Psychiatry has always been a mixed blessing. At its best it is humanistic and brings kindness and understanding to emotional suffering. At its worst, it can be coercive, controlling and damaging. What annoys me the most about current psychiatry with its overemphasis on medications is that it pretends to be scientific when it is not.
The pharmaceutical manufacturers do not submit their raw data when seeking FDA approval. Raw data would include the exact number of patients who started a clinical trial, the exact number who dropped out, the reasons why they dropped out and many other specific details concerning the clinical trial. Instead, data is manipulated and twisted to suit the needs of the manufacturer, and this manipulation is hidden from physicians and the FDA. The FDA has the ability to demand the raw data, but rarely does. Instead, the drug companies are free to reinterpret or exclude data that is not favorable to their product with no transparency.
Sometimes I am a reviewer for a professional psychology journal. When I review an article, I insist on the raw data, or the article is rejected for publication. The only raw data on a pharmaceutical that I have ever had the chance to review is the data on Paxil which was inadvertently made public in the trial of Lacuzong v. GlaxoSmithKline. http://www.breggin.com/index.php?option=com_content&task=view&id=160
The raw data reveals a shocking cover-up of information and indicates an extraordinarily high completed suicide rate of 7 subjects in a clinical trial of about 1400 people, mostly within a short period of time after stopping the drug.
As a physician, I seek to protect patients from this sort of danger. How am I to make a credible, scientific decision about a drug’s risks and benefits if I do not have the proper data? Professional, legal and scientific forums demand a ‘scientific’ discussion of drug effects, yet I am limited to data that has been manipulated for the benefit of pharmaceutical sales.
Sometimes I feel like I am wearing handcuffs in a boxing match. When I make an observation of adverse drug effects on my patients, my colleagues admonish me that I need to have controlled scientific data before I can draw a conclusion. I recall a decade ago when, in casual conversation with another psychiatrist, I mentioned that Paxil seemed to be addictive and that patients were unable to stop taking the drug. The response was a venomous assertion that I had no data to support my opinion. But did I even need data to support my opinion? And am I only limited to comments that are based on manipulated drug company data?
In 1990 when Harvard psychiatrist Martin Teicher reported six case studies of serious suicidality in six patients treated with Prozac, instead of prompting serious scientific study of Prozac-related suicide, Teicher was excluded from academic circles – despite the fact that Germany initially would not license Prozac for sale because of the possibility of suicide. Voicing professional opinion on adverse drug effects is hazardous to a person’s career.
Any observations or comments indicating side effects or adverse effects of psychiatric medications are met with indifference at best, but the doctor making the observation will more likely be labeled as “fringe” or as an “antipsychiatrist.” Any opinion that does not support the pharmaceutical industry is considered political opposition rather than professional and scientific observation. Given the lack of self regulation and lack of scientific scrutiny, the findings in Anatomy of an Epidemic that mental illness increases in proportion to the amount of medication prescribed is not surprising.
Not too long ago I saw a young man who had tardive akathisia – a sense of almost intolerable restlessness – for a second opinion. I felt the condition related to taking SSRI antidepressants. He was the son of an academic psychiatrist. After my opinion that the patient had tardive akathisia he went for another opinion from a prominent academic psychiatrist, who concurred with me. The young man’s father commented that he also agreed, but could never voice this opinion in public because his peers would be highly disapproving.
What is to stop the drug manufacturers from deliberately making drugs that are ultimately damaging to the patient if a physician is not free to discuss observations and findings?
In the late 70’s, before the invention of CT scanners or MRI scanners, I practiced emergency medicine. Without these sophisticated tools, I had to diagnose potentially fatal problems such as internal bleeding from head trauma or abdominal trauma on the basis of history and examination. A doctor had to look at a patient and make a decision about whether or not they appeared ill or in distress. A doctor had to examine the patient; smell the patient, touch the patient, talk to the patient; this was crucial to the decision making process of diagnosis and treatment. With that sort of background, why do my observations and opinions somehow no longer matter?
“He was the son of an academic psychiatrist.”
What a dangerous position to be in.
” The young man’s father commented that he also agreed, but could never voice this opinion in public because his peers would be highly disapproving.”
Such is the group-think associated with psychiatrists. Imagine trying to find one brave enough to disagree with his colleagues if your very liberty depends on it. Good luck.
Smelling patients? I didn’t know they did that. Sounds like an unpleasant part of the job.
There is much more to the story of how psychiatry is in no way scientific than drug company studies. The entire concept of labeling unwanted behaviors and thoughts ‘medical problems’ is utterly flawed.
The only benign form of psychiatry is not psychiatry really as it is known today at all, some form of counseling on life’s problems, is what I am talking about.
Report comment
Re: “Mixed Blessing”
IMO, the only “blessing” from psychiatry has come from those *few* (very few) brave souls who have had the courage to make a clean-break.
There are 50,000 psychiatrits in the United States. There may be 50 who meet the criteria of having made a “clean break”:
– Ccome forward with the facts
– Taken a stand against fraud
– Truly infomed their patients about dangers
– Refused to prescribe off-label – children, elderly, PTSD
– Exhausted all other methods, before drugs
– Become knowledeable about non-drug alternatives
– Provided information and support for withdrawal
– Refused to use force; insisted on due process in MH courts
– Advocated for/with those who have been harmed
– In short, done the right thing as a medical professional
50 of 50,000
1/10 of one percent
IMO, 99.9 percent of psychiatry has been a curse.
Only 1/10th of one percent a blessing.
Duane
Report comment
In fact 50 is probably a stretch.
Duane
Report comment
50,000. Hmm.
49,000 odd war criminals and one platoon of heroes.
At least we have established a beachhead.
We could go deeper on this…
50,000 psychiatrists = 40,000 spouses? who decided to marry a psychiatrist? That makes 40,000 spouses who voluntarily lie down in a bed with a psychiatrist, and many more than 40,000 who get mechanically restrained to a bed by a psychiatrist.
50,000 psychiatrists = 80,000 children of psychiatrists? 80,000 kids who get read bedtime stories by a psychiatrist who loves them, and millions of kids who get their growing brains assaulted by a psychiatrist who views them as a malfunctioning piece of meat.
50,000 psychiatrists = 100,000 parents who are just proud as punch that little Jimmy grew up to ‘help those brain diseased mentally ill people for a living ain’t he a good boy, rich and successful too’. (But of course many of his ex-patients hate his guts for the human rights abuses he carried out on them)
I wonder how much money it costs the taxpayer when a psychiatrist is added to the world. Most psychiatrists are going to leave a litany of iatrogenic disease in their wake, millions of dollars in disability payments, millions in lost productivity from the people whose lives they kneecap and destroy…
There was a fork in the road, at medical school, every one of them could have become a primary carer, or a cardiologist, and actually been of service to society. Instead, 50,000 menaces to society sitting in a football stadium cheering on their pseudoscience, signing innocent people’s lives away with their Abilify logo emblazoned pens.
What time is it? Check the Abilify plastic wall clock. It’s time for this pseudoscience to GO.
To prison.
Report comment
I agree. One of the few reasons that I come to this site these days is to read your responses. You are witty, have a sense of humor, are extremely intelligent, and obviously care one hell of a lot about what happens to people. You have such a way with words.
Report comment
“But of course many of his ex-patients hate his guts for the human rights abuses he carried out on them”
**Very well put — as a former patient who continues to fight through the aftermath of 30 years on brain altering psychiatric drugs, I feel very much that my human rights have been profoundly abused.
“I wonder how much money it costs the taxpayer when a psychiatrist is added to the world. Most psychiatrists are going to leave a litany of iatrogenic disease in their wake, millions of dollars in disability payments, millions in lost productivity from the people whose lives they kneecap and destroy…”
**One more educated and highly skilled person here — on SSI disability due to severe benzodiazepine and SSRI damage to what used to be a great brain. Divorced and suffering in isolation, waiting for a protracted withdrawal to resolve. Hoping that it will…
The hardest thing is that no one — NO ONE — in my circle of friends, former co-workers, or PCP understands it. We truly do suffer this in isolation.
