many psychiatrists work in private practice in wealthy urban centers and their surrounding suburbs without being associated with any insurance panel. They charge high fees ($200+/hr) to do just what you say psychiatrists want to do. If such care (regardless of how effective it is, costs so much, than how can anyone who does not have huge savings, high incomes, substantial familial support, or excellent out-of-network insurance coverage able to access such care? If psychiatrists want to treat other kinds of people than those who seem to be able to keep high incomes, how do they expect anyone else to pay? If you already agree that your training is no more legit or helpful than any folk healer (I do think than you have done a 180 from you first post if this is true) and biological pathology does not play a role in people’s emotional/cognitive expressions/distress, why are you entitled to such high pay/reimbursement? Either work with folks with a lot of money willing to pay you for having a special friendship (like many psychiatrists in private practice do), or take the reimbursement or limited pay that is available to you or that other non-physician mental health providers get.

          • Nathan,

            As I think I’ve said elsewhere, I and many psychiatrists have done the last thing you’ve said. I’ve also worked in a low-paying prison. My principle was to focus on those in most need who also wanted care. I can’t remember the last time I played any role whatsoever in forced treatment of any sort. My main question in an evaluation was always “what gives your life the most meaning and let’s see if I can help you achieve that”. Of course, at times I might disagree or say I couldn’t help, i.e., get or prescribe certain drugs. That question I found to be the best inroad into one’s inner world. I don’t think it is of much use here to state it, but a psychiatrist has (or at had) the broadest training of any mental health clinician, including anthropology and the humanities. The training of folk healers is different, but valid and valuable in itself. There is just so, so much we don’t know about the brain and mind (which may be different than the brain).

        • Steve,

          I am intrigued by your direct “no” response to Laura’s first two questions above. To be clear, are you saying that you do not believe there is a biological basis to a person’s emotional/cognitive experience of the world and that biological pathology does not play a role in mental and emotional experiences outside the mainstream “norm”? Are you saying that your Western training as a psychiatrist is not more legitimate than other “primitive” understandings of human experience?

          If so, it seems you have undergone a significant shift since April of this year when you wrote your first MiA blog:

          http://www.madinamerica.com/2012/04/why-we-still-need-psychiatrists/

          In that piece when you envision “Stepping into an Integrated Future” you state the following:

          “Who has the best potential to lead this advance? By now, you should know the answer. It is still only psychiatrists that have the most comprehensive education and training in all aspects of mental health and mental illness. In the loving spirit of Shakespeare, let us count some of the many ways they can add unique value to those in need.”

          You then go on to state a number of things that seem to me to contradict what you told Laura above. (I will give one example but I hope interested folks will check out the whole piece as I don’t want to be accused of quoting out of context): “Psychiatrists are leading the way in understanding that disorders like PTSD and Major Depression may turn out to be not just brain diseases, but now whole body illnesses.”

          Based on what you told Duane regarding the quote he posted above, it also seems that you no longer believe what you originally wrote about anosognosia, i.e. “Psychiatrists know that deficits in the frontal lobes of the brain can cause a condition called Anasognosia …” This is such an authoritative statement made with great confidence!(i.e. not “some psychiatrists theorize” but “psychiatrists know”)

          Are you consciously undergoing a paradigm shift in the months since April? I am genuinely curious if you see a difference in what you are saying in this thread and what you said in your first piece. Do you agree with Nathan’s observation that you seem to have done a 180?

    • There are still a few graduate programs in psychological anthropology, cultural (or transcultural) psychiatry, and cross-cultural psychology, with interrelated aims. It is very much a research discipline, and I have found it has had little impact (beyond some lip service) in professional mental health services, particularly psychiatry.

      In fact, the current trend is to push forward a nosology that is ahistorical, neurobiological in the most important regards, and somehow universal. I know the DSM has a subsection on “culture-bound syndromes,” but as I have noted before, demarcating a subsection as such creates the illusion that only some syndromes are culture bound (ones held by patients who are “primitive,” “pre-literate,” tend to me non-white, etc.), while the official DSM diagnoses are universal without cultural consideration. See: http://en.wikipedia.org/wiki/Culture-bound_syndrome#DSM-IV_list_of_culture-bound_syndromes

      The truth is that DSM diagnoses are also culture-bound, and a product of a particular modernist cultural/intellectual tradition that I believe has acted quite violently since its inception in trying to define itself as trust/correct/normal/healthful/scientific/most respectable, while delegitimizing other understandings of wellness and lack thereof. Even though drawing power from the belief it is allied with science, the contemporary mental health industry (which is led by Psychiatry) has failed to offer much more than pseudoscience to rationalize its standard operating. Psychiatrists are “our” culture-bound “healers” we go to first, precisely because it has supplanted the infrastructure of and how believable other notions of health are by tying itself to medicine/rationality, but we have seen that the outcomes of psychiatry may not be all that much better than other culturally meaningful healers from different times and place.s

