Okay, so, I couldn’t completely dispense with the plays on the name ‘Pies,’ but please be clear, I am using ‘slice’ in the sense of a ‘slice of life,’ – or, in this case, a ‘slice’ of conversation – and in no other way.
For those of you who haven’t read it, I published a blog post called, ‘Too Much Pies,’ on Mad in America on Wednesday, April 10th. The post included an invitation to psychiatrist Ronald Pies (who caught the interest of many when he wrote a letter to the New York Times about psychiatric diagnosis) to a real dialogue, not limited by number of words, frequency of reply or professional licensure.
I copied the letter directly to Mr. Pies, not knowing if he would reply. On Thursday, April 11th I received a direct reply that Mr. Pies has authorized me to repost here. I am also including my response to him, sent Friday, April 12th.
Depending on whether or not there are multiple replies that I am given permission to share, I will be doing my best to figure out a way to share them on Mad in America that is as accessible as possible, so be sure to check back if this dialogue is of interest to you!
Received from Ronald Pies on Thursday, April 11th at 10:13 PM:
Dear Ms. Davidow:
I’m sorry that you felt that my response to your letter in the Times “…summarily disregarded so many years of pain and loss and abuse of power”, which evidently has been your experience with psychiatric care. Like you and the other correspondents, I was severely limited by the structure of the Sunday Dialogue, including the very strict word limits. More than that, I’m sorry that your experience with psychiatric care has been so painful. Having practiced in Massachusetts for more than 25 years, I have seen both the best and the worst of care–with most falling somewhere in the “average” range.
My letter to the Times was aimed at asserting the medical and ethical legitimacy of the diagnostic process in psychiatry. It was neither a defense of the DSM categories, nor a rationalization for deficiencies in the legal system, nor an apologia for over-zealous and inappropriate use of medication.
I am aware that the theoretical legal safeguards for those diagnosed with mental illness are not always put into practice, and that some individuals facing civil commitment are not adequately represented by legal counsel–despite requirements for due process of law. But in my view, these are not failings that can be laid at the feet of psychiatrists or psychiatry. They are part of a broken-down “non-system” of mental health care in the U.S., which has also transformed the U.S. prison system into the nation’s largest de facto psychiatric “care” facility–as detailed in the 4/11 New York Times re: California. I was frankly surprised that this injustice was not addressed in your own letter to the Times.
I’m sure you are aware that it is not just psychiatrists who have been “tapped” by the states to be involved in emergency hospitalization of individuals deemedan immediate danger to self or others, by virtue of mental illness. A physician in any medical specialty is able to enact an emergency (involuntary) hospitalization–lasting usually no longer than 48 to 72 hours – when the doctor believes that the patient represents an immediate danger to himself or others. It is only after this initial emergency detention that formal civil commitment is usually considered, and that is the decision of a judge--not a psychiatrist or other physician. In those proceedings, the patient must be represented by counsel, and there must be clear and convincing evidence presented, establishing the “dangerousness” to self or others. Judges do not move to commit a patient simply because a psychiatrist “says so”.
I do not defend this system as ideal or always in the best interests of the patient – nor was it a system created by psychiatrists or other physicians. But the system will not be changed by launching vituperative character attacks against psychiatrists or psychiatry; it will change only when our legislators find the will and wisdom to ensure adequate mental health care for all who need it; and adequate legal protection for those with mental illness who face judicial hearings and decisions.
None of these issues was the focus of my Times Dialogue, which simply asserted that a psychiatric diagnosis is not, in itself, “stigmatizing” or dehumanizing; and that, when carefully and respectfully carried out, diagnosis may lead to appropriate treatment and relief of the very substantial suffering often accompanying serious mental illness. Indeed, over more than 25 years of practice, I witnessed many more patients benefit from psychiatric treatment than were harmed by it–including many who were chronically suicidal, psychotic, or incapacitated by severe depression, until they received appropriate treatment.
I have read your recent blog and–despite its rather insulting language – I do appreciate the benign intent behind your invitation to continue a dialogue on the Mad in America (MIA) website. Alas, I do not have confidence that further exchanges on the MIA website are likely to be fruitful or respectful. My experience with the MIA website – and based on the experience of one of my colleagues, who used to post on MIA – has not been positive. I believe that the profusion of anonymous and insulting comments – poorly-moderated by the website administrators – makes for a very unhelpful and demeaning forum. Having read some of the hateful comments and personal attacks that followed your blog, I think my judgment has been amply confirmed.