Report comment
Ditto
Report comment
You may indeed by right Duane, but in the spirit of sharing accurate and real data about medications, where do you get your data about psychiatrists?
Report comment
An educated guess.
Again, there may be *less* than fifty.
I wanted to give your profession the “benefit of the doubt.”
You’ve been in te profession (recently reired)… How many docs do you know who meet the criteria listed above?
Any?
Do you?
Honestly?
Duane
Report comment
Apologies for the typos lately…
I’ve had a sudden, 40-fold increase. Joseph Biederman must have put a virus on this notebook computer.
Ha!
Duane
Report comment
Dr. Moffic,
With all of your work in the field of psychiatry… a lifetime’s work.
Do you know 50 docs who meet the criteria?
Really?
Who are they?
Duane
Report comment
I’ve worked in healthcare for many years and have known a significant number of psychiatrists and prescribing psych-NPs. There is not one among them who truly understands the issues being discussed here or who fits Duane’s criteria for having made “a clean break.”
Report comment
Time for a little disclosure. When Dr. Shipko sent me this post, there was no title, so I just lifted the “Psychiatry as a Mixed Blessing” meme from the text as a temporary one, expecting we would change it. When I told him, he laughed and – well, I won’t speak for him, but he said something more aligned with Duane’s sentiment, if not even more extreme. But he said to go with it. I said the title alone would probably draw some fire. But he was on the way to the gym and clearly one who enjoys some heat.
I think we’re going to enjoy the posts he’s working on.
Report comment
Dr. Shipko said something “more extreme”?
I look forward to reading future posts!
Thanks for the clarification.
Duane
Report comment
Good first post. Very good.
And, great comments preceding mine, by Discover and Recover (Duane) – and by Anonymous.
I particularly appreciate that Anonymous states, “The entire concept of labeling unwanted behaviors and thoughts ‘medical problems’ is utterly flawed.” And, I wonder what is your view of psychiatric labeling?
I ask you that, as I see this, in your bio, “In his private practice in Pasadena, CA, Dr. Shipko dispenses empathic psychotherapy with a good measure of common sense and a practical approach to emotional problems,” and I think to myself, ‘Calling ones psychotherapy “empathic” is fine, but “empathic” is just a word; it’s not *proof* of empathy.’
So, I wonder what is your view of psych labeling; and, no less, I wonder:
What is your opinion, ultimately, of psychiatry’s locked wards and forced ‘medical’ treatments?
Note: Some months back, I put that same question, to another new psychiatrist/blogger – here on the MiA website – Malika Burman. Her answer was indirect, at first; but, eventually, she explained:
“I have no interest in forcing anyone to do or take anything. If someone wants to come to me for help, I do my best. If said person does not like what I have to offer, does not like my style, or does not like me personally, they are free to leave.”
In my view, that’s was/is a perfectly respect worthy answer.
Report comment
Good post, Stuart.
I’m interested though, why you offer no personal opinion on the nature of this strange phenomena, in our deep reluctance to criticize the consensus reality? It seems rather easy for us all to sight it, yet far more difficult to understand it? Is there also a real phenomena, that we don’t we don’t even try?
“The young man’s father commented that he also agreed, but could never voice this opinion in public because his peers would be highly disapproving.”
Group-think? As Anonymous points out, and we all recognize it in so easily in others, yet resist the mirror of self-reflection? Insider outsider status, seems to be very much a function of human dependency on group support for survival?
Yesterday I commented, that *unconscious* used to be a word which generated much interest in those concerned with the human condition, yet here we are discussing mental illness and the associated behavior of all involved, and the word is surprising absent in many, many, hundreds of thousands of written words?
I’ve suggested in the past that nothing will change until we begin to address the way human beings actually function, in the anxiety of the lived moment? Why does voicing a perfectly understandable, critical view of any group-think, create so much fear of being cast-out? Why has *unconscious* seemingly all but disappeared from forums such as MIA, which seek examine human behavior?
If we examined our own behavior more, would we become more creative than just critical, in the great need for solutions? Would be be able to use the passion and lived experience of the survivor community, to divine some clearer view of group mentality and function?
Is human intelligence a bit of s myth? Are we intelligent, only when exploring anything but, our own internal motivation? That ideological *stance* of group think, the reaction beneath our so-called reason? Our postural attitude to the life we see *out there* Consider;
“MODERN EDUCATION & ASSUMPTIONS ABOUT COGNITION:
This is the most recent instance in history of favouring man’s ‘reason’ as his distinctive glory. Although Genesis equated ’knowing’ with carnal knowledge, that fateful loss of innocence that exiled him from the Garden of Eden, in both theological and secular thought reason has been glorified as the divine spark in man. This perennial idealisation of the cognitive function has prejudged its definition.
If human beings share sensory and motor equipment as well as drives and passions with other animals, and if reason is represented as both the distinctive and most valued function in man, then the cognitive aspects of the sensory and motor functions are denied by definition. Further, ‘irrationality’ is thereby also denied to be inherently cognitive.
‘Superstition’ and mysticism are prejudged to be different from cognition rather than to be special cases of knowing. In the extreme derivative of such idealisation, even science would fail to meet the criterion of true cognition, in-so-much as today’s science can be tomorrow’s superstition. In some theologies just this inference was drawn so that only God knew truly and fully.
Yet if all cognitive theorists would resonate with Socrates dictum that an unexamined life is not worth living, they would part company as soon as ‘examination’ was scrutinised more closely. Are daydreaming and thinking equally ‘cognitive’ ‘inner’ processes that had to be both objectified and operationalized”
Ideology and Affect/Emotion:
Now let me introduce the concepts of ideo-affective postures, ideological postures and ideo-affective resonance. (1) By ideo-affective postures I mean any loosely organized set of feelings and ideas about feelings. (2) By ideological postures I refer to any “highly organized” and articulate set of ideas about anything. A generally tolerant or permissive attitude would be an instance of an ideo-affective posture, whereas a progressive or democratic political position would be an example of an ideological posture.
(3) By ideo-affective resonance we mean the engagement of the loosely organized beliefs and feelings by ideology, when the ideo-affective postures are sufficiently similar to the ideological posture, so that they reinforce and strengthen each other.
Ideo-affective resonance to ideology is a love affair of a loosely organized set of feelings and ideas about feelings with a highly organized and articulate set of ideas about anything. As in the case of a love affair the fit need not be perfect, so long as there is sufficient similarity between what the individual thinks and feels is desirable, to set the vibrations between the two entities into sympathetic resonance.”
Excerpts from “Exploring Affect,” (1995) by Sylvan Tomkins.
Can we face the mirror, the cave within, and be so enthusiastically critical in our thinking? Can we come to a *realization* that the SYSTEM, is actually an internal system of survival needs, projected onto the world “out there?”
Report comment
Duane,
I think you are missing the point I am trying to make. We can not answer your question unless we agreed on your criteria, then did a survey of all psychiatrists, and tried some way to verify their responses. In other words, the same kind of “scientific” study we want for other issues. Just throwing out stats to make a point can be very misleading; one could say the same was done to push medications. All I’ll say again is that there are many other psychiatrists who feel horrible for the injustices we know of, desperately want our field to improve and would participate more if they felt welcome. Does this site just mainly want “like-minded” points of view, or to my mind, more hopefully, the “like-intended” that Kermit Cole relayed? “Like-intended” would include different points of view with the hope for some consensus and improvement in certain causes.
Report comment
Dr. Moffic (aka ‘Stevie’)
My comment was prefaced wirh ‘IMO’ (in my opinion).
Surely, there’s room for emotion (including passion) in the dialogue?
