Help End the War Against Psychotherapy

How come we are doing the same thing over and over, expecting different outcomes? Why aren’t we looking at changing the fundamental way we do business? Specifically, why do we need to take health insurance at all? Wouldn’t everyone, the client and the therapist, be better off just charging a reasonable cash/credit rate and then offer sliding fees for those who cannot afford our customary rates and cut out the middle man of health insurance?

Cindy – I would sign your petition if you didn’t use words like “mental illness.”

Kisaphia – what your proposing might work fine for people with middle-class incomes; it doesn’t work for poor people.

While meaningfulness of intended psychotropic drug effects and their harmful effects are poorly studied, poorly regulated, and highly influenced by financial interests, the meaningfulness of intended psychotherapy effects and their harmful effects are even less studied and regulated. Cost of psychotherapy can be as high as the most expensive psychotropic medications.

I would leverage similar critiques against psychotherapy research and treatments as I would against pharmacological or somatic research/treatments. I don’t like when psychotherapists use this crisis in biopsychiatry to try to reinsert psychotherapy as a primary treatment, even though harmful effects of psychotherapy are even less studied (or reported) and folks harmed by psychotherapy have less redress. As a social work school dropout, I was highly dismayed by idolizing of the biopsychosocial model as a way to frame people’s experience of distress, but in practice, I just saw how by tacking “social” to the end of model, allowed social workers to take a piece of the insurance reimbursement pie from clients who had it by submitting to the hegemony of psychiatry. Social workers diagnosed the same, relied on the same crappy studies, referred for the same medications, and spouted the same ridiculous etiologies (ex. chemical imbalances).

I agree that health care resources spent on issues that are more related to stress and lifestyle would be better spent on making life less stressful and life more meaningful. I don’t see why spending this money on psychotherapy would be more cost-effective than in policy programs that let people access high quality food, support fitness, have secure housing and child/elder care, have meaningful work with living wages and paid vacations/sick leave, and works to undue overt and covert institutional oppression. I bet this would all still be much cheaper than our current health care expenditures on managing symptoms of stress of the fragility of our existence in a highly dysfunctional society and of the added negative effects of the drugs prescribed in the first place. Psychotherapy still relies on a giant clinical infrastructure, money few people have, and lots of harmful diagnosing.

No side effects? Psychotherapy literature is full of evidence of folks who get worse in psychotherapy, and some psychotherapies themselves (like Critical Incidence Stress Debriefing, a very short-term targeted psychotherapy) are likely in general to increase and add to the very symptoms they are intended to alleviate. What about all of the folks who spend years and thousands of dollars in unfocused/eclectic insight oriented psychotherapies that don’t seem to get their lives any better. Or the folks who decompensate in such therapies and are left much worse and poorer than where they began, with fewer emotional, social, and material resources, let alone trust, to seek any kind of support in the future?

Part of the whole move to remedicalize psychiatry in the 70s and 80s was precisely because of the dogmatism, inaccessibility, and poor outcomes of the psychoanalytic hegemony of the previous decades. I know that all kinds of psychotherapies have grown and “advanced” since, but the bigger issues still stand. Before advocating for more psychotherapy, I’d rather see mental health professionals advocate for saner social and economic policy/relations, and then see how much mental health treatment is needed.

Thank you all for your comments. I will try to respond here to some of them.

I am uncomfortable myself with the term “mental illness”. What I see is people in severe emotional distress as a result of what has happened to them in their lives coupled with a lack of coping skills and/or supportive people around them who have the skills to help them. In these circumstances, a caring, compassionate, well trained professional can be of enormous help.

It is true that psychotherapy can sometimes be harmful, in the hands of the wrong person. This is sometimes called “psychonoxious therapy”. The odds of psychonoxious therapy go up when the therapist is poorly trained, unaware of their own unresolved issues or burnt out. This is where low fees make things much worse. Psychotherapists who cannot afford to pay for additional training to stay updated in the latest therapeutic methosds or to take time off from their practice to do training, who cannot afford health insurance or psychotherapy for themselves, who are seeing too many clients and taking too little time off or sick time because of economic realities so they become burnt out–all of this increases the likelihood of psychonoxious therapy for the client.

Psychotherapists must play the insurance game of giving people labels in order to access insurance reimbursement. The reality is that very few individuals, and particularly those in great distress, have the economic resources to pay the fees that are necessary to pay business expenses and insure that those who provide the services can meet their own basic survival needs, not to mention the standard of living they should have as highly educated, highly trained professionals with sometimes 30 or 40 years professional experience. In the U.S. we are spending $2.2 trillion dollars on health care per year. Only 1.6% of that is being spent on mental health, down from the double digits in the 70s.

The cost of one psychiatric medication can be less than psychotherapy, but many people are now on four or five psychiatric medications. Medication is meant to be taken for a lifetime. In contrast, even the most extended psychotherapeutic interventions are still time limited. In addition, psychiatric medications have side effects that can land someone in the hospital for medical reasons, and they do not improve physical health. In contrast, psychotherapeutic interventions are well documented to decrease medical illness and medical utilization/costs.

Cindy,

You say that psychotherapists MUST PLAY THE INSURANCE GAME OF GIVING PEOPLE LABELS FOR INSURANCE REIMBURSEMENTS and other statements that I see as rationalizations for the same evil behavior perpetrated by bogus biological psychiatry. I’ve read quite a bit on this and some exposed how psychologists and social workers especially sold their clients out when they jumped on the PSYCHIATRY/BIG PHARMA bandwagon to access insurance instead of validating, exposing and fighting the many social injuries, abuses, evils, injustices, oppression, inequality, racism, sexism and others of which the mental death profession is chief of all evil social stressors and trauma.

As long as so called therapists collude with this evil status quo while pretending to be the victims of a vile system to which they all eagerly sold out to take advantage of this despicable gravy train at the cost of countless human lives including children and toddlers no less, I believe it belongs in the dust bin along with other biopsychiatry oppressors.

Yet, the real purpose of the mental death profession is to push BIG PHARMA’s poison drugs and other lucrative tortures on patent with a bogus veneer of the most laughable junk science that exposes their huge global billions and power to corrupt most it rolls over. The fact that so called psychotherapists have colluded with that to get their due as highly educated professionals (a complete farce when you consider the BIG PHARMA curriculum) as you claim along with Dr. Thomas Szasz’ THE MYTH OF PSYCHOTHERAPY like his other exposures of fraud in the mental death profession makes them the same paid shills bullying their so called patients to get and take their “medications.”