      I know you don’t seem to agree with me on this Dr. Moffic, but I believe Psychiatry needs to be constantly defining itself as ahistorical/universal/scientific and in doing so denigrating/analyzing/limiting other understandings of mental health in order to maintain its own powered position in our world and to maintain any positive effect people to experience from interacting with it. Its a systemic feature beyond anyone’s individual intention. It also is not the case that psychiatry’s nosology is universal/ahistoric, as even the history of the DSM project shows so much historical, cultural, political, and economic influences at play with each subsequent edition/revision (remember neuroses or gay people manifesting sociopathic characters?). Each time, Psychiatry has to say something ike , “this time we have it more right, and it is righter than what anyone would say, and whatever happened in the past that was harmful was just because we didn’t know enough to be right enough yet. Of course we’re not sorry, we just weren’t as right as we are now. Keep on trusting us to make these distinctions, as no one has ever been more right than us.”

      To challenge it, I think it is important to do what Laura did, and find a sense of Self and community that can function outside of the nosology/pathologization of psychiatry, find novel ways of interacting and caring for ourselves and each other.

      • Nathan, I agree with you just about with everything you said. However, I would add that “psychiatry”, generally led organizationally by those in private practice, gave up the power of leadership in institutions (state hospitals, community mental health centers, etc.) long ago. As individual psychiatrists, most of us wanted to have enough power to do more than just med checks, a quest most of us have lost.

        • Steve,
          I would very much like to hear how you think psychiatry gave up leadership in institutions… I understand of course that managed care has given tremendous power to insurance companies, but to me the more insidious power lies in the dynamics of a locked ward, a clinic, an office. In the very existence of the DSM. In the very existence of a residency program in psychiatry in every medical school. The existence of managed care relies on the paradigm of psychiatry, and on the existence of psychiatric diagnoses (which, yes, you can say you only give to people so that you can bill insurance, but it is only through your voices as psychiatrists that the message of the DSM’s complete falsity and fraudulence will be believed by the ‘mainstream’).

          Looking forward to hearing back from you, Steve.
          -Laura

          • Laura,

            You make good points and I’m loath to respond too much, given some of the reactions. All I’ll about managed care is that most psychiatrists (other than those who are in private practice and have self-pay patients) hate managed care and feel managed care has used and distorted the field (say with “medical necessity”) for the financial gains of the companies (which are immense). Personally, I have a more mixed view of managed care, including supporting the need to reduce hospitalizations (and time in the hospital) and unnecessary treatment, which I tried to present in the book “The Ethical Way: Challenges and Solutions for Managed Behavioral Healthcare” (1997). Most systems of mental healthcare nowadays are run explicitly or implicitly by business people; what makes money and keeps the system afloat tends to rule the day.

  8. Laura,
    I see a sea change happening anyway, brought about by the Internet and people sharing information with each other. One stubbornly resistant area in the mind of the general public is “the mental patient,” especially the “seriously mentally ill.” The public is still prepared to believe that these conditions (bipolar and schizophrenia, but especially schizophrenia) don’t apply to the consumer rights movement.

    You asked:
    •How do we help our broader communities and society at large understand this issue as one of human rights and civil rights?

    There is an article in the Well Column of the New York Times this week about an epidemic of overtreatment and patient backlash.

    “But an epidemic of overtreatment — too many scans, too many blood tests, too many procedures — is costing the nation’s health care system at least $210 billion a year, according to the Institute of Medicine, and taking a human toll in pain, emotional suffering, severe complications and even death.”

    There is only one patient story within that article that concerns psychiatric drugs – related to an elderly patient who was put on antipsychotics, and the underlying problem turned out to be something else. The public gets that. My suggestion would be that the mental health recovery movement makes it a goal to also be included in media stories that also cover real disease – no descrimination by type of complaint. It may eventually penetrate the public consciousness that we are all in the same boat and that mental health activist complaints are valid.

    • Hi Rossa,
      Thanks for the comment. I actually think that pushing to include stories about “consumers” and “mental health recovery” alongside media coverage of physical diseases is very dangerous, and will only perpetuate the false knowledge that our society has around the nature of emotional experience as being part of a disease process.

      I haven’t used the word “consumer” in a long time, because in my opinion it perpetuates a power dynamic that I see as inherently oppressive and damaging to human dignity. To call a person a “consumer” implies either literal consumption (i.e. of psychiatric drugs), or economic consumption (i.e. of “mental health” services). To be defined by either of these two things is, in my opinion, to be reduced to a role as a passive recipient, a dependent; a person with unfulfilled needs until they are satisfied by whatever it is they are consuming from a “professional” source.