Re: “Clean-breaks” from psychiatry
You still haven’t answered the question, “Do you know 50?” My guess is that you don’t kmow any; especially any who are truly well-versed in providing support in safe drug withdrawal… because there are only a handful out there, doc.
Re: Science and facts
You’re hardly in any position to lecture any of us on this subject. Bio-psychiatry has no science, and knows no facts.
Re: “Different points of view”
This site IS a *different point of view* from the dominant, mainstream view… however, allows room for bloggers such as yourself, who continue to advocate for the failed paradign of care known as bio-psychiatry (notwithstanding small, meaningless changes such as how the “care” is paid for).
In short, you’ve come onto a site with many folks who want to see a revolutionary change, and you continue to try to persuade us that one is not needed. And we (many of us) simply do not agree with you. In the words of the character Stewart Smalley, of SNL fame, “That’s okay.”
Re: Hurt feelings
It gets tough on here sometimes. What did you expect?Put on your tough-skin, doc…
You’re amongst revolutionaries!
Duane
Report comment
I’ve made too many comments, and need to allow others to have some time/space.
You get the last word.
Duane
Report comment
No, Duane, I am not defending psychiatry, like you I am only giving my opinion about the state of emotional care or whatever we decide to call it. If you want to keep labeling me in another way, that is up to you, but just as I can learn from others here, perhaps others can learn something from me. If this site is just to bash psychiatry in any way possible, that is up to this site.
Yes, I know way over 50 who would meet much or all of your criteria. How do I know these people so that it is more towards a fact than opinion. I have had – and had – leadership roles in many of the more fringe psychiatric groups that tend to be more critical of psychiatry: the Group for the Advancement of Psychiatry (where Mr. Whitaker was invited to speak last April, and where he was not tarred and feathered, Past President and current Board member of the American Association for Social Psychiatry, Founding Board member of the American Association of Community Psychiatry, ethics chair of many committees. Would I recommend any of them to become involved with this site right now? No, but I do know that some are watching and reading some of the stuff. When we are more welcome, I’ll let them know.
What revolutions are you using as a model? The USA? Great for certain populations, not for the Natives. South Africa? Political freedom for the oppressed, but the political leaders that came out of the oppressed have shown much corruption. Revolutions, as exciting are they are, like any attempt to make things better, have very serious potential side effects and aftermath.
“Tough skin”. Yes, I have it, but I am continually saddened by words that hurt others unnecessarily.
Report comment
I do appreciate your courage and commitment in coming here and posting, despite some very hostile responses at times. I am sure you are on the “right intentions” side of the ledger in the psychiatric community, and I do appreciate as well your willingness to take some heat in that community by standing up for alternative viewpoints.
What I’d really like to see from some of the groups you mention is some concrete positions on important issues of the day. Maybe they have done so, but I’m not aware of it. For instance, it would be awesome to have a group of psychiatrists go public with the position that Joseph Biederman’s alternate view of “childhood bipolar disorder” was not scientifically based, and turned out to be dead wrong and has hurt lots of kids. An extra bonus kicker would be a statement of concern that Dr. Biederman’s position and advocacy for this new definition appeared to be motivated by a conflict of interest, due to his Big Pharma connections, but that would just be icing on the cake.
An article on criticism and change movements within the psychiatric community would be most welcome. I think the psychiatric community can no longer pretend to be unaware of the lack of scientific support for many of the positions the APA has taken or supported over the years, and they could be very helpful in spearheading some real change, just as a few selected heroes have done. But so far, those heroes get attacked by the psychiatric community in general, and they need some “insiders” to speak up and support them. This would be a great role for people like you to play in supporting this movement of change.
You’re right about revolutions, but corruption is everywhere. While I don’t want to trade an old corruption for a new one, I would love it if some people currently in power were willing to point out the current level of corruption in some concrete and public ways, as the example above outlines.
Report comment
It’s a war when you think about it. Even if a group of psychiatrists stood up and declared that children are not “bipolar” and that neuroleptic drugs are brain damaging chemical straight jackets this doesn’t simply mean that pro-drug child psychiatrists would be vanquished and forced to mutter shamelessly to the news media in defeat. They would have hundreds of thousands, if not millions, of misinformed public supporters to defend them. There would be parents of so called “bipolar” kids on the news, screaming violently about how their kids most definitely do have brain diseases and that this naysayer group of psychiatrists are quacks.
The pro-drug psychiatrists would stand behind their armies and the other psychiatrists know this. I am by and far not sympathetic to psychiatry but I understand why most of them are so silent. It’s career suicide. Even if the rebels did win, they’d lose their business by the fact that insurance companies wont pay them for non-medical services.
Report comment
And of course I meant shamefully. I actually told myself that I wouldn’t post this correction because it was too obvious of a mistake…
Report comment
Great post Jeffrey! Very much the heart of the matter… yet…
I think that the longer the so-called conscience of *psychiatry* remains mute the more likely their career suicide will be complete. I say this as one of the little people who pays into this system of *medical harm*. How long before the 99% just decide to opt out— maybe upon a spiritual awakening that leads us to a higher calling of care for each other and true community?
As we, the little specks of dust, come together, we form hills, then mountains. As we tiny drops of water occupy the same stream, we begin to flow toward the ocean.
Throughout the past 30 years, as I have watched this disaster evolve into a runaway train scenario, I have asked myself this one question: Why do we, the little people, resign ourselves to the role of commodities in the eyes of an authority based system that flourishes without a single shred of evidence that it runs on higher knowledge? In other words, Why do we pay for crap? Sure, 20 years ago we believed we had to pay for what we *needed* and did not have the time or ability to learn or supply for ourselves. 20 years ago, we trusted in a value system that sure looked like it was the creation of a noble calling to serve humanity. 20 years ago, we were too busy establishing our own careers and lifestyles to be vigilant over the cream of the crop. Surely, we have gained some measure of competence in the art of critical reasoning and decision making — enough to have gained something worth protecting.
The big nasty health care conglomerate is funded by us little guys. We buy it working hard and paying taxes… We pay for it coming and going. And what have we received from our multi billion dollar health care industry? Where do we stand in terms of health and longevity alongside undeveloped countries?
The systems look , actually ARE so big, because so many of us busy little bees supply the fuel for it’s growth. When we decide we deserve better and hold out for it, these big systems will … lose our support. So, I say that the silent, conscience driven, self preservationist psychiatrists are just securing themselves a place in the category of obsolete authority. They may reach Hall of Fame status in that group, but they will never be worthy of the respect, trust and financial compensation that they have no desire to lose today.
Report comment
Dr. Moffic,
What is it you would like us to learn from you?
What would you and your friends require to feel more “welcome”?
What changes would you like to see in psychiatry?
What is your understanding in regards to the reason why so many people on this site expresses rage against psychiatry?
Do you understand the difference between anger expressed directly at you, and anger expressed at what you stand for or defend?
Is it possible to express anger or disgust at what you stand for and not have you take it personally?
Do you see anything positive in the anger expressed against psychiatry? Please explain.
Do you want to ask me or anyone else who are critical of you any questions of this type? If yes, what are they?
Do you have an interest in learning from us? Please explain. Maybe even take some or all of these questions and work them in to a blog post.
Malene
Report comment
Hi Malene,
I really appreciate your comments here and throughout the website!
I am curious if you are aware of Steven Moffic’s Psychiatric Times blog. If not, I strongly recommend that you check it out. He has a relatively recent blog there called Psychism: Defining Discrimination of Psychiatry in which he addresses some of the important questions you raise here. In the past Steve has accused me of quoting him out of context so I won’t include exerpts. But given your interest in Scientology I would hope you don’t miss the paragraph where he mentions them! (sorry I don’t know how to post a link on this device).