Unless so called therapists/social workers can divest themselves of biopsychiatry, the pseudoscience DSM and BIG PHARMA, I don’t think they deserve any less contempt than others pushing bogus stigmas and poisons on the vulnerable for greed, profit, power and status at others’ horrific expense WITHOUT INFORMED CONSENT!! You of all people should know that these horrific bogus stigmas follow people for life, so any pretense that any junk science “therapy” makes up for that shows a complete lack of conscience!! The only possible solution is to have people pay out of pocket for the “privilege” of talking to a fellow human no more or less qualified or smarter than them WITHOUT BEING SUBJECTED TO BOGUS STIGMAS.

It is the type of evil rationalization that you gloss over so glibly with the pretense that OF COURSE, THERAPISTS ARE FORCED TO COLLUDE IN THIS EVIL DESTRUCTION OF FELLOW HUMANS FOR THEIR OWN CAREERS, PROFIT, STATUS, LIVELIHOOD while destroying others in the guise of mental health that helps such evil thrive as it did when psychiatry instigated Hitler and the Germans with its evil eugenics/euthanasia theories to gas to death the so called mentally ill and later Jews and others deemed unfit to live.

There is no way I would ever wish to see your toxic agenda of collusion with the psychiatry/the mental death profession/BIG PHARMA cartel in the guise of help or less dangerous psychotherapy when the opposite is true. I truly hope that you will rethink the implications of your post and its very evil agenda.

I realize this sounds harsh, but I think we need to call a spade a spade.

Hi Donna,
I spend a great deal of my time and energy with clients educating them about the dangers of psychiatric medications and helping them to safely withdraw. I think the problem with most psychotherapists as it relates to drugs is that they have been misinformed or brainwashed about the implications of taking these drugs, not that they are evil. I recently met with my psychology professor from my college years (over 40 years ago). She was a dedicated teacher (now retired)and caring activist for human rights. I gave her a copy of Anatomy of an Epidemic and told her that there was absolutely no evidence that mental illness was due to a chemical imbalance in the brain. She was so shocked that her jaw dropped. Please consider the possibility that not all of us are evil. I went into this profession because I enjoy helping people and I know that in many cases I have. In situations where I’ve failed, it has not been due to lack of caring or trying.

Donna,

I am also a fan of Dr. Peter Breggin. I have met him, spent time with him and presented at one of his conferences. Besides being a relentless critic of biopsychiatry, Dr. Breggin is also a provider of and promoter of psychotherapy as an alternative to psychiatric medication. If psychtherapists, however flawed, become extinct, there will be no alternative offered to persons in distress except meds and things will get even worse. This has already happened in many parts of the country, and it is by design by organized medicine.

Here’s a brief review of some of the psychotherapy effectiveness literature, with references:

Short term psychotherapy has been shown in numerous studies to be as effective as antidepressants without any of the risks. Long term psychotherapy has been demonstrated to be more effective than psychiatric drugs for mental disorders.

A 2005 study published in the Archives of General Psychiatry compared 16 weeks of group cognitive therapy with Paxil for the treatment of moderate to severe depression and found the two treatments to be equally effective. The researchers reported, “On the whole, these findings do not support the current American Psychiatric Association guideline…that ‘most (moderately and severely depressed) patients will require medication’. It appears that cognitive therapy can be as effective as medications, even among more severely depressed outpatients, at least when provided by experienced cognitive therapists.”

A study published in 2008 in the American Journal of Psychiatry of psychotherapy for panic disorder found that after 12 weeks of twice weekly talk therapy more than 70% of patients with panic disorder were significantly improved. Treatment focused on the symptoms as well as developing insight about the various unconscious factors that may have caused the panic disorder to develop in the first place.

A review by the Cochrane Collaboration evaluated the efficacy of short term psychodynamic psychotherapy relative to minimal treatment and non-treatment controls for adults with common mental disorders. The primary focus of psychodynamic psychotherapy is to reveal the unconscious content of a patient’s psyche in an effort to alleviate psychic tension. It also relies on the interpersonal relationship between patient and therapist. This form of therapy tends to be eclectic, taking techniques from a variety of sources, rather than relying on a single system of intervention. The studies that were reviewed evaluated short term psychodynamic psychotherapy for general, somatic, anxiety, and depressive symptom reduction, as well as social adjustment. Outcomes for most categories of disorders suggested significantly greater improvement in the treatment versus the control groups, and these results were generally maintained in medium and long term follow-up. “Modest to moderate” gains that were often sustained were achieved for a variety of patients.

A comprehensive study of the effectiveness of psychotherapy was published in Consumer Reports in 1995. The study evaluated the responses of readers to questions about their experience with psychiatric treatment. The conclusions of the study were that patients benefited very substantially from psychotherapy (most respondents got a lot better), that long term treatment did considerably better than short term treatment, and that psychotherapy alone did not differ in effectiveness from medication plus psychotherapy. No specific modality of psychotherapy did any better than any other for any disorder. In addition, psychiatrists, psychologists and social workers did not differ in their effectiveness as therapists. Patients whose length of therapy or choice of therapist was limited by insurance or managed care did worse.

A review of the 1995 Consumer Reports study was published in American Psychologist shortly after the study’s publication. The author, Martin Seligman, Ph.D., concluded that the study was very well designed. Dr. Seligman reported that he concluded after reviewing this study that the usual randomized, controlled study with detailed scripting of the therapy approach and a fixed number of sessions is not the right model for evaluating the effectiveness of psychotherapy because it differs too substantially from how psychotherapy is done in real life. Dr. Seligman pointed out that in real life, psychotherapy is not of fixed duration. It usually keeps going until the patient is markedly improved or until he or she quits. In real life, psychotherapy is self-correcting, in that if one technique is not working, another technique or even another modality is tried. Patients actively shop for treatment, entering the kind of treatment they actively sought with a therapist they screened and chose. Patients in psychotherapy in real life usually have multiple problems and psychotherapy is geared to relieving parallel and interacting difficulties, unlike in controlled studies where patients are selected to have only one diagnosis. He also reports that psychotherapy in real life is almost always concerned with improvement in the general functioning of the patient, in addition to the amelioration of the disorder which brought the patient into treatment. Because the Consumer Reports study was based on people’s real life experience with psychotherapy, Dr. Seligman concluded that its results were more valid than the usual study.