      I actually have been struggling a lot with phrases like “mental health”, “recovery”, “wellness”, “peer” (full disclosure— I currently work as one, although I have no “formal” training, i.e. CPS), because I believe they perpetuate a medical paradigm. To me, “wellness” implies “illness”; “recovery” implies that someone has gotten better from a sickness or abnormal condition; and using the word “peer” in this context perpetuates an otherness, as though there are those of “us” who have been labeled, and then there’s everyone else. Of course those of “us” who have been labeled have experienced trauma and oppression that those who are unlabeled haven’t, so we share a common bond, but in my opinion the only “peer” I feel like I am is a human one.

      But I digress… Back to your comment. I definitely agree with you that the overarching dilemma of Big Pharma transcends just psycho-pharmaceuticals, and that the mainstream, at this point, may more readily absorb a message about the dangers of drugs like statins. However, like I said above, I believe we need to talk about psycho-pharmaceutical drugs as separate from other drugs because they treat non-existent conditions. I guess, actually, that you could say many other physical conditions were created out of thin air, too…. Again, I digress… But nonetheless, to associate emotions, thoughts, and behaviors with physical conditions, I believe, can do nothing but harm to our movement.

      I really appreciate your input, @Rossa, and like I’ve said before, thanks for all you do!
      -Laura

  9. Steve,

    In the thread above you told Nathan that “I can’t remember the last time I played any role whatsoever in forced treatment of any sort.”

    On April 20, 2012 you told readers of the Psychiatric Times:

    “Recently, I was asked to write a request to possibly extend the outpatient commitment of a patient of mine. What for, I said to myself? This would be a waste of time because he had not exhibited any more dangerous behavior, was taking care of himself, and was compliant with his intramuscular medication. However, when as part of the ongoing monitoring of my patient’s improvement, I asked him to rate on a 0-10 (best) scale how well the medication was working, he said “0”. When I asked why, he said it was because he didn’t need the medication. Uh, oh, I thought. Could this be Anasognosia? Or, has he read or heard of Robert Whitaker’s book Anatomy of an Epidemic (2010), which discusses the potential long term risks of such medications? There’s no way he’ll be committed longer, but will he stay on the medication voluntarily? Without it he’d surely relapse into psychosis and possible dangerousness.”

    http://www.psychiatrictimes.com/blog/moffic/content/article/10168/2062591

    I hope interested readers will check out the whole piece in which you advocate for limited reinstitutionalization.

    How do you reconcile what you told Nathan with what you told PT readers? Please do not misinterpret this sincere question as an attack. I am genuinely curious. Do you see no elements of “forced treatment of any sort” in your description of your and your patient’s situation above? Do you see any contradictions in what you wrote in PT and what you wrote above? Do you consider outpatient commitment laws a form of forced treatment? What about involuntary hospitalization?

    I look forward to your response. As “da man in psychiatric ethics” I hope you understand that this is not quibbling over details but legitimate concern related to transparency on a critical issue.

    • Is there *no end* to this?!

      Moffic never stops.
      He’s the gift that keeps on giving!

      Laura,

      You come across as an extremely intelligent woman – centered, focused, caring.

      You have a wonderful opportunity to do something positive/ to create a dialogue for lasting reform with your upcoming forum.

      Moffic ain’t gonna help.
      He’s gonnna muddy the waters.

      Duane

      P.S.: And if folks like me are too *negative*, cut us loose too. Make it a success…
      Really!

    • He was already on an outpatient commitment and I didn’t know him that well. Actually, we psychiatrists don’t recommend whether to extend that or not, just send them our treatment view. As far as I could tell so far, he hadn’t changed from when he came in.

    • This is from “da man in psychiatric ethics”:

      From http://www.behavioral.net/blogs/h-steven-moffic/preventing-epidemic-psychopharmacology-lawsuits April 20, 2012 by H. Steven Moffic, MD

      “You’ve probably by now heard of, or read, Robert Whitaker’s book “Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America” (Broadway Paperbacks, 2010)….

      What I still doubt that we know, however, is how many lawyers have read the book. I can just see some of them salivating over the prospects. I wouldn’t even be surprised if some “ambulance chasers” out there are already finding patients who may have been damaged, or at least a case could be made, by long-term psychiatric medications.

      ….In the meanwhile, our key tool to avoid lawsuits and help our patients to the best of our ability is in informed consent, as tricky as that can be with psychiatric patients.

      So, here’s how I might respond post-Whitaker’s book, and even tell the patient if they don’t ask, all the meanwhile being careful not to scare them away from taking the medication when they really need it. (Of course, I would not say this all in one breath, or without breaks to discuss different points).