Stuart, I am sorry to be off topic on the comment section of your piece which I found engaging and helpful. My only concern is that you’re preaching to the choir here and I wish I was reading it in the Psychiatric Times!
I know others here read both PT and MiA. PT is the most widely read psychiatric publication in the US while MiA does not (yet!) have that distinction. As a regular contributor at PT Steve Moffic has an amazing opportunity to influence his profession that most of us will never experience (many of us cannot even comment there as that privelege is restricted to healthcare professionals.) I suggest that people who are interested in Steve’s views check out how he is using that platform in addition to his contributions here.
Report comment
Sonia
Thanks for that heads up on Dr. Moffic”s articles in Psychiatric Times. I just completed the one on “Psychism” with its references to Scientology. Scientology gives our movement a bad name and I completely agree with Malene’s position that we need to draw a clear line of demarcation from that organization.
It is totally irresponsible of Dr. Moffic to discuss the antipsychiatry movement (his charcaterization) and only mention the Scientologists and then make references to “hate speech.” Who else was he referring to with this type of negative description and why leave out the most significant developing trends in our movement?
This article appeared on June 12th. He had a perfect opportunity to mention and promote the MIA website with its high level of dialogue, including insightful and scientific critiques of Biological Psychiatry combined with the stories of psychiatric survivors.
Dr. Moffic stated above: “Revolutions, as exciting as they are, like any attempt to make things better, have very serious side effects and aftermath.” So therefore are we suppose to give up our revolutionary dreams for a better system and just accept the status quo, or, perhaps, instead just plod along slowly begging for minor reforms?
There is no victory without risk. Just think if other great revolutionaries adopted his view stated above; no great social transformations would have ever taken place. His comments seem to embody the fear of the old order anticipating the loss of both power and priviledge.
The educated and well directed fury of the oppressed contains great power and beauty and we are witnessing it on MIA blog.
I am currently crafting a contribution to this blog on the relationship of addiction and its treatment to the diease model of so-called mental illness. I am not a survivor but have worked in community mental health (with a specialty in addictions) for 19 years as a counselor. I have witnessed the devastating take over of the medical model. As a former activist I became part of this movement 21 years ago when I read my first Peter Breggin book.
If I do get a posting I will be interested in all the feedback, but I will pay special attention to the critiques of the articulate survivors on this blog. I will be nervous about those responses but I know there is much to be learned, “Dare to struggle: Dare to win.”
Dr. Moffic; please open your mind and learn from this blog. You have an opportunty to play a role in dismantling the old order of modern psychiatry. We don’t know exactly the end result of this, but those most damaged by this sytem will play a crucial role in determining its replacement – listen!
Richard
Report comment
Hey Sonia,
Thanks for the nice feedback. I have not read the PT website or Dr. Moffic’s contributions on that site. I posed above questions to (probably naively) further the communication and understanding between Dr. Moffic and myself and maybe other survivors as well. Which means, if Dr. Moffic has an interest in furthering our dialogue, and understanding then I would need for him to answer those questions directly.
At the moment, based on what I have seen from Dr. Moffic so far he has zero credibility with me. I suspect he is here to defend psychiatry, the status quo and himself. I also suspect he deliberately uses shame to reach his goals, IE “you are hurting me”. If Dr. Moffic really does want to improve psychiatry then I would hope that he would be willing to engage in a genuine exchange with the purpose of learning from each other. That is why I decided to set my emotional gut reactions to the side and ask Dr. Moffic the questions above. We will see if he has an interest in answering me.
As far as inputting links – just copy and paste the url, the software on the site will make it a link.
On scientology, they are a vicious, horrific cult. At this moment I do not see psychiatry as a cult, although I am willing to be proven wrong if someone can do a detailed analysis with current knowledge of how cults work. That does not excuse or validate psychiatry, it just doesnt fit the description of a cult. I know scientology agree with some of our ideas about medications but they are very dangerous. Getting associated with scientology hurts our credibility.
Report comment
Dr. Moffic, I admire the fact that you continue to be willing to participate in the dialogue here on this site–it takes courage. I know this from personal experience, although not the same as yours—I know what it is to take a stand and be THE ONLY ONE who does so. So I know from my experience that courage is not the absence of fear; and I also know how threatening it feels when others are shall we say, are less than receptive to what one has to say. That said, I can’t help but question the veracity of your statement,”I know way over 50 who would meet much or all of your criteria.” Because it seems to me, if this is in fact the case—how could these ethical psychiatrists remain unknown and silent? I have no doubt they have an ethical duty as physicians speak up and to act in defense of psychiatric patients who were and are being victimized; children and adults who continue to experience a great deal of harm.
The fact of the matter is one of your colleagues, Ronald Pies, writes how he admires you for your efforts here but then disparages and maligns the people who voice their anger, pain, and outrage due to the harm they have experienced; in a manner he disapproves of! That he seems to believe this is realistic way to defend his profession, defend his integrity; and defend what’s left of the integrity of the psychiatric profession is ironic; to say the very least!
This entire mess exists because of the utter and complete failure of the psychiatric profession to hold individual unethical psychiatrists accountable–worse, the profession has allowed these criminals to be YOUR LEADERS electing them to positions of power in within your professional societies. It is because of unethical academics, unethical peer reviewers and editors of “professional journals” and unethical professors of psychiatry who are not censured, discredited, or let’s be honest, PROSECUTED for their criminal behavior, that the profession is in a position of needing to defend itself. So, I am less than sympathetic to any blame being assigned to any VICTIMS or their defenders–all due respect, if psychiatrists spent half the time spent pointing the finger at other medial specialties and psychiatric survivors on holding unethical psychiatrists accountable, and purging your “professional” literature of the marketing agendas that are ineptly disguised as “research;” it would go a long way towards earning the respect and trust that your colleagues seem to believe the profession still has.
So where are the voices of these more than 50 of your colleagues who leave you, their colleague, to to speak on their behalf? In my opinion, any professional who is aware of the facts, yet remains silent, is complicit in the human rights crimes that are being perpetrated by the psychiatric profession. The silence is DEAFENING.
Report comment
Dr. Moffic, I am looking for doctors patients can see who will assist in gradual tapering off psychiatric medications at the rate of least harm to the individual’s nervous system.
Gradual tapering is the safest way to go off the drugs, but you would be surprised at how few doctors know how to do this, or even grasp the basic concept of “tapering,” or who can recognize withdrawal symptoms if they appear.
Too many advise their patients to skip doses to taper, a bit of incorrect folk wisdom that’s taken deep root among these supposedly scientifically minded professionals.
(If you tell a patient to faithfully take medication every day to avoid withdrawal symptoms, why would you advise skipping doses to go off the medication?)
Anyway, I am looking for tapering-knowledgeable doctors to list here http://tinyurl.com/7cp8l8v for referrals.
Please contact me at survivingads at comcast dot net if you can recommend any among the 50+ progressive psychiatrists you know.
Report comment
This is a super awesome series of questions and I’ve been wondering much of the same things myself.
I liked when Bruce Levine said that most folks with mental health labels are antiauthoritarians. That means we don’t trust authority figures unless they have proven they are honest, listen to us, and have our best interest in mind. I know much of the questioning of mental health providers on this site is because we are testing them to see if this is true.
Maybe more mental health providers would be welcome if we had some of “Whitaker Certification” process where people would be tested against Duane’s list of criteria or some other fairly standard criteria. Then we wouldn’t have to individually test or challenge each provider that comes on this site – we could just check their “Medication Optimization Awareness” (or whatever we call it) profile information.
Also, it only takes 12 doctors to make a board, so maybe 12 docs could make a “board certification” on “Truly Informed Prescribing” or “Temporary Emotional Pain Management” (or whatever we call it). Then it would be much easier for patients and doctors to connect. My mom is a doctor and just took the board exams in family practice and all of the questions lead to a pill instead of a preventative chat. So we need better board certification processes as well and only takes 12 docs to get this ball rolling.