A follow-up survey by Consumer Reports in 2004 which focused on treatment of depression and anxiety confirmed the earlier results. The study concluded that talk therapy rivaled drug therapy in effectiveness. Respondents who said their therapy was “mostly talk” and lasted at least 13 sessions had better outcomes than those whose therapy was “mostly medication”. The rates of adverse drug side effects that respondents experienced were much higher than those noted on the medications’ package inserts. The report noted that drug therapy has become a more prevalent mode of treatment for emotional problems in the last decade. In 1994, only 40 percent of those who sought care for any type of mental health problem received drugs compared to 68 percent in the 2004 survey (and 80 percent of those with depression or anxiety). The number of talk therapy sessions received by people with a mental problem drastically declined over the decade since the first survey. In 1994, survey respondents averaged well over 20 visits with a mental-health professional, while in the 2004 survey the average was 10 visits. Since the survey indicated that longer term therapy is linked to more positive outcomes, the authors of the survey found that trend troubling

A meta-analysis published in 2008 in the Journal of the American Medical Association examined the effects of long term psychodynamic psychotherapy on complex mental disorders such as personality disorders, chronic mental disorders, multiple mental disorders and complex depressive and anxiety disorders. They included only studies in which psychotherapy lasted a year or more. The authors concluded that long term psychodynamic psychotherapy showed significantly higher outcomes in overall effectiveness, target problems and personality functioning than shorter forms of psychotherapy. After treatment with this type of therapy, patients with complex mental disorders on average were better off than 96% of patients in the comparison group. The improvements were “significant, large and stable” across all types of complex mental disorders.

DeRubeis R, Hollon S, Amsterdam J, Shelton R, Young P, Salomon R, O’Reardon, J, Lovett M, Gladis M, Brown L, Gallop, R. Cognitive Therapy vs Medications in the Treatment of Moderate to Severe Depression.
Arch Gen Psychiatry, April 2005, 62:409-416.
Milrod B, Leon A, Busch F, Rudden M, Schwalberg M, Clarkin J, Aronson A, Singer M, Turchin W, Klass ET, Graf E, Teres J, and Shear MK, A Randomized Controlled Clinical Trial of Psychoanalytic Psychotherapy for Panic Disorder, Am J Psychiatry, Feb 2007; 164: 265 – 272.
Abbass AA, Hancock JT, Henderson J, Kisely S, .Short-term psychodynamic psychotherapies for common mental disorders, Cochrane Database Syst Rev. 2006 Oct 18;(4):CD004687
Mental Health: Does Therapy Help? Consumer Reports, November, 1995, p. 734-739.
Seligman M, The effectiveness of psychotherapy: The Consumer Reports Study. American Psychologist, December, 1995, 50:12:965-974.
Leichsenring F, Rabung S, Effectiveness of long term psychodynamic psychotherapy: A Meta-analysis. JAMA, October 1, 2008, 300:13, p.1551-1565.

Cindy,

This long defense of using psychotherapy for “mental disorders” from the DSM is very “depressing” and proves my point since it assumes these so called bogus DSM disorders are all in the victims’ head or faulty brain. But, this article would fare well with biopsychiatry and the mental death profession in general since it does a great job blaming the victims while not acknowedging any environmental stressors that are known to cause severe emotional distress that are NORMAL REACTIONS TO ABNORMAL EVENTS with the mental death profession one of the worst human stressors ever inflicted on the human race. Dr. Fred Baughman, Neurologist, in his book ADHD FRAUD and many articles, shows that every DSM stigma is 100% fraud and that psychiatry has perpetrated the worst medical crimes against humanity ever.

I do not see where your posts do anything to alleviate these crimes.

Cindy,

I value research sophisticated research in psychotherapy. I support the evidence-supported treatment movement (despite a lot of problems reifying DSM diagnoses as part of demonstrating applied treatment effect). I do think lots of poor science is done in psychotherapy research, science similar to ones for psychotropic medications. Similarities include high publication bias, allegiance bias (clinicians who ascribe to particular theoretical orientations who do studies on their kind of psychotherapy show high effectiveness of that kind of therapy similar to the effect of drug companies who that fund research on their own products), inappropriately powered studies that lead to confusion in the meaningfulness of statistical significance of statistical equivalence (psychotherapy studies are often underpowered, drug studies are often over powered), inappropriate selection criteria,poor data cleaning/analysis (not including drop outs in in the final analyses, or doing intent-to-treat analyses), etc. I could go one. Control/comparison groups in psychotherapy research are often no treatment or an intentionally poor treatment, which doesn’t tell you much about the comparative effectiveness of a psychotherapy (beyond it being better than doing nothing), and when comparison studies to happen, they are so under powered that it’s hard to demonstrate anything but equivalence. Psychotherapy research has also not been good at assessing and mitigating potential harms that have been demonstrated to reliably occur (at frequencies higher than many of the more common side effects of drugs).

Again, I do not think psychotropic medication research has been quality science the past 30 years, but because that is so does not lead to an increase in psychotherapy services, as I believe psychotherapy research has also been poor (though in some circles getting stronger). I also think a broader issue, if we want to use the money we spent so wastefully on (mental) health care, more efficient uses in social and economic policy outside of the mental health world may actually be more beneficial for people’s mental health.

Beyond that, I would like to comment on some of your evidence for the effectiveness of psychotherapy (even beyond the fact that you list disparate studies of very different kinds of therapeutic interventions for very different issues using particular kinds of outcome measures that many would say lack clinical meaning).

In the group CBT vs Paxil for moderate to severe depressive symptoms, saying the CBT is equally effective as Paxil for depression isn’t saying much about CBT, as Paxil, of all the SSRIs, show’s the most modest drug effect (if any) on depressive symptoms. So this study echoes perhaps at best Irving Kirsch’s analysis that depression alleviating effects of Paxil are placebo, in that taking it feels like taking a positive step and associated drug effects increases hopefulness. This is proposed mechanism of CBT, increasing hopefulness through changing behavior and thought processes. If CBT is as good as taking a placebo pill though, is it worth the cost to engage in it?