      “I would recommend that you try this medication for this problem, but only for as long as necessary. At some point of time, we might want to try you off of it, but when we do so, taper the dose very slowly. Please do not stop the medication all at once on your own, because your body and brain will not have time to readjust. In addition, sometimes there is a so-called placebo effect when first starting medication.

      You may feel better just starting the medication, but it may not be really working yet. Therefore, don’t stop it because you are feeling better for just a few days. We will also explore all other treatments and natural remedies that might help in addition to—or instead of—the medication. In the meanwhile, please try to avoid alcohol and street drugs, for they may limit the beneficial effects of the medications, worsen any side effects, and even cause your illness to become more severe. Is this OK with you? Any questions?”

      Get a signature someplace….”

      Stevie is not appalled at the possibility that, as he says, “the medications may have longer long-term risks to the brain and body that we knew before.” What he is most concerned with is what’s technically called Covering Your *ss.

  10. Robert Whitaker, Matthew, Kermit,

    I’m going to go way out on a limb, and say,

    “Moffic needs to go! He cannot be trusted!”

    Duane

    P.S.: If I just lost access to comment on this site, I understand. It needed to be stated. without mincing words… “A man’s gotta do what a man’s gotta do.”

    • Duane,

      I too find Dr. Moffic completely out of line. His lack of comprehension of the damages done within his profession is probably what makes it so impossible to get any place positive with this person. He has shown no genuine desire to learn from others.

      Dear Moderators and Owners of this site,

      I would like to know if there is a limit to how much apologetics of psychiatry we have to listen to?

      Dr. Moffic’s underhanded distortions, obfuscations and indirect attacks on us are over the top IMHO, and funnily enough really rivals $cientology techniques to muddy the waters and undermine their detractors. I know I have no rights to any decisions here, but I would ask, from the bottom of my heart that his ability to write here could be a little better moderated.

      I say this, while remaining more than willing to engage with those of differing opinions from myself – including prescribing psychiatrists. I would just hope there would be a limit to what we will accept from those psychiatrists.

      Again, I say this respectfully. It is not my decision, but it is endlessly frustrating to witness this person work so hard to undermine the questioning into his field and the experiences of survivors.

      We spend our time defending ourselves and exposing the words of Dr. Moffic, rather than focusing on positive ways to move forward. It has reached a level that is not healthy.

      Malene

      • I have been traveling for the past week, and quite unavailable to follow comments, post new material, etc. I’m taking a few moments now to say this: I’m at the Open Dialogue conference in Finland. This fall I will be at many other conferences that are pertinent to this website’s mission. I’m meeting a lot of people with wonderful projects under way, and gotten commitments from many of them to blog about them. The conversations I’m hearing, some of which I am videotaping for inclusion on the website, reflect a sense of change and hopefulness I really was not seeing just a few years ago. I am excited to see these things unfold, and I think that this website can provide a true service in helping people around the country and the world stay abreast of substantive developments, see and hear the wonderful people who are creating them, and draw inspiration for doing the same where they live.

        The video we put up of Steven Morgan and the Vermont Soteria project is just the beginning, but I’ve already met people at the conference here in Finland who saw it and were moved and excited by it.

        My involvement with this website started, in part, when I mentioned to Bob Whitaker a couple of years ago that I didn’t feel I could continue doing this work unless it somehow involved substantive, real change in the system; that I would rather sell aluminum siding that feel like I’m tinkering around the edges. I had done work I was proud of, but always feeling like it was covert, as if I was running an underground railway. That can be challenging, sometimes fun, and even intellectually kinky; but it is not sustainable as a way of life.

        I now have the opportunity to participate in chronicling the substantive change. Open Dialogue is, indeed, coming to America; Jaako Seikkula told me yesterday there seems to be more opportunity for it there than in Scandinavia at the moment; I hope to interview him more on that point. Earlier this week I videotaped an interview with Mary Maddock in Ireland. I came away thinking she is a latter-day Rosa Parks or Angela Davis.

        I’ve had conversations with Sandy Steingard, who is here at the conference. I think I can fairly say that she is excitedly, courageously, embracing ways of thinking and approaches to this work that had not been obvious to her. She has told me she will write about her ongoing process, and I believe that for those who will entertain the conversation that ensues the rewards will be rich.

        All of which is to say; we have a lot to look forward to. I think the fact that there has been a (largely) civil conversation about difficult topics on this website is merely a warmup for things to come. This is where my attention is directed at the moment. I think that these current conversations will fade into the rear-view when we really get up to speed.

        And I honestly believe that, if we can manage to remain civil, we may be surprised at who we find is riding with us.

        Open Dialogue is, as much as anything, an exploration of reality as something that arises as part of a social fabric. I like to think that everybody who contributes to the website in these early days is weaving it with us. I’ve had conversations with Dr. Moffic that leads me to believe he is every bit as much a seeker after new knowledge and new truths as anyone here. Call me pollyanna (or worse, as I’m sure some will), but I like to think everyone has a place on the bus.