Report comment
I agree, Corinna, I think dissident psychiatrists should form their own professional organization with their own journal publishing “clean” research and real-world clinical advice.
Report comment
I apologize for the delay in responding as our computer needed fixing and then I was away. When someone says “it is totally irresponsible of Dr. Moffic”, then we lose the ability to dialogue. I am just giving my opinion; if I am wrong, that is not necessarily being irresponsible. To me, being irresponsible is not incorporating all the information and data one can obtain, and then proceeding as best as possible in action. It seems to me that this site, as valuable as it is for criticizing psychiatry, is missing any other consumer/public point of view. Let’s say there are 50,000 psychiatrists, as Duane says, and perhaps we average 200 patients each (I had more than 400 when in practice). So, we have maybe a million patients. Do we know and hear from those who are satisfied? Those who have mixed feelings? In stopping meds, some may need very slow titration off and some can stop easily cold turkey after chronic use, and many other in-between. To do so the best way possible, I think one needs detailed discussion with each individual. Alternative “certification” may be a great idea, but not if the criteria are too narrow. Again, just my opinion.
Maybe this needs repeating, but I write for what I think is useful for a particular audience. This is akin to how I worked with patients; I would never try to shove something down their throats (meds) that they did not want to try or when there were other alternatives. If you consider all my blogs for three different sites, here, PT, and Behavioral Healthcare, you’ll have a much better idea of how I really view things, if that matters.
Lastly, I think it is indeed of utmost importance to distance Scientology from this site. I just don’t know if that is possible, given how what is behind one’s moniker or stated beliefs can not readily be checked.
Report comment
Okay, I’m still looking for the names and contact information for those more-than-50 progressive psychiatrists who get even the simpleminded basics of tapering people off drugs: Steady, small decreases in doses, no skipping doses.
I don’t give a hang for whatever interviewing or clinical ritual precedes tapering. Someone’s desire to get off psychiatric medications is a healthy movement towards autonomous decision-making, a keystone of mental health. The doctor should support it.
My e-mail: survivingads at comcast dot net.
Report comment
Duane,
I don’t know any psychiatrists who are so “simpleminded”. No sense being a doctor or psychiatrist if we will automatically taper someone off meds whenever that is desired without discussion and providing our opinion. I guess that is one reason to get rid of psychiatrists, or at least the education of psychiatrists. This is the same reason most psychiatrists will not – and should not – put someone on the medication in the television advertisement when the patient wants what they saw on TV (now there’s another area that should be addressed – the misleading ads on TV). For some people, “autonomous decision-making” is essential for mental health; for many others (especially from certain ethnic cultures), they would prefer expert advise. When – and if – we can get some agreement on this complexity of tapering, and get more points of view, then those psychiatrists might come out of the woodwork and even participate in this site.
Report comment
Stevie, I’m not Duane. You seem to have confused my opinions with his. We commenters are individuals.
When I say “simpleminded,” I’m talking about readily understandable techniques that few doctors seem to grasp.
“Agreement on the complexity of tapering”??? What complexity? Who is supposed to be doing the agreeing? Are your friends withholding care from patients because they don’t feel sufficiently appreciated by rest of the world?
You bragged about knowing umpteen progressive psychiatrists. I asked politely for referrals to help people taper. Now it seems we have to do a little dance around Scientology! Nothing could be more irrelevant to me.
Report comment
Stevie, I believe my request (repeated often) is very clear.
Patients are being injured by doctors, including psychiatrists, who do not understand tapering.
If you know of doctors who do understand tapering, I would like to have their contact information so I can refer people to them.
Our communication seems to get snarled in strange ways. It appears to me that you take my request as an opportunity to posture about the prerogative of psychiatry and — rather passive-aggressively — suggest you’ll divulge the information if people are a whole lot nicer to you and your colleagues on this site and maybe the rest of the Internet, too.
The night, the day, the dusk, the dawn — what the heck are you talking about? I’m looking for doctors to help people.
I believe that you are a nice person, kind to your family, and want to do right. Did you really intend to respond to me like that?
Report comment
Yes, I did. Tapering or stopping such medication is just not so simple as you make it, and I would not respect any psychiatrists who thought so. Sorry I tried to respond metaphorically.
Report comment
Stevie —
That was a straightforward request in order to REFER PATIENTS TO BETTER DOCTORS than they have now, doctors who are giving them bad advice about tapering.
In response, all you’ve done is play power games. You’ll divulge the information when you get what???
As a representative of psychiatry, think about how this looks to the rest of the people reading this.
(Dr. Shipko, by the way, is expert in tapering people off psychiatric medications.)
Report comment
Dr. Moffic,
The psychiatrists you say who are reading but not participating, waiting for the climate of the website to be more favorable to their views for them to join, even though they could comment under an alias, seems strange for me. They seem like the folks who would have the different opinions, who have different points of view, who you think having on this website would be beneficial.
I don’t know what they are waiting for. If they don’t like the comments they get, if other psychiatrist bloggers on different forums are any indication, they can fee smugly satisfied in labeling their detractors “hater.” I do think that different opinions can stimulate a lot of interesting discussion, and if folks have thought about participating, they should go ahead and do it.
I think we are repeating the same dynamic of reform (to what extent and to who’s benefit) vs revolution (to what ends). Dr. Moffic seems to interject caution and fear of change, the real potential loss of benefit many people experience with psychiatry, and (more than he cares to admit) lots of apologist notions to some of the more distressing aspects of psychiatry, its power, and our relation to it. He also offers some points of I think more easily agreed upon reform (that I think could easily be psychiatrist led) like direct-to-consumer advertising issues, pharmaceutical company influence in psychiatric education/practice/research, and I think stronger research ethics.
I suppose if psychiatrists are waiting for this MiA “movement” (really, this right now is just a website bringing together a bunch of diverse interests and people with different agendas, growing, but I don’t think in itself constitutes a movement), folks here can just as easily wait for psychiatrists to engage in the reform that we all seem to be ok with happening in their own profession/industry/publications before we jump on board to support them. It can go both ways. The problem is that critics/survivors don’t have the luxury of benefiting from that system as is, are de-legitimization by it, and can’t just wait around for it to reform or not. So we are here, trying to start something new, bring ideas and voices together, and start engaging in change. It is great that Dr. Moffic can engage here, and if other psychiatrists want to put in their perspectives too, have their ideas reviewed and potentially challenged (something that we all benefit from), then come and join already! My suspicion is that there is not all that much will to make much change from the professional side.
I apologize to Dr. Shipko for contributing off-topic, as I thought his initial post was well stated and interesting, particularly in regards to the importance of reviewing raw data (should be a no-brainer.) When I worked as an evaluator, even some of the smallest funders were interested in seeing raw data so they could assess if reporting was accurate, that the FDA and many journals don’t want to check the results or conclusions of papers sent to them is tremendously irresponsible.
Report comment
I believe the blog was titled (not by Dr. Shipko) as psychiatry being a mixed blessing, not the curse you seem to feel.
Report comment
Dr. Moffic,
Where did I say Psychiatry was a curse?
Report comment
Nathan, if Stevie’s view of reality is correct, before they enact real change in their profession, progressive psychiatrists want their collective rings to be kissed universally by patients and Scientology to be silenced.
Which seems more than peculiar to me. Even, maybe, a projection.
Report comment
Alto,
Good luck with finding 50.
After seven years of online research, I would have found them…. So would many others who have been looking for good ones.
There are only a few.
VERY few.
Duane
Duane
Report comment
Dr. Moffic,
Altostrata is with the ‘Surviving Antidepressants’ website.
I have ‘Discover and Recover’, a nutrition and integrative medicine website.
We are as different as night-and-day, rarely agree on much of anything.
I’ll leave it at that.