Evidence of dynamic therapy for reducing panic symptoms is in the study you note is stronger. But again, this is a basic efficacy study, showing that dynamic therapy is better than doing nothing to treat panic symptoms. I bet a lot of things are better than doing nothing for addressing panic, and doing some well-powered comparative studies next would be able to help make stronger claims about the value of dynamic therapy for panic, and whether other interventions may be better first or second choice interventions.

The Cochrane study mixes outcomes of broadly defined short term dynamic therapy for many “conditions” in its analyses. That adds a lot of noise to their meta-analysis, a method that requires some thoughtfulness in study selection as it is prone washout effects when combining too many kinds of things being studied with different kinds of outcome measures. I do know that Abbas is also a huge advocate of intensive STPP and seems a biased author. Even more, again, they only found STPP better than minimal or no treatment. Again, I bet just talking to someone for many general adult conditions is better than doing nothing. This study does not tell much about the efficacy of STPP for particular concerns or whether its comparative effectiveness is meaningfully better than cheaper or less burdensome interventions.

The 20 year old Consumer Reports study main outcome measure was people’s satisfaction of their experience in psychotherapy. Satisfaction is not a meaningful outcome (I consider it an output), as satisfaction is not a value engendered by a treatment, but a reflection on the process of it.

Seligman notes the many drawbacks and methodological limitations of the study, I think the most important is that is neither an efficacy or an effectiveness study. There is no comparison of psychotherapy to anything, not even nothing. It could be that people in this study were worse off due to their treatments than doing nothing, no matter how satisfied or not they were with it, the study doesn’t help with determining this. I’ll quote Seligman in his conclusion, “The study is not without flaws, the chief one being the limited meaning of its answer to the question ‘Can psychotherapy help?'” This should not be included in the category of effectiveness literature, and full of all sorts of biases that the make answering the question of effectiveness mute (Seligman notes these too).

The Leichsenring and Rabung meta-analysis has been severely challenged I think to a point to be discredited. The methodology of their metaanalysis was poor, they do not compare treatment group to a control, but individual patient at endpoint to baseline. They include all sorts of disparate diagnoses that add so much noise to their data. For more detailed critique of this study, see here: http://www.psychotherapybrownbag.com/psychotherapy_brown_bag_a/2010/05/wading-through-a-sea-of-bad-science-a-closer-look-at-a-metaanalysis-comparing-longterm-and-shortterm.html

Cindy, my main argument this whole time is just that psychotherapy research is similarly poor to medication research, so trying to increase psychotherapies as treatment for mental health issues instead of drugs does not have strong research support. Eysenck (starting in the 1950s), Mors, Lillienfield and others have done research in the potential limited effects of potential harmful effects of psychotherapies. Additionally, iatrogenic effects of psychotherapy is not taken nearly as seriously as iatrogenic effects of medication, and folks who experience it have little redress, support, or acknowledgment that engaging in what was told to them is safe and “just talking” can actually lead to worse outcomes from when they began. Finally, non-clinical interventions (beyond drugs or therapy) should be part of the conversation on supporting people’s well-being as a potentially effective and efficent way of doing so. As you say, if 90% of visits to doctors are stress related, I bet we can work at more systemic changes in reduce that stress and increase well-being than engaging in more clinical treatment.

Nathan,

I have gone back and forth in my professional career and volunteer activities from trying to effect systemic change to trying to help individuals. I have studied the mechanisms of each. Effecting systemic change can take generations. In the meantime, helping people learn coping skills and empowering them to fight for systemic change may take only a few hours. I believe in doing both.

I’m a believer in psychotherapy because I’ve experienced its benefits in my own life and because in my work I’ve been able to help others reduce their emotional distress and improve their functioning. That’s all the proof I personally need.
All studies are somwhat flawed–some because of the complexity of what is being studied and others by design. We need to look critically at them and draw our own conclusions then make the best decisions we can from there.

I wasn’t aware there was a “war” being waged on psychotherapy.
Psychotherapy may be unaccessible for many who are poor, but I’ve not witnessed any effort to shut down the profession.

I spent some time in grad school studying various counseling theories, but remain convinced that there is no *one* method that is *magic* for the masses.

The more I study and listen to others, the more I tend to think that a *number* of approaches can be helpful, especially when used in combination… some have *nothing* to do with talk… in fact, *continuing* to talk may be the *last* thing a person needs to do.

I feel outrage toward the large number of psychotherapists, social workers, and others who have been *silent* when it comes to what has been allowed to take place – labeling people, drugging them, shocking them and locking them up – all under the guise of *treatment*.

Many of these folks work in *tandem* with shrinks – share office space, refer patients back-and-forth, rub elbows at meetings as colleagues.

A “war” on psychotherapy?
C’mon… give me a break.

No, the “war” has been on the “mentally ill”.
And there have only been a handful of professionals with the courage to utter two words about this *slaughter*.

Duane Sherry, M.S. CRC-R
http://discoverandrecover.wordpress.com/overcoming-stress-trauma-ptsd/

Donna

Your criticisms of Cindy’s use of Biological Psychiatry’s language without quotations to denote questioning or a critical analysis, has been appropriate. It is also appropriate to seriously challenge people working in the so-called mental health field about their complicity with the “Disease/psychotropic drug Model” or any elements (even shades of thinking)that reflect any attitude of superiority over the people they engage with in a so-called therapeutic relationship. Cindy did respond and amend some of her comments from the original post to address some people’s earlier critisms on these questions.

Donna, I have followed many of your writings and contributions to this blog. I have great respect for your unrelenting criticisms of Biological Psyhiatry and other comments you have made questioning practical and ideological aspects of the current forms of activism. But it is off the mark and counter productive to our movement to place all therapists and mental health workers in the same camp as Biological Psychiatry. And if you want to know what I mean when I refer to “our movement”; I mean a movement whose goal is the complete defeat of Biological Psychiatry and the complete dismantling of the mental health system as part of a revolutionary movement to transform the material conditions in this country that gave rise to this reactionary trend, and that creates on a daily basis all the forms of stress, violence, patriachry, racism, sexism,and classism that ultimately causes the symptoms that get labeled as “mental illness” or “addictions.”