        • To the MiA team,

          Malene wrote: “it is endlessly frustrating to witness this person work so hard to undermine the questioning into his field and the experiences of survivors.

          We spend our time defending ourselves and exposing the words of Dr. Moffic, rather than focusing on positive ways to move forward. It has reached a level that is not healthy.”

          I agree. I think something needs to be done about this situation, but I have no idea what. Frankly, I find Dr. Moffic’s conduct throughout the comment threads toxic. This has nothing to do with any views he might hold and everything to do with the way he relates to others. I also believe that he has as much right to participate in the comment threads as anyone else. I realize that he blogs here at Robert Whitaker’s request.

          When I look at Steve M’s rhetoric in the comment threads it reminds me of watching an interview with a politician who evades tough questions while continually promoting himself. I do not see “great dialogue” and I am not enjoying this. I would agree that Steve’s presence is stimulating, but for me this is not in a good way.

          Kermit, I would encourage you and other MiA decision makers not to generalize from your own experiences with Dr. Moffic when thinking about this difficult situation. One of the major problems I see is that Steve responds well to those with outstanding educations and an academic writing style. He is disrespectful, dismissive, and insensitive to many others who do not express their anger or critique in forms he is comfortable with.

          I believe with my whole being that there is a place for everybody on the bus! I also think that when a passenger on the bus is behaving in a way that endangers other passengers, for example by continually trying to grab the steering wheel or harassing other passengers, someone needs to get him to sit down so that everyone can make the journey safely.

        • Kermit,

          How exciting that you get to participate in those conferences and be on the forefront of what is hopefully an amazing paradigm shift in the years to come. Thank you for making efforts to share that with us.

          It might be hard to follow along with the frustration that some of us feel with Dr Moffic. You have spoken with Dr. Moffic in person and he has been able to say the right things to convince you that he genuinely wants change, but I will say that his behavior on this site has not been consistent with such a statement.

          I can understand allowing everyone a seat on the bus. Maybe Dr. Moffic will awaken and at that point maybe he will have something to contribute. I just ask that he is not allowed to be in the drivers seat, because right now, he will drive us right back into the medications. He has not yet had the courage to face the essential, destructiveness he represents. Please, lets do set limits and say NO, loudly NO. Yes, yelling NO to the old paradigms – the paradigms that Dr. Moffic still represents and try to sell on this site. Even if it is out of not understanding, even if it is not deliberate we still need to say NO.

          In other words – sure, allow him on the bus, but please, I beg, put some boundaries in place. Much worse than Dr. Moffic getting his tender little pride hurt is the re-traumatization he represents for survivors, imho.

          Malene

        • I believe it’s possible Steve Moffic’s heart is in the right place, but he simply hates hates hates having to discuss what he thinks of as his esoteric field of practice with non-physicians — as though we could not possibly understand it.

          He is having trouble integrating this environment into his schema. He doesn’t understand his audience and keeps on asking for a different one with which he’d be more comfortable — psychiatric patients happy with their treatment.

          That said, I respect him for pursuing this growth experience, although I find his evasions and rationalizations annoying.

        • Thanks for keeping us up to date with your news and travels Kermit and all the best in Finland. I’d seen your photo with Mary Maddock in Ireland on Facebook. We’re in a global village right enough.

          Also good to hear about the psychiatrists who continue to engage on MIA. All the best to them for hanging on there. I sometimes feel like a lone voice in Scotland but know there are many others here supporting the campaign for psychiatric system transformation.

          Regards, Chrys

  11. I recognize that for many here, the human rights violations that were perpetuated on them are the most egregious thing. If we say “Psychiatry is a human rights violation that must be abolished”, some people will ask “Then how do we help these people who are suffering greatly?” I agree that psychiatry overall is doing a mostly sucky job at helping people who are suffering, and is often harming people. But I think it scares a lot of folks to threaten to abolish a supposed source of “help”, and not have much to offer to replace it. It scares them (including me) to not know where to turn to instead (even though I’m thoroughly discouraged by my long experiences with psychiatry).

    For some people, simply turning away from psychiatry may be sufficient for them to greatly improve the quality of their lives. But for others, it probably won’t be. For me personally, I’m much more interested in seeing people accumulating more good information about what kinds of help actually helps people (and I believe this will be very individualistic), then figuring out how to put more of that kind of help in place. I’m not confident the “peer movement” can sufficiently fill in the gaps. Interacting with highly distressed people is challenging for most people, and a lot of people do it poorly, with poor outcomes. I for one wouldn’t mind some “expertise” involved, if we could ever come to any consensus of what decent expertise might look like.