Duane
Report comment
Sorry I mixed up you two. Wouldn’t change what I said, though. Besides night and day, there is dusk and dawn which links them. Maybe that can happen somehow with us if we look also for what connects us instead of separates us.
Report comment
Duane, now that it is crystal clear to me where we disagree, I agree that I could not find the 50 that you want for the reasons you define.
Report comment
And Dr. Moffic makes yet another 180.
How surprising.
Or, not.
Duane
Report comment
Dr. Moffic: I agree with the assumption that it is important to separate and distance the critique of biopsychiatry from Scientology. Yet it is you, in your Psychiatric Times article, who conflates the two in what is essentially an ad hominem attack on critics of biopsychiatry. And then, in your comment above, by suggesting that it might not be possible to know “what is behind one’s moniker,” you deploy a rhetorical slight-of-hand in which you imply that any critic of biopsychiatry might be a secret Scientologist. Claiming to desire dialogue while making such rhetorical maneuvers does not show good faith.
Report comment
Dr. Moffic,
Re: Safe, Slow Psychiatric Drug Tapering
You wrote:
“… some can stop easily cold turkey after chronic us…”
Peter Breggin, M.D. says that rapid withdrawal from these drugs can be *emotionally life threatening*.”
Your words are *dangerous*, and I tell every reader to *ignore* them!
Duane
Report comment
More here (scroll down) –
http://discoverandrecover.wordpress.com/warning
Duane
Report comment
Well, then, tell me how to make that distinction in a critic that does not identify themselves, or decides not to be truthful, or even might be paid to say something? I am not claiming or suggesting that would fit anybody on this site, but it could. When critics make blanket criticism of psychiatry and psychiatrists, it is hard for me to completely have “good faith”. If my wording in Psychiatric Times conflated the two unintentionally, I apologize.
Report comment
You and Ronald Pies both seem to think all of psychiatry’s critics are one big lump of Scientology.
As I’ve pointed out to Ron Pies, injured patients have very valid complaints. Here’s his very grudging concession at http://www.psychiatrictimes.com/blog/couchincrisis/content/article/10168/1968125
“….And yet, dismissing all critics of psychiatric treatment as querulous crackpots would be a serious mistake. Some of those who wrote to me were both knowledgeable about psychiatric medications, and sophisticated in their grasp of medical research. Some spoke from painful personal experience with psychiatric medications—whether antidepressants, antipsychotics, or mood stabilizers. They spoke, for example, of becoming agitated or manic while taking antidepressants, and feeling depressed or “doped up” while taking mood stabilizers. They spoke of painful “withdrawal symptoms” lasting many months, after their antidepressant was stopped. They spoke of lethargy, blunted creativity, or impaired cognition while taking antidepressants or mood stabilizers. Perhaps most disheartening, they spoke of how little they felt understood, “listened to,” or respected by their physicians.
….
We need to investigate carefully even the very rare side effects of antidepressants, so that we do not lose the confidence of the general public. We need to avoid even the appearance of conflicts of interest, related to “Big Pharma.” And perhaps most important, we need to listen attentively and respectfully when our patients tell us they are not happy with their treatment.”
Now here you are on a Web site populated by injured patients, and what you do is repeatedly say you want to hear from somebody else!
Report comment
Dr. Moffic,
The “Scientologist” card has been played for many years by your profession and it really needs to stop.
You are Jewish, with a Rabbi son.
And I have told you that I have great respect for your religion, Judaism.
How would you like being called a “Scientologist”?
I really wish religion would not come up in these debates, unless it’s done with respect for the faith of others, which is how I took the story of Joseph (old Testament, Torah). I thought the post was well-written and brought out the best in us. In fact, a momentary cease-fire…
But the battle continues.
The nature of revolutuionary change.
Duane
Report comment
Thank you for the comment about the Joseph blog. It was not meant to be a call for a cease fire, but for what we might have in common as far as a healing approach. Feeling like this is a war or battle will make me feel too much on edge and defensive.
Report comment
Re: “… will make *me* feel too much on edge and defensive.”
This discussion is not about YOU!
Don’t understand?
Go to the DSM – look up the term *Narcissistic personality disorder*.
Duane
Report comment
You could just assess people’s comments, assertions, and evidence as they are posted. You’re right, we know very little about the people behind a lot of monikers here. We can, however, assess what people post regardless of where it comes from.
As for blanket criticism, I think people are speaking more of the Power of Psychiatry (capital P) and psychiatrists, without (much) judgment of individuals in that field. Because like it or not, our sociopolitical system is structured in a way that requires Psychiatry to function in particular ways to maintain that system, often to great duping, harm, and coercion of many. This is difficult to change, particularly as individuals, in Psychiatry or not. Perhaps it is more difficult for you to see how Psychiatry functions systemically because as a psychiatrist, you have more nuanced experience than most with schools, residencies, journals, conferences, professional organizations, insurance companies, drug companies, regulators, colleagues, students, etc. The system is more personal to you, differently than the way many of us have felt hurt/duped/abused/ personally by a system (regardless of our doctors or whatever). I don’t discount your experiences/perspectives with a full professional life in psychiatry, but please recognize people have had radically different experiences than you have and those experiences are starting points for valid critique.
As for your “Psychism” article, I appreciate your attempt at an apology here. Though I don’t think apologies that follow the phrasing: “If my [words or actions] [did/seemed to] [do something that others found hurtful/offensive}, I’m sorry,” are actual apologies and more like offering of pity, it is a gesture of something. I believe for people to apologize, they need to own and recognize what they did, even if it was unintentional. An apology is a recognition that words/behavior, sometimes even despite intention, caused offense/hurt, the apologizor realizes that, expresses that, and wants to reconcile. Pies’ article that you referenced made as if anyone who ever had any criticism of psychiatry was actually saying
“I hate shrinks. Shrinks should die. Shrinks are evil” (without actually citing anyone who said that) and shame on all of us for being so crazed/uniformed/hateful. Blaming the lack of interest of med students in psychiatry on open criticism as if that was a stigma was insensitive and disingenuous. Maybe med students have seen the problems facing Psychiatry and don’t want to be a part of it. Maybe they just have other interests. Maybe they want to make more money than psychiatrists. Maybe they want to make less.
Stigma, similar to stigmata, is an embodied marker that at once separates people who experience it from those who don’t and allows folks who do not experience stigma to see themselves as normal/good, have to police/limit their own lives to avoid being stigmatized, and maintain a stigmatizing system of others in order to maintain their sense “normalness/goodness” that the separation by stigma provides. On the flip, it also leads people who experience stigma to feel less worth because of their stigmatization, often try to divert stigma to those already more stigmatized in order to “identify” with the folks do not share that stigma (to feel better about themselves at the expense of others), and internalize that because they are not “normal/good” they are really as freaky/bad/hopeless as everyone else seems to think.
Lots of folks experience all kinds of “stigma” in this regard, an embodied, never-goes-away marker of somehow deserved “less-than status.” In the US, gay folks certainly experience stigma, and we see how straight folks have to police their own behavior in order to not seem gay, and the contemporary gay rights movement led by professional non-profit orgs in DC has tried to identify with middle-class/straight norms to experience less stigma and in doing so pushes gay folks who do not aspire to those norms to experience more. People labeled with mental illnesses also experience stigma, as after their labeling they are treated with suspicion/fear/mistrust that people who even have documented histories of violence/abuse/coercion are not treated. Organizations like NAMI form that try to mitigate the stigmatization of people labeled mentally ill by “identifying” with the psychiatric establishment. This of course is failing strategy because it will never eradicate the effects of stigma of mental illness from folks labeled and throws more stigma on people who resist identifying with “establishment” as being more sick, more dangerous, more hopeless.