I do understand that many on the MIA website have had very bad experiences with psychiatry, but that is no excuse for the abusive (and usually anonymous) comments that are often posted in the MIA forums. This is unfortunate, since I would like to foster a collegial and respectful dialogue between mental health professionals and patients (or “consumers”, clients, etc.) But that would require a modicum of mutual tolerance and good will, which I do not find in abundance on the MIA website.
I hope you will understand my decision, and while I do not intend to post replies on the MIA website, you do have my permission to post this letter in its entirety(not edited or excerpted) on the MIA website, if you care to do so.
I wish you well in your efforts at helping those you serve, in their recovery process.
Respectfully,
Ronald Pies MD
My reply to Ronald Pies sent Friday, April 12th at 2:57 pm
Dear Mr. Pies,
Thank you for your reply. I will post it on Mad in America in its entirety, per your permission.
First, I guess I would like to clarify this point: I absolutely do not lay the failings of an entire system solely at the feet of psychiatrists. In some ways, I think psychiatrists actually have a somewhat limited role in the problems of the bigger picture. Terms like ‘anti-psychiatry’ and the ‘psychiatric system’ get broadly applied these days, but very often they have more to do with a psychiatric model that hovers above the actual psychiatrists themselves.
In actuality, the abuses I have observed have involved many more nurses, social workers, psychologists, police, lawyers, judges and paraprofessionals than medical doctors of any kind. And yet, it cannot be ignored that psychiatrists, even in their lesser numbers, take up the most ‘space’ with their ‘power.’ This is true whether or not they want it, though some have also seen fit to attempt to use some of that power for a different purpose (e.g, Dan Fisher, Mark Foster, etc.).
Said power is held by psychiatrists exclusively; their ability to approve sections and testify as the oft-unquestionable ‘expert’ and, most of all, their ability to influence opinions and both literally and figuratively silence the voice of those most commonly oppressed in the process. That you have chosen to post responses to a public dialogue in a forum where anyone can ‘watch’ but only ‘qualified healthcare professionals’ are able to respond is a perfect example of how that power can be used in a way that perhaps seems benign to you, but replicates the sense of powerlessness so very many have experienced in their lifetimes.
You point out that it is the decision of a judge – not a doctor – whether or not someone is committed. Indeed, it is, but the decisions are often made – as one commenter on Mad in America pointed out – by judges seated in rooms within the very hospitals where people are to be committed. Hardly neutral territory, wouldn’t you say? Moreover, the testimony of the psychiatrist, with whom the judge is already often quite familiar, is given inequitably heavy weighting. Both social capital (which cannot be underestimated) and credentials play a critical role here.
In 2010, I sat in on a commitment hearing as an advocate for a woman who was trying to fight against hospitalization. When testifying, flat affect was common, and questions were typically answered in monotone and with pronounced delays. But, wait! To be clear, I am referring to the psychiatrist, and not the psychiatrically labeled Defendant! It was further notable that the psychiatrist repeatedly made arguments for commitment like, “She almost hit someone.” When questioned by the Defendant’s lawyer as to what that meant, he would explain that, “She yelled really loudly at a nurse.” And, when the Defendant’s lawyer countered with, “So, she did NOT hit anyone or threaten to hit anyone,” he would just circle back around to, “She almost hit someone.” This – along with the Defendant’s refusal to acknowledge that she was ‘mentally ill’ (and in spite of her acknowledgment that she was a trauma survivor who did really struggle with life at times) – was a large part of what led to her commitment.
Sure, it was ultimately the Judge’s decision to commit her, but a ridiculous amount of credence was given to a psychiatrist who seemed barely able to form his own sentences. This may be just one story, but it is one of many and does quite well to exemplify the power afforded to psychiatrists by judges, lawyers, police and so many others who have been conditioned not to question that sort of authority and/or to believe wholeheartedly in the expertise of doctors.