    • Hi Philroy,
      You raise a really important issue. Although it is my hope for the institution of psychiatry to be dismantled, it is an unquestionable fact that there are many, many people who have been funneled so deep into the system that they no longer remember any other way besides being a passive, agency-less recipient of “mental health care”, or no longer believe that it’s possible for them to find their way without “professional” help. I can very much identify with that mindset– I was there for a long time. To simply remove what’s become their “safe-haven” (again, I can very much relate– I tended to be the psychiatric patient who never wanted to leave the locked ward because I came to believe I needed to be kept safe from myself), could be devastating. I too agree that it can’t be done without “alternative” sources (in my opinion, true alternatives lie completely outside of the mental health system altogether).

      Speaking for myself, the institution of psychiatry became completely obsolete to me when I came to believe that (a) I never had or will have “mental illness” because it doesn’t exist, and (b) that I was not alone with my intense emotional suffering and that there were others who’d found meaning in their experiences (I now see my journey as a spiritual one) and learned to co-exist with their emotions in a way that didn’t leave them feeling hopeless and incapacitated by life, and that the answer hadn’t been found in the mental health system. Once I saw these things, and faced my fear of the unknown– which meant an unmedicated Self, the future, the thought of being a responsible human being with agency and self-determination, and a life without psychiatry– I was able to move forward and out. It was by NO means easy, but I knew somewhere inside of me not just that I HAD to do it, but that I COULD do it.

      I think this is parallel to what you’re saying– I educated myself with facts about the truths I’d always believed that were actually false (DSM language,”mental illness”, psychotropic drug efficacy, for example), I sought support in “alternative” venues, and I built up the courage to change the way I saw myself and my relationship to the world around me. I’m still on that journey– I believe I will be on that journey for the rest of my life, and I’m able to be excited about that today– but I do feel complete independence from the mental health system.

      I agree with you that it is a very challenging experience to be with someone who is in an extreme state– I know from personal experience of being on both sides of it. I believe that the more we dialogue about these extreme states as being part of what it means to be human, and that we don’t need to slap words like “crisis”, “safety”, “risk management”, “liability”,”lack of insight”, “danger to self or others” and so forth onto the process, but rather be with the person and acknowledge their pain and encourage that person to see the experience as part of their humanity, which they are not alone in, the odds are that we will get better as a society and as a human race at simply being with each other, without getting paralyzed and debilitated my fear. We each have “expertise”– on our own experience of reality– and the more we accept that and stop turning over our agency to outside people whom who’ve been told have some sort of power (aka “expertise”) that we don’t have, the less we will feel connected and united as human beings.

      The more we dialogue about the intense fear that you raise around what a world without psychiatry would look like, the less we’ll be controlled and imprisoned by that fear, and the more we’ll be able to move forward.

      So glad you brought this topic up. Thanks so much, Philroy.
      Onwards,

      Laura

  12. Hey Philroy,

    I completely agree actually. As a helper, paraprofessional and volunteer, I have been in situations where behaviors or symptoms of those I was there to help scared or overwhelmed me. I have learned a few things from those situations. I have also been in the situation where my reactions scared someone else. Although I do not and did not then see a reason to be “scared”, I know that is how they felt.

    If I get scared, that is my problem. I do not have the right to dehumanize the person that is scaring me.

    If I get scared I need to get support so I can remain a human when I try to offer help. We tend to respond to our fear by labeling, belittling and ultimately drugging someone if we feel fear or overwhelm when interacting with them. This is not ok.

    Sometimes I have seen medications help, and it should be an individual choice if that is an avenue to pursue.

    Yes, we need systems in place to help those who are in crisis, with various behaviors that can be overwhelming, without dehumanizing them in the process. It will take a while to develop such systems. Unfortunately, we will make little progress as long as people are unaware of how horrific the degradation of psychiatry as it works today is.

    Malene

  13. Dr. Moffic,

    Your inability to acknowledge the horrific damages done by your chosen field, and by prescribing psychiatrists like yourself is a slap in the face of every survivor here.

    It is disrespectful and insensitive (and that is me moderating myself).

    You keep claiming that you have something we should learn from you, but you have refused to tell us what that is. Even worse, in my book, you are much more focused on what we should learn from you than you are on what you can learn from us.

    So, let me be clear on what I see here. You told us that you had more than 400 patients at any given time in your practice. Let’s just hazard a guess and say that amounted to approximately 2600 people a year, over a 20 year career that would amount to 52000 people that you have medicated.

    Lets be ridiculously conservative and say that 30% of those people developed physical and / or emotional reactions to your medications that caused them further damage. In this I include obesity, diabetes and other physical ailments as well as the mental side effects that we know are there. 30% of 52000 people is 15600 people whose lives you have destroyed. 15600 people who were traumatized, drugged and damaged by you. How many of those were children?