I have worked in a community health clinic for 20 yrs and watched the final stages of the takeover of the medical model. I have fought this takeover for many yrs and have taken some risks in that struggle and will continue to do so with even more intensity. I read my first Peter Breggin book in 1991 (I first became a political activist in the 1960’s) and was provoked to write my disertation for my masters degree on the dangers of psychotropic drugs; I likened the prolific use of these medications to the AIDS crisis at that time. I have contributed to the MIA website in discussions for two years. I have written a three part series on “Addiction, Biological Psyhiatry, and the Disease Model.” Part 3 of my series is currently up on the blog. I encourage you to read this series in a critical manner to determine if I still harbor any of the ideology or elitist thinking represented by Biological Psychiatry. I welcome any feedback, for I have learned a great deal over the past few years while intently reading the comments and critiques of the survivor/activist movement; my views are constantly evolving.

Donna, there is a general alienation and the rumblings of dissent among those working in the mental health field. They know something is terribly wrong (with a primitive level of understanding) with this complete takeover and dictatorship by Biological Psychiatry. The suvivor/activist movement can play an important role in educating and arousing a significant section of people working in this field. I believe it is possible at this time to even unite with a small minority of psychiatrists to wreak havoc in the APA and throughout their profession to target this takeover by Biological Psyhiatry and build a movement to totally dismantle the mental health system. By the way this does not mean that I am uncritical of psyhiatry before the advent of Biological Psyhiatry, but I believe as this movement develops all forms of elitism and hierarchy of power will be challenged along the way.

To place everyone working in the mental health field in the camp of the enemy is not only wrong but will lead to the defeat of our movement and isolate those working in that way to the fringes. We must UNITE ALL WHO CAN BE UNITED around a radical agenda; this is both necessary and possible.

Therapy does help some people. It is nothing more than another form of “coaching.” Some coaches are good and successful, others not so much; some are terrible. And it is certainly appropriate to evaluate and critque how someone goes about coaching another person when they are experiencing extremes states of psychological distress, including addictions. I am not so comfortable with promoting all these studies to back that up the superiority of therapy over medications; Nathan raises some good questions. One study, however, in recent yrs concluded that it was not the form of therapy that mattered when evaluating success rates, but it was the nature of the relationship developed during the process that mattered most. I believe if the person counseled is given respect,empathy,and support from an equal plane of hierarchy, and there is an exchange of ideas and feelings where each learns from the other, then something good might happen and problems may be solved. I have always criticized the DSM labels even when people seemed to be resigned to accepting them, and I have done my best to steer people away from medications and to challenge their psyhiatrist if they had one (70 % percent of psych meds are now prescribed by regular physiscians).

We all have a lot of work to do to defeat Biological Psychiatry as part of changing the world we live in to be more humane and just. Knowing exactly who our friends and enemies are, and uniting all who can be united is a critical part of this process.

Richard

Cindy,

Thank you for your post. I was about to sign the petition but then noticed the citation of Scientology’s CCHR. Unfortunately, while I may agree with the fundamental premises of CCHR, I have to accept that the broader citizenry regards any affiliation with Scientology as a reason to dismiss the argument(s). Hence, in my writings, I’ve stayed as far from CCHR/Scientology as possible, which means never citing them as sources. Fortunately, there is such a mountain of empirical support for your arguments that CCHR-as-a-reference is unnecessary and potentially distracting. Please keep up the good work. Your voice, added to the chorus of advocates, is vital to the cause.

If all the pychiatric establishment flunkies cared about serving the people they would have long ago at least given half their salaries to help fund underfunded psychiatric survivors who are the only ones qualified to show those suffering what a path to survival looks like.I agree very much with Donna’s comments.I’ve never seen an extreme arrogance like that of the psychiatric establishment except in portrayals of nazis.

All of you who are rightfully concerned about the stigma of psychiatric labeling need to direct your considerable energy and ire towards the insurance establishment that has created the system of requiring a label in order to pay service providers for their work. If service providers could bill for an office visit without a diagnosis, the problem would be solved. Many people who consult psychotherapy professionals do so for help with very ordinary problems, such as dealing with a stressful situation at work or to learn how to help their child deal with bullying at school.

Just like people who build things, sell things, clean things, design things, count things, teach or whatever else people do for a living, those who spend time with others trying to help them solve problems need to get paid for the time they spend working so that they can feed themselves and their families and keep a roof over their heads. I spoke with a colleague, a Licensed Marriage and Family Therapist, the other day who, after 16 years working as a professional, still owes $70,000 on his student loans, more than he originally borrowed.

It is true that talking about a problem can sometimes make it worse. This is particularly true with posttraumatic stress disorder. Other times people need to talk about their problems in order to resolve them and may not have anyone in their lives who can provide the needed support. Many techniques have been developed in recent years to heal trauma without talking about it–including somatic therapies, EMDR, EFT and neurofeedback. Competent, highly trained psychotherapists have a wide range of tools to use that can address the considerable variation in the needs of people who come to them. Without adequate income, we cannot afford to do get that training, much less stay in business at all.

Here are just a few examples of why psychotherapists are needed that I personally know about:

A happy, popular, 12 year old girl who had test anxiety was put on an SSRI antidepressant. A short time later she committed suicide.

A young father of 4, whose wife described him as a man who would run into a burning building to save his children, killed two of his children after being put on an SSRI antidepressant after complaining to his PCP about work-related stress.

A young adult man who had been experiencing anxiety for a few weeks who jumped off a building to his death after being prescribed an SSRI antidepressant.

What all of these people have in common is that they were never offered counseling to help them develop coping skills. Instead they were given psychiatric drugs, with deadly consequences.

This is a tough argument. I am totally in agreement that the DSM is the source of almost all the evil we are fighting, and that when psychotherapists have to buy into DSM diagnosis to be paid, they are making a pact with the devil and end up colluding. I say this having been such a person for a while. It is also very true that many, I’d have to say a majority, of those purporting to provide psychotherapy either don’t know what they are doing (despite or perhaps as a result of whatever training they received), or have so many emotional issues that prevent their effectiveness, that they can either waste a lot of money or screw people up pretty badly. I was fortunate to have received almost no training prior to learning how to be a therapeutic agent, and so fell back on my own sensitivity and creating a safe space for good, solid communication, in addition to considering my clients to be the primary source of information on what does and does not work. And I had some quality psychotherapy before I ever started, which was probably more important than any training I could have had.