Perhaps there is an argument to be had that once someone is labeled a psychiatrist, they experience a kind of embodied marker of difference/denigration in comparison to perhaps other medical specialties. However, people have to compete for a med school admission, pay hundreds of thousands of dollars for tuition, go through at least 12 years of post-secondary education to become a psychiatrist. They have to really invest to get that marker, it’s not slapped on them without their consent, and in fact, they have to struggle hard to get that marker. They are basically assured a comfortable income and societal prestige. While Psychiatry as an institution may try to mitigate its sense of stigma by trying to be more scientific/doctorly aka identifying with more privileged specialties in medicine (by making all sorts of neurobiological claims of illness in the DSM-5, explaining mental health, pathology, and treatment in terms of biochemical functioning, etc.) and throwing more stigma down the ladder of respectability (claiming other mental health professionals, primary care doctors, and “mid-levels” lack the qualifications they do and are less deserving of payment/reimbursement for mental health services, by denigrating peer-led movements or folks offering suggestions to each other without medical consultation, etc.), in the scheme of things, based on its role to demarcate mental health from illness, psychiatrists as a whole have it pretty good. Lumping “stigma” psychiatrists face with those who are labeled mentally ill I believe showed remarkable insensitivity. Throwing more stigma on critics/survivors by lumping them with less respectable groups like “haters” and “scientologists” in order to further delegitamize their critiques/experiences is beyond troubling from someone who seems to always want more “equal” dialogue.
Report comment
Nathan,
Thank you for this beautifully crafted eloquent discourse on the *method* behind the madness!
Demarcation. Delineation. Divisiveness. All breed and fuel evil. Psychiatry has succeeded in dividing us at our essential level of existence as human beings, and in so doing, has given us pause to consider what is lacking in their own humanity.
Dr. Moffic’s insensitivity on this site is the flip side of the whining heard behind closed doors at every APA conference. Two sides of the same coin. A cycle of passive aggressive outbursts that evades confrontation with an ugly truth. If only psychiatrists could receive their wage in these coins. They would have to come to grips with their well earned TRUE rank and position in our society— when they set out to spend their *play money*!
Report comment
Stevie (aka Dr. Moffic),
If you are truly sorry for conflating our movement with Scientology in the Psychiaric Times then I suggest you print a retraction in that publication in order to educate your colleagues.
I believe that anyone who conflates these movements is either ignorant or irresponsible. When people point this out (thank you, Richard!) they are not the ones shutting down dialogue.
Report comment
It’s not only what is said (and corrected), but (I hate to say again) how it is said.
Report comment
Dr. Moffic,
Well, it ought to be clear by now what my attitude is to $cientology. If you want references to my work in the anti cult field – I will be more than happy to provide them.
When we talk about the survivor movement, then I do not see why we even have to speculate in whether or not people belong to $cientology, unless they publicly announce themselves as such. What does it actually matter? Using $cientology as a way to invalidate those of us who hates psychiatry is a fallacy of “guilt by association”.
I am not even 100% anti medications – I know some folks that feel they were helped by medications and I respect that. I am 110% against the prevailing attitudes within psychiatry – those are the attitudes that dehumanize those they are trying to help. Attitudes that I have seen in spades from you and Dr. Steingaard. Attitudes that allow psychiatrists to force feed people on medications unhindered. Attitudes that uses force, lies and humiliation at psychiatric units. Attitudes that pathologize and diminish those that are hurting. Attitudes that focus only on medications as a way to offer help. Attitudes that glorify medications without even a hint of critical thinking. And finally, attitudes that sometimes use chemical restraint or prescribe into insanity. Those attitudes do not use “good medicine”. They do not aid in healing, they just do damage.
Now, I reached out a hand to you above – it was meant as a genuine attempt to communicate, and maybe, possibly (I dont know) find some common ground. I notice that you didnt as of yet take the time to answer.
Which leads me to the question – are you genuinely interested in a dialogue that you can learn from as well? Or, are you more interested in defending psychiatry?
Malene
Report comment
I’m here for a dialogue where I can learn as well. If it seems like I am interested in defending psychiatry, I am not. I am not even practicing psychiatry anymore. However, I may not have the same conclusions and recommendations as others.
Report comment
Dr. Moffic,
If you are genuinely here to exchange in a dialogue why not start by answering the 9 questions I asked above. They were specifically directed at you. They might go a long way towards building some bridges – or outlining exactly where we differ and why. We clearly will not end up at the same place – but we might end up with more appreciation for each other’s point of view.
Malene
Report comment
Dr. Moffic,
Re: What is said, *how it is said
I hear fellow readers saying they are concerned about what is being *done* and *how* it is being done.
In other words, many of are trying to say that we have peronally experienced and/or witnessed grave harm by your profession. And telling us that our words hurt your feelings when we express the pain we habve experienced from such injustice takes the conversation in an undesired direction…
Away from dialogue about transformation and toward *you*
This is not about *you*.
And we are not being cruel to make certain it does not become about you.
We have work to do.
A revolution to win.
Put on your tough skin.
Duane
Report comment
Hey Duane,
You know, if you listen to the Chinese government then we are not allowed to express the opinion that the Chinese have no business in Tibet, because that opinion is deeply hurtful to all the Chinese people. Same argument of course.
Malene
Report comment
Malene,
I’m sorry I did not answer all your questions. They are good ones, but would take a long time to consider and answer properly, and right now there is not enough time for me to do so, so I just made the brief comment I did.
I’m not sure how our interaction here is at all like China and Tibet. Personally, I’ve been a strong and clear advocate for a “free” Tibet. I’ve even written a blog on China for PT, but you may not like it since I advocated for the development of some more psychiatry there. I also think there is a time and place for angry, vehement protest and criticism; when that is and how that is directed we seem to disagree about.
Report comment
I think the analogy was:
just as
the Chinese government tries to shut down critique of their occupation of Tibet for the states reason that it is offensive to many folks in China,
so to
psychiatrists try to shut down critique of their work for the states reason it is offensive to psychiatrists and people who experience benefit from their experience in psychiatry.
In both regards, while some people may feel offended by such criticism, that is not a rationale for limiting expression of such criticism. It also links the power of the Chinese government to limit critique in order to protect its own interests to the power of Psychiatry to limit critique in order to protect its own interests.
Report comment
“states” reason should be “stated” reason
Report comment
Thanks Nathan, You did a tremendous job clarifying my position.
Malene
Report comment
Malene: No problem, Malene. It made perfect sense to me when I read it. Online communication can be tough though, particularly with things like analogy, metaphor, sarcasm, and satire. I personally try to avoid them unless I put in the energy to write them out more formulaicly.
Dr. Moffic: I think some of your attempts to make broad points through metaphor get lost in translation in online forums because of the limitations of the medium. Perhaps this above misunderstanding/situation can illustrate that point in a different way.
Report comment
Stevie,
Well, I am sorry for being so obviously hmm, should I call it confused? (because I am not confused at all, this is what I expected, and I think you are clear as a whistle) It seems that your stated purpose of coming here is greatly at odds with your actions.
You state that you come here because you would like to see psychiatry grow – Yet, you have not at any time told us how you would like psychiatry to grow, or what you do in order to assist in this endeavor.
You state that you come here to learn from us, yet you do not have the time or inclination to ask us questions or try to understand our point of view.
You state that you would like us to learn from you, but you don’t want to tell us what it is you would like us to learn from you.
You state that you are not here to “defend” psychiatry – yet you claim to be personally insulted and hurt when we demand change a little too loudly. Then you go on and associate all psychiatry’s detractors with $cientology, as a way to undermine our desire for change.
You state that you genuinely want an exchange for the betterment and growth of all. Given how far apart our positions seemingly are, such an exchange would take work, effort and genuineness. Then you go on to tell us that you don’t have the time to engage in such a genuine exchange.
Now, Stevie, What do you think my word(s) to describe you would be?
Malene
Report comment
Psychiatry is the antithesis of Buddhism, I am thrilled to report! It seems that Stevie is as unenlightened as he is enterprising or at least as in the dark about people whose culture prizes the unfettered mind as he is unaware of his propensity for tooting his own horn.