    Frankly, if you want to be on a site like this – then it is time that you listen to and learn from us. Lets think of those 15600 people. Lets stop thinking about how you are getting hurt, but lets think of the 15600. We, Stevie boy, we are the 15600. The 15600 people who are absolutely furious, who wants to be acknowledged for the damage done. No, you have nothing to offer us Stevie.

    Until or unless you genuinely want to learn from us. Until or unless you can acknowledge the horrors, until that happens, you have nothing to offer.

    Malene

  14. “… 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

    Moffic,

    Common sense would dictate that an amendment that applies to any person who is convicted of a crime would certainly also apply to any person whose greatest “crime” is severe emotional distress.

    Unless, of course one sees “bipolars” and “schizophrenics” (two very marginalizing terms)as less than a person, fully human.

    Which of course, is the real issue here, isn’t it, doc?
    When it comes to these fundamental rights, *your* opinion is *moot*.

    In short (plain English), who cares *why* you think you have the *authority* to ignore these rights?

    You do NOT have such authority!

    Natural Law.
    Raed about it.
    Learn about it.

    And stop spitting on the Constitution!

    Duane

  15. “In my heart, I know what my solution is– any institution in which one person claims the right to be an “expert” on another person’s emotional, thinking, and spiritual existence is, in my opinion, oppressive and in need of dismantling.”

    I love you for this clarity of vision, Laura.

    I read the rest of these comments, but, really, that’s all I needed to say.

  16. How did I miss this particular bar fight that has been going on for days? I honestly didn’t even notice it. Wow. Some serious discord here.

    I don’t have that much of a problem with Steve Moffic. From the first couple of blogs he wrote, I knew where he stood. I knew he was an editor at Psychiatric Times, and I knew what this told me. I knew he’d only recently been exposed to Whitaker’s work, etc.

    I’ve read all these comments, and if he did say he “couldn’t remember the last time he was involved in forced treatment”, and then you found the 2010 Psychiatric Times article where he admits to being involved in a community commitment forced drugging case, well then, that could be seen as incongruous with what he said here.

    Moffic seems to rile some people here, he doesn’t bother me, he doesn’t even approach the level of hypocrisy of others, I’m thinking about the stealth electroshock psychiatrist in the reform movement here.

  17. Laura, you are awesome as always!

    “…the biggest change I believe I can create in my work as a peer specialist (a title I take numerous ethical issues with, and that my heart really struggles with having, although that’s a conversation for another time…) is to help a person connect to a sense of inner-agency and hope that he/she has forgotten exists inside of him/her.”

    It is sad to me to read this comment, because I have been a counselor/therapist in the community in the past and this is exactly what I always have done. Of course, I didn’t actually receive any training in counseling before I became one (undergrad degree in Chemistry, grad degree in Education, but somehow the MS convinced people I was a counselor!), and maybe that was a huge advantage. But I recall a lot of folks back in the 80s who thought similarly, and we got some really great results. Empowerment was the watchword – helping the “client” (whether self-identified or forcibly labeled as such) realize that it was the “client” who defined both whatever problem we were working on and what the solution was.

    We have come so far from that paradigm that it is apparently almost unrecognizable as “mental health treatment,” and only “peers” (as in survivors of the system’s abuse!) seem able to recognize that this is what really helps people thrive. That paradigm came from the place of believing that everyone had a REASON or PURPOSE for their behavior, and that critical to helping was to assist the person in identifying what they were trying to accomplish and then have HIM/HER decide if their behavior met his/her own goals or if change was in order.

    I concur 100% that it is the definition of “mental disorders” as medical entities needing “treatment” that is at the core of why the current system is so destructive. And despite Stevie’s protests, it is the APA that publishes and supports these definitions, and adds the social validation required to obfuscate the obvious lack of scientific validity or even scientific approach involved in developing them.

    I am looking forward to the new forum. I’ve been involved in working to change the system “from the inside” for years, including helping pass a law in Oregon that has reduced the rate of psych meds in foster care from 24% to 14% in 5 years. I can tell you that it only happened when we were able to join together a group of people who had some social clout (judges, advocates, attorneys, foster youth, government officials, the news media, and the legislature), and it took a long time to make what still amounts to a significant but not sufficient impact on the system. System change takes time, and it does require an alliance of “insiders” in addition to critics from outside the system. Political power is very real, and in this country, as corrupt as the process has become, the power can and ultimately does belong to us, if only we will step up and take it back from the people who have bought it, including (sorry, Stevie) the profession of psychiatry.

    Thanks again for your inspirational blogs. Let’s shake psychiatry to its foundations. The good ones (Sandra Steingard and her ilk) will come along for the ride, where as the rotten ones will fight like cornered badgers, but in the end, have nothing but their status and their illicit financial motivations to protect themselves. If we all band together, including those IN the system who want to change it, we can bring this edifice to its knees!