At the same time, I see people being drugged partly because doctors and even “therapists” see no other options. There HAVE to be other ways available to help people who are in distress, or the psychiatrists and the drug companies will own the field. Self-help and peer-delivered services can fill a lot of this gap. But in truth, this world we live in is exceedingly complicated and painful to experience, and I have found that nothing truly exceeds communication with a safe terminal who is willing to ask some tough questions in a caring way in its ability to help me create lasting change. That a lot of therapy fails to meet those criteria does not mean that quality therapy should be discarded as an option.

Interestingly, I recall a study that showed the process or school of thought employed by the therapist was relatively irrelevant to whether the client got better in the end. The client’s sense of “therapeutic alliance” with the therapist, such as feeling safe an unjudged, and being supported in trying out new things, and feeling validated for efforts they had historically made, were far more important than the therapists theoretical orientation.

I would much rather send someone who is in distress to talk to someone than to get drugs. Even if the talking is overly expensive and doesn’t always work, it at least has a chance of success. Whereas the drugs are clearly a dead-end street. Sometimes literally.

Again, a very hard topic. I don’t know what the answer really is. People do need support, and therapy can be very powerful, but the critiques raised are quite valid. In particular, I have to agree, the war is not on therapists, it’s on individuals who are suffering. But one tactic in that war is to make legitimate social and emotional support unavailable to those individuals, and cutting out the option of therapy seems to forward that goal effectively.

—- Steve

Donna,

I know you wouldn’t be as angry as you are if you or someone you care about hadn’t been harmed in some significant way. I work independently and I have never given anyone a diagnosis of bipolar or schizophrenia. The vast majority of the people I see have seen other providers before me and already have been given a diagnosis. I often use a less severe one myself. The federal mental health parity laws that took effect in the last few years have helped a lot in that insurance companies no longer can legally limit the length or intensity of treatment based on the diagnosis. In theory, at least, they can be no more intrusive or directive about mental health treatment than they are about medical/surgical treatment.

Cindy, You are right that I had loved ones at huge risk from biopsychiatry I was able to save/extricate thanks to Dr. Peter Breggin at great personal cost as I said before. I have come in contact with some very evil, abusive, dishonest psychiatrists and their cohorts in crime in my rescue efforts from whom I got the “mental death profession” label.

I know some survivors here have a high opinion of you, But with all due respect, some of the things you wrote did come off as some of the worst of biopsychiatry that I would suggest you reconsider for this audience. For example, you give a typical sales pitch for the huge number of people with “mental illness” that is so costly to society, which comes off like a typical BIG PHARMA disease mongering ad campaign when people like me know those statistics are grossly inflated given the many bogus stigmas in the hundreds in the current junk science DSM if one even believes in the concept of “mental illness,” which I don’t because it was derived from twisted semantics and very faulty thinking and metaphors per Dr. Thomas Szasz. I do believe people suffer from severe emotional distress due to severe life stressors, abuse, trauma, loss, crises, oppression, injustice, etc. Given the support you seem to have from Richard Lewis and Corrine, I am saying this to be helpful.

I have no problem with your getting paid, but rather, using life destroying DSM stigmas to get paid. Do you work in a Community Health Center or your own practice? Do you have the freedom to adopt a system whereby you could allow people to pay themselves to avoid DSM stigmas as one psychologist posting here does? As I said above, you have to follow your own conscience and if you feel you can prevent harm to people with your therapy and approach to treatment then, that’s what you should do. Obviously, psychiatric stigmas on one’s health record are very harmful for life, so any way you can eliminate or minimize this harm is obviously in everyone’s best interest and avoiding bipolar and schizophrenia stigmas is an excellent start. I believe that people should be informed about the consequences of DSM stigmas on their health record.

Anyway, I regret that I may have overeacted. I am afraid that your post pushed a lot of hot button issues for survivors or protestors of biopsychiatry like me. I hope that you will take our comments in good faith and understand that many of us are very passionate about these issues because of all the harm that has been done in the guise of mental health.

Thank you for your comments and response to our concerns.

During World War 11 when Hitler invaded Denmark and demanded the Jews of Denmark (for extermination) and that all the Jewish People must wear yellow stars on their clothes the King of Denmark refused and appeared himself wearing a yellow star on his clothes. That kind of integrity and courage is lacking among the psychiatric establishment busy playing both sides against the middle while they know full well the shit has hit the fan for so many millions of men,woman,children ,and babies in this thinly disguised high tech eugenic operation which they call medicine, psychiatry,dentistry,healthcare,etc.As a Kapo who do you think you are helping? Or are you just trying to save yourself for a little while longer or are you trying to pay off your house? Us survivors ,we see through you and through your subterfuge.We must birth a renewed real friendship with the oppressed.

Morias,

Thanks for your usual support and kind words. I tend to be vague about my personal experience because it involves people I love very dearly who are very close to me. I feel I have no right to betray their trust and certainly would not want to endanger them again after what we went through to escape the mental death trap.

However, I have done tons of research about biopsychiatry fraud that applies to both my personal experience and everyone’s experience that has made me sadder and wiser that I try to share from a general perspective. What is most appalling and horrific is our govnernment and its corrupt hacks aiding and abetting this BIG PHARMA and other predation on all of us for their own self serving greed, power and profit. It’s pretty obvious that it takes tons of money to get elected, stay in power and get rich at the same time. Further, many in Congress who sold us out to BIG PHARMA went on to get lucrative lobbying jobs for their “efforts.” This is not some big conspiracy theory, but rather, you can find a mainstream media video on PHARMALOT with a newscast about this appalling betrayal of the American public and our children especially.

I’d like to hear more about your experience or opinions if wish to share them.

Donna

I really appreciate your willingness to reexamine some of your comments and be open to feedback given the volatile and highly charged nature of this topic. This is especially true given some of your own traumatic family experiences perpetrated by Biological Psychiatry. BTW I always capitalize Biological Psychiatry as I would any significant reactionary or oppressive historical entity.

Don’t think for minute that people on this website who are working inside the mental health system aren’t deeply affected by all the provocative comments such as yours and people like Anonymous (who unfortunately has been absent for a while). They make me reevaluate my choices at work on a daily basis and provoke me to do everything possible to expose Biological Psychiatry and work towards dismantling this oppressive system.