When I try to ponder how much effort Dr. Moffic employs toward this end… well, I figure he must be just plum wore out!
To ANY psychiatrist who can see the big picture,( not you, Stevie…YOU can just go sit down somewhere and rest!) but for ANY licensed, practicing psychiatrist who GETS IT, and cannot roll up his/her sleeves and assist Altostrata (and many others) in the mission to help people get off of these toxic drugs, I strongly suggest you do SOMETHING about preventing the widespread drugging of ALL children!
How does one break free of the prison of the small minded ego? CARE DEEPLY AND CONSISTENTLY ABOUT SOMETHING BIGGER THAN YOUR OWN PERSONAL GAIN AND COMFORT !!!
Report comment
Thanks for the kind words, Sinead.
Did you know that some psychiatrists base their practice on Buddhism?
Report comment
You are welcome, Stevie,
I have practiced Nichiren Buddhism (Tibetan Buddhism is Zen) for the past 24 years. I have worked in the field of psychiatry for 24 years 6 months. I will usurp authority on this one and tell you straight up: Psychiatry is the antithesis of Buddhism.
Matters of urgency with regard to the health and well being of children compounded with the human wreckage that has been left in the wake of biomedical psychiatry leave little time and less tolerance for your “Psychiatry Trivia” games.
I think you have inadvertently answered Malene’s most salient questions. Even though you obviously have no idea how deeply you insult many of the regular commenters on this blog, I am not inclined to reinforce your delusions of being a pioneer for positive change within *your field*. At this stage of the *game* your ignorance is a matter of choice, guided by your deep rooted emotions/feelings for the high regard you have for yourself–no doubt.
I tell the truth, Stevie, using words that don’t fit your definition of “kind words”. You, on the other hand, use *kind* words to insult and manipulate. Therefore it not possible to determine when, or if, you are telling the truth.
Report comment
Perhaps, then, both “sides” feel insulted, though I do not feel that way with some of these interactions. Do you know a way to lesses the mutual feeling of being insulted without having to completely agree with one another?
Report comment
How about responding sincerely without playing power games?
Although Sandy Steingard takes her lumps, she seems to be able to do it.
Report comment
Stevie,
You are the only one who has ever claimed to feel hurt. I don’t feel hurt by you. I feel disgust towards you. I also find it entertaining and funny to expose you for what you are. So no, the only one who claims to feel hurt is you. You only claim to feel hurt when our criticism of everything you stand for gets a little too close to home.
As far as agreeing with each other, I have a very high threshold for disagreeing. Which is why I suggested we engage in an honest attempt to understand each others point of view. If you were genuine in your endeavors on this site then you would have engaged with me, and who knows, we might both have learned and grown. You are the one who didn’t have the guts.
Malene
Report comment
Thanks for the smile Sinead. It was well put, and you are right, the ability to care, genuinely care is what this world is about.
Malene
Report comment
Why would you assume that others who do not respond are not hurt? I believe it is impossible to have an on-line dialogue with someone who feels “disgust” toward me. So, I’ll close my responses with this passage (and, if offensive and necessary, take out the religious references):
“O God, help me avoid every abuse of speech. Let no untrue word escape my lips. I pray that I may never speak badly of others, or speak empty words of flattery. Help me stay away from profanity. Teach me, dear God, when to keep silent and when to speak; and when I speak, O God, save me from using Your wonderful gift of speech to humiliate or hurt others”.
-Reb Nachman of Bratzlav
Report comment
נ נח נחמ נחמן מאומן
Thank you, Dr. Moffic, for the reminder to speak true, to listen with care to others, to say our minds when appropriate, and to communicate with intentions beyond humiliation or hurt.
I think we have done an ok job at doing that here. Feelings are strong here, perspectives varied, but there is room for constructive, critical, heated dialogue. I will rededicate my intentions as a desire to express with others my evolving thoughts about many complex issues we have discussed here (as I don’t have much of community in my daily life to do so right now), think through what can be helpfully different with folks who have varied perspectives, and make sophisticated links between mental health liberation movements/theory with other movements/theory, and to do so with as much sincerity and humility as possible.
Report comment
Thank you for the heartwarming response, Nathan.
Report comment
Stevie,
And, I will say again. Just as I will continue to speak for a free Tibet, even if all of the Chinese people are hurt by such speech, just as much will I speak against what you stand for, even if every single psychiatrist is hurt by such speech.
I know hypocrisy when I see it. Psychiatry, psychology or religion, I have seen a lot of exactly this kind of hypocrisy and you quoting religion just makes it even more obvious.
Respect is earned.
Malene
Report comment
Malene,
Re: “Respect is earned.”
Amen.
Duane
Report comment
Amen!
Report comment
*Feeling* insulted ? Oh, i see, you are trying to make up some rules to protect *feelings*?
I was thinking more in terms of respecting factual information and the implications of that factual information as it reflects a respect for the dignity of the lives of people who have been harmed by psychiatry… or rather, anyone who has been in close proximity to psychiatry and does not have the letters, MD behind his name! …
Your *feelings* about the success of your practice based upon your satisfied customers don’t match up with the *facts* that are supplied on this site from a myriad of perspectives every single day. Your *feelings* about conducting a discussion that focuses mainly on the *feelings* of the participants, with extra emphasis on YOUR *feelings* is a major distraction from the actual topic.
I can certainly see why you would be so invested in avoiding the *feeling* of being complicit in the most egregious form of child abuse and human rights violations occurring in our great country today. I hope you can see why indulging your need to protect yourself from this horrifying realization, placating you and praising your personal track record, entails complicity with the perpetuation of a current— in real time— crime against humanity.
ANY psychiatrist who is explaining and defending himself or the profession is either uninformed or delusional. The extent to which you do not engage around factual information and avoid answering direct, truth probing questions, identifies you as belonging to the latter category.
Let’s play doctor! I’ll be the psychiatrist and you can (easily) be the patient who persists in delusional thinking that is harmful to the public. I’ve tried talk therapy, religious/spiritual therapeutic awakening therapy, but STILL you persist in your delusions of grandiosity to the severe detriment of… regular people. Do you know what happens next?
ME…the DOCTOR says;
“Stevie, your commitment hearing is set for next Tuesday.”
Report comment
Interesting, Sinead. I’ve given up making sense of Stevie’s posts.
Report comment
Sinead,
Narcissism seems be to be alive an well in psychiatry. Hell, they wrote the book on the subject!
Duane
Report comment
Stevie, One is not apt to learn anything useful if one does not have a genuine positive regard for others who have different views due to different experiences than you do. At this point, I am skeptical of your intent—I am wondering at this point if you purposely avoid direct communication and use metaphors and other sorts of avoidance and diversion tactics purposely? Say what you mean, mean what you say. As other’s have observed, using ‘nice’ polite words is NOT the same thing being ‘nice’ or ‘polite.’ Using ‘civil’ words is not the same thing as being civil. You have repeatedly stated your desire to learn and participate in a dialogue. You have also repeatedly stated you don’t care for what others share, or the manner in which they share their views–these two views are obviously contradictory.
Perhaps if you consider what you think about how wrong someone else’s opinion is, is not so important. Try to consider that perhaps, just maybe, there are opinions and experiences that are JUST AS VALID as you consider your own to be…You may discover that you have the ability to respect others in the same measure you yourself want to be respected. Who knows, you may even one day discover you have a genuine positive regard for others, even if/when you don’t agree with them. Other people’s opinions and experiences are meaningful to them; just as your own are to you. Perhaps if one can not validate the idea someone expresses, one should not necessarily simply assess it (and by extension the person) as unworthy, invalid—or just as bad, imply the person may belong to a particular group.
Report comment
I look forward to Stuart Shipko’s next blog post.
Report comment