    —- Steve

  18. Why are we spending all this time on Dr. Moffic? Maybe the answer to this question is that the unspoken yet clear assumption of this website is that the change we are looking for will come through convincing psychiatrists to be nicer. Almost every new blogger announced is yet another mental “health” professional, as if we psych survivors are stupid and can’t speak for ourselves.

    This is really nonsense. This isn’t the way social change is accomplished. When the abolitionists were trying to end slavery, did they think they would win just by convincing the slave owners? And later, when black people had at last the freedom to act on their own, did they succeed by getting white people to lead them? Did the women’s movement ask men to be their leaders? Did gay people wait around for straight people to tell them what to do?

    I am feeling very frustrated by the discussions I see, where lots of energy is being wasted on trying to convince people like Dr. Moffic to be nice. We should be spending our time and energy trying to figure out how we, those who have been hurt by the system, are going to change it.

    Laura wrote earlier that we should try to see how we can learn from the civil rights movements that came before us. (Our movement was actually contemporary with the movements I just mentioned, but has been thrown off course for a long time by the bribes from the federal mental “health” system.)

    I don’t think it is hard to figure out at all. When our movement started over forty years ago, we had the inspiring civil rights movement, led by people like Doctor King, as our example. We followed that example and we made progress until the system bought off a large part of our movement.

    Times have changed, and many other movements have been bought off too. (See the very enlightening book “The Revolution Will Not Be Funded.”) But even though these movements have become less “militant” in their style, they have accomplished a lot. Gays, women, black people, disabled people, all have won respect and a certain amount of power. Maybe even more important, they now think differently of THEMSELVES. Unfortunately, though, these movements are at a different stage of development now, and don’t give us the inspiration we need.

    But really, brothers and sisters, Dr. Moffic is not important. He will do whatever he wants anyway.
    Instead of fruitlessly arguing with the shrinks, let’s discuss with one another, in the most supportive and mutually respectful way we can, what we need to do to accomplish our own liberation.

    WE are the ones who will make the changes we want to see (along with allies who understand the difference between helping us and being in charge). How can it be otherwise? We must do what all other movements for liberation have done and learn to rely on ourselves.

      • Malene, I will be having a meeting soon for people who want to work on the APA demo and I will contact you soon. Do I have your phone number? You can send it to me by email if you want. I don’t want to post mine here though. Seems to me we have already spoken on the phone, but I am not the most organized person in the world.

        On another page, I saw your discussion of your cult experience when you were younger. Now I understand better why you felt so strongly about Scientology. I know you had mentioned being in a cult before, but it didn’t register on me.

  20. I would say the first step is for that community to see us. Most of the time we are spoken for my psychiatrists who have no idea what they are talking about or our parents or family members or worse, the media. The public needs to see us as people. Their ability to distance themselves so far from us is why it took so long to shut down old asylums, as long as that distance exists, it’s easier for them to turn a blind eye.
    As to the second, I would say you could set up websites and such, but it won’t have any effect until we can relate to them. A better idea may be to do presentations at colleges open to the public.
    Support for withdrawal can get sticky. Depending on the medication and reaction, we may have to get them medical help at some point. It might be good to be a available as a short term house guest. Especially if they have young children or are on their own. We want the transition to be as calming as possible for them, and it would give them someone to be there if they felt unsafe or needed some assistance.

    There are some serious problems in our weigh if we are seeking civil rights. In the nineties, the High Court became concerned that the mentally ill might be a suspect class. Suspect classes have an established history of prejudice and abuse by the general public and may find it difficult to be heard legally. It is my opinion that establishing us that way would have disallowed forced drugging, demanded adequAte treatment, and established proof to be committed. I think this because Congress randomly volunteered to do something, and that’s never a good sign. They did the studies on prejudice and access to the courtss, and instead of granting us rights, they formed the ADA. They also states that any feeling of prejudice was in our minds essentially. About two years later the studies were found, and they established without a doubt that a nationwide prejudice towards mental illness was rampant.

  22. Stevie,
    “Anogosognosia”
    Where did you learn this word, or what it means?
    So if I inform you that my troubles are not an illness, you will say I suffer from this A word?
    What if I told you you have this, because you cannot see that my troubles are not “illness”?

    And by the way, the “upper politicians” had zero to do with teaching you to apply
    this and other words to people, at your discretion, however you see fit.

    • Psych “diagnoses” are opinions, every one of them. It is ridiculous to apply such a term to a so-called “illness” that is not objectively observable or determinable. Like saying someone who doesn’t acknowledge that they’re “cowardly” is suffering from “anosognosia.” There is a proper application of the term to a known, observable neurological problem that can be tested for and verified. Saying someone has “anosognosia” because they disagree with your opinion is about as far away from scientific as you can get.

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