While I have not directly experienced the oppression of this system on myself or my family, I have seen some of my clients die and others have their brains fried by the chemical cocktails of psychotropic drugs. It is difficult enough to listen to all the multiple stories of horrific traumas that seem to pour out of every fiber of this profit mad system, but to see human resilience crushed before your very eyes under the facade of it being so-called “medical treatment”,this can be almost too much to bear when your intentions were to provide empathic help to people in desperate need.

The more people working inside the system can learn from and unite with and be a part of the survivor/activist movement on the outside, the sooner we will be able to create an unstopable force for radical change. Let’s keep very SHARP YET PRINCIPLED struggle going strong to create this unity of purpose.

Comradely, Richard

I have been working for several years on a book called Health Care Hijacked: How We’re Being Cheated Out of Safe, Effective, Affordable Health Care and What We Can Do About It. It is about the war against all natural forms of healing by powerful interests who profit greatly from pharmaceuticals and other dangerous forms of medicine.

What has happened in psychiatry has also happened, often to a more extreme degree, in all aspects of medicine. For instance, pharmaceutical companies falisified the data about the addictive potential of narcotic painkillers like Oxycodone and Hydrocodone, claiming that addiction to these drugs by people in chronic pain was an extremely rare event. In fact, the rate of addiction is 50% and millions of lives have been ruined. Meanwhile, chiropractors, who have been historically thrown in prison for “practicing medicine without a license” more recently have been facing the same economic issues that psychotherapists face–no increases in fees for over 30 years. The number of chiropractors leaving the profession has greatly accelerated in recent years.

The worst abuses have been in the field of cancer care. Patients are put through tortorous treatments while being told we are winning the war against cancer. The truth is that the five year survival rate for people with cancer who get chemotherapy is only about 2%. Many are killed by chemotherapy. At the same time, many of those who have dared to treat cancer with therapeutic nutrition and herbs, which are far more effective and less toxic, have lost their medical licenses, been prosecuted and thrown into prison and even killed. Even Nobel Prize winner Linus Pauling, who was the only person in history to win two unshared Nobel Prizes, for chemistry and peace, was labeled a “quack” by mainstream medicine and denied research funding for his work with Vitamin C and cancer. Meanwhile, over 560,000 Americans a year continue to suffer and die from cancer.

My hope is that when more people are educated about these issues, more people will say no to this fraud and choose safer, more effective treatments.

Wow. I come to this site because the articles are interesting, but sadly, my memory is severely interrupted and I can’t really comment with any good sense. I do not know if I am going to recover, so by the time I read the comments, I can’t even remember what the article read. (I suppose, my comment could be at the end of any article on this site). I can’t seem to get it right.

My life is incredibly altered by medicine and particularly psychiatry.

Reading the posts only gives me more anxiety because I’m too sick to do a thing about the harm done to my family by psychiatry and cannot afford the care I believe would help us; acupuncture (regularly), massage, supplements, an organic whole food diet, true counseling which I’m beginning to think that almost anyone could offer; a neighbor, sister, cousin, or friend. My dog could do a better job than most folks who are educated in social work, psychotherapy and god only knows the psychiatrists. We need people with a caring heart.

We need what we cannot access.

I am poor. I am disabled. My son is disabled and now, after only a few months of Latuda, he has serious Akasthisia. He has been dismissed by the doctors (ha! psychiatric Nurse Practitioners) who gave him the Latuda. The last time we saw the NP she said, “I don’t see any signs of Akasthisia in him right now.”

I knew then, when she said that, that I could never face her again. I cannot stand the lies and coercion anymore.

sigh…

They dismissed him saying he would be better served at the clinic who specializes in ‘severe and persistent mental illnesses.’ The clinic doctor wanted to not only double the dose of Latuda, but triple it. If Akasthisia is permanent, then my son probably does not have a future to look forward to. I am so incredibly sorry for him and to him. I am so sorry that I ever once stood by and allowed psychiatry to screw his body up so badly!

Poor people can’t afford any form of treatment that will get us better. Dr. Peter Breggin, at least as far as I know, does not see poor people nor offer a sliding scale fee. I called his office once, when I was less disabled and would have driven across the country to see him. I would move anywhere if I could; if there were people who could help my son and I, but we do not have the money they expect or charge.

Psychotherapy might as well be the moon! We can’t access it anymore. Psychiatry intervenes and says oh wait, we must see you first, before you see a free resident at the supposedly free hospital. They want to get their reimbursements, which is quite a fat check!

Psychotherapists do not want a Medicare/Medicaid patient.

My son is now seriously physically disabled from Akasthisia, but of course, the NP who gave him the drug and treated him for two days with clonozepam, gave up on him and never saw him again after having seen him for several years.

I feel like it is my fault because I got sick with pneumonia, then given an antibiotic, a medicine of which has made me even more ill, which I didn’t think was possible and I don’t know if I’ll ever recover.

I’m not in any shape to fight anymore.

I would like a therapist, but not one who believes there is any antipsychotic drug that will help my son. Psychiatrists do not care what their drugs do or how much harm they cause. There are a few psychotherapists who understand the dangers of psychiatry, but I haven’t met many. Only one to be specific and I can’t even remember her name!

What are poor disabled people supposed to do? Just sit, or jump around because they can’t sit for even one minute without torture, suffering to no end and wait to die?

PS I would like to add that the most recent psychiatrist my son saw claimed to be a holistic one. I was very excited and hopeful. That didn’t last long. The supposedly holistic psychiatrist also wanted to continue Latuda, and eventually, triple the dose. Why on earth? His conclusion was to give one of the older drugs, with the most side-effects of all because of the communication issues my son is having. My son communicates fine when people take time to listen.

I told him that I was upset. I told him that there are many people who believe psychiatry does a lot of harm.

“Yes,” he responded. “Those people are terribly misinformed.”

I learned that if I had cash, then there was holistic care available at his office.

I cried. I left crying. I left completely hopeless and have been ever since, which was a month or so ago.

Am I wrong, I wonder? The psychiatrists say I can’t give up (on them!). They make me feel like I am doing wrong by my son by believing in radical non-believers like the folks who write on this blog.

The truth is that I agree with the writers on this site, but I am so afraid. I am so afraid because I do not know where to turn anymore.

Hi Michelle,

I am so sorry about your troubles. Regarding your health situation, antibiotics can be just as disabling and deadly as psychiatric drugs, particularly a class of drugs known as quinalones. Just like with psychiatric drugs, patients are not warned of the possible side effects and when patients do develop side effects their doctors deny the connection.

As far as your son, akithesia is not permanent if the person gets off the drugs. Your son needs to safely wean himself off of his drugs. There are instructions in Dr. Breggin’s books and in many places online on how to do this. It is tardive dyskinesia, a movement disorder, that is permanent if the person stays on drugs for too long. Akithesia is dangerous because the person feels so horrible that sometimes they commit suicide to stop the torture. You and your son do not need a doctor’s permission or blessing to wean off the drugs, though it would be safer to do it under a sympathetic doctor’s supervision.

As far as access to pschotherapy for poor people is concerned, there is a tradition, at least among clinical social workers and possibly other mental health professionals to offer some free and reduced fee care. However, as fees have gotten lower and lower and business expenses have gotten higher and higher and providers have to see more and more paying clients just to keep their heads financially above water, they are less and less able to offer reduced fee or free care. In addition, funding for free public care, such as county mental health facilities, has been drastically cut in recent years as financially distressed governments cut back on everything. This leaves poor people with no place to turn.

Theoretically, Obamacare will increase access to all medical services for everyone, however, as the saying goes, “the devil is in the details”. Will drug alternatives such as psychotherapy, peer to peer support programs, Soteria-like inpatient treatment facilities and other safer, more effective programs be adequately funded? It is up to all of us to do whatever we can to make that happen.

My own efforts include the petition referenced in my article. While I agree with some of the comments on my article that psychotherapy can be harmful in the hands of incompetent or uncaring providers, many competent, caring providers who do provide genuine help to others are struggling to survive themselves so that they can continue to provide help to others. So signing my petition is one small step you can take to make a difference. Please provide a comment on the petition, as all comments will be presented to policymakers.

Psychotherapy has done more harm to me, than medications, which I had horrible side effects from, some of which I have not recovered from, even after having been off them for over a year. Most of the time drugs numbed me to oblivion. The lasting horrors of psychotherapy will live with me for life.

I have been with some of the top therapists of ALL types of therapy, you name it I experienced it, and NONE of them helped me and all of them harmed me. The latest catch cry of CBT solving everything is as useless as the drugs. When I was told I could get over being raised in a pedophile ring, by simply thinking as the therapist told me, I really knew it was not going to work. But hey it was my thoughts that were causing the problem, and what caused those thoughts is totally irrelevant. I just need to think what the therapist tells me to think, because there thoughts are right!!! Then you get the psychoanlyists who insist on you lying on a couch and telling all your problems, which they interpret as resistence. Be on a bus that has an accident and end up in hosptial, it is your resisting therapy, you unconciously arranged the bus crash as you wanted to avoid therapy and getting better!!! But of course when I don’t get better from these therapies, it is all me and not the therapies, or the therapists providing the therapy.

Many countries do not have these restrictions from therapy, yet there is no evidence that people are getting better in our countries!!!

If therapists only gave therapy to other members of the “professional” psychiatric establishment and if in turn psychiatrists limited their neuroleptic prescriptions to therapists and other members of the psychiatric establishment only adding pharmacuetical company heads and employees and of course the Rockefeller family for therapy and prescriptions then maybe that black hole would slowly drift into another part of outer space and leave the rest of us most thankfully to manage without their “professional” services.

Michelle and all,

If you want poor people to have access to options other than medication, then please sign my petition. That is in essence what it is about–that insurance, whether it is private, Medicaid or Medicare, pay adequately for other services so that providers can afford to stay in business and provide services to anyone who needs them at low or no cost. All consumers can have equal access to almost any provider if the insurance problems are corrected. If the supply of providers was plentiful, people would flock to the good ones and the bad ones would go out of business eventually.

If someone wanted to see a Tradittional Naturapath, or a Homeopathic Physician or a YuenMethod Energy Healer or have their denistry correctly done by a Hal Huggins trained dentist,or to be counciled by a Peer Survivor, or all of the above,…. WHERE IS THE INSURANCE TO COVER THESE MODALITIES WHICH ACTUALLY WORK?

Cindy, the fact that you said “psychotherapy has no negative side effects” reveals ignorance of the realities of iatrogenesis and the history of psychotherapy. Lives have been ruined and people have even been killed from therapies such as attachment therapy, repressed memory therapy, gay conversion therapy, etc. When a therapy is not grounded in robust replicable scientific evidence, the outcome is a crap-shoot; you’re recklessly experimenting with human lives with potentially profound and devastating consequences. There are some readings listed here that might help for starters: http://www.trytherapyfree.wordpress.com/links.

You are right, of course. Human interaction is a powerful thing, for better or for worse. I was thinking of the kind of side effects that are caused by introducing a foreign substance into the brain that alters the way the brain functions, with potentially catastrophic consequences such as suicide, homicide, making a transient situation chronic or birth defects. There is no doubt there is such a thing as psychonoxious therapy that makes the person worse. There is also therapy offered by competent, compassionate, accepting, respectful therapists who help people struggling to cope with life’s challenges or who are overwhelmed by the aftermath of trauma to find peace and healing. Research shows that the latter type of therapy, regardless of the techniques used by the therapist, results in significantly better outcomes than medication. The point of my activism with the petition is that if present trends continue, even the best psychotherapy will disappear as an option and the only “treatment” available for those who are emotionally struggling will be psychiatric drugs.

-Cindy

Asymmetrical paid relationships and drugs are not the only alternatives. For alternative recommendations, please see http://trytherapyfree.wordpress.com/ (“Recommendations” section) and http://trytherapyfree.wordpress.com/about

Also, please note that there are no reliably effective psychotherapy treatments for trauma, and those that are tried out on people often make them worse off than no “treatment”: http://www.ncbi.nlm.nih.gov/m/pubmed/19588408/

Further, the psychotherapy industry has done an egregiously poor job of tracking and taking responsibility for the harm it causes: http://www.ncbi.nlm.nih.gov/pubmed/24607768 and http://www.comppsychjournal.com/article/S0010-440X%2814%2900006-6/abstract

There is no justification for therapists, no matter how good their intentions are, to go on engaging in dehumanizing relationships and playing dice with human lives.