To your credit, you do acknowledge that there are indeed misuses of power and problems within this system. You go on to say, “I have seen both the best and the worst of care–with most falling somewhere in the ‘average’ range.” I would certainly agree that there is a range of experiences in the system, and most do inevitably fall in the middle, if for no other reason then because of the bell curve nature of all things. However, I would argue that ‘average’ typically involves at least some level of disempowerment of the person supposedly being helped. I don’t have 25-years to claim, but I do have about 15 years worth of exposure (not including my own personal experiences) to witnessing and/or hearing the stories of people who have been treated inside the psychiatric system and it seems to me that the bar has been set quite low.
Your points here are valid:
“But the system will not be changed by launching vituperative character attacks against psychiatrists or psychiatry; it will change only when our legislators find the will and wisdom to ensure adequate mental health care for all who need it; and adequate legal protection for those with mental illness who face judicial hearings and decisions.”
While you clearly found some of my words insulting and I was admittedly sarcastic in places, my style does not generally include personal attacks. I can’t speak for others. Overall, I would agree that it is broader systemic change that is needed, and that all of us – psychiatrists included – are often trapped in a system that has limited options and tolerances for doing things differently. However, I find it naïve to lay the responsibility for change on the backs of legislators who are tasked with making decisions about any number of topics on which they are very ill informed. In the limited time they have to become even a little bit informed and make a decision about a myriad of issues, who do you suppose they will most tend to ‘hear’? Yes, this does indeed circle back around to psychiatrists such as yourself and other professionals regarded as having ‘the answers.’ In all but perhaps the Mad in America circle, you are much more likely than I to be ‘heard’ by professionals and legislators. More importantly you also have much more access than I to shape the minds of students who will someday enter this same profession. I hope you will not only carefully contemplate why that is true, but also consider your power carefully.
But to the main point: You say, “None of these issues was the focus of my Times Dialogue, which simply asserted that a psychiatric diagnosis is not, in itself, “stigmatizing” or dehumanizing; and that, when carefully and respectfully carried out, diagnosis may lead to appropriate treatment and relief of the very substantial suffering often accompanying serious mental illness.’
Fair enough. Perhaps in a utopia, the discrimination, oppression and power abuses I’ve written about would not naturally follow a process that starts at the point of labeling someone with a diagnosis that is popularly thought to be a life-changing and permanent condition. Perhaps it would simply serve to help organize our thoughts around a common understanding of what may be happening and how to move forward. However, this is not a utopia and we can not treat it as one. As such, this assertion seems relatively meaningless.
Moreover, while I do believe that there are many people who have experienced relief through some aspect of diagnosis and treatment within a traditional model, I would argue that the relief seems primarily founded in finding someone who is providing some hope about next steps, some access to resources and some reassurance that their experience makes sense within some framework and that they are not alone. While diagnosis can provide a dose of all that, it is not the only thing that can and it continues to strike me as absurd to suggest that psychiatric diagnosis is not fundamentally problematic.
Consider the following:
Inequity of Power – The reality is that psychiatric diagnosis is just one version of what might be ‘wrong’ with someone. While you might believe in it, the scientific proof put forward so far has been dubious at best and often debunked entirely. I personally buy most strongly into a trauma framework for many people’s distress (including my own), but I take an agnostic approach to the rest and would never attempt to blindly apply a trauma framework to everybody. It is not within my power to truly know, nor is it within yours. We’re in the same boat here, in spite of all my years of first-hand experience and exposure to hundreds of reports from others and in spite of all your years of training and practice; Here we are, together.
That so many people accumulate different diagnoses simply by going to different doctors certainly seems to be supporting evidence of the fact that no one really knows. (It seems to me it would be far less likely that someone would receive varying diagnoses on their comparatively straight forward headache experience by visiting multiple physicians.) To speak about psychiatric diagnosis as if you do know – as if you have an answer – as if there is only one framework within which we must exist – has the impact of giving you all the power. What do you suppose the harm would be in equalizing some of that power by acknowledging that you don’t really know? Or do you really feel that you do?
Lack of Transparency & Lack of Choice: By speaking of diagnosis as if it were harmless and absolute truth, one fails to be transparent by sharing the wealth of information (including scientific research) that supports many other perspectives. By failing to share information, one fails to give one the tools they need to make an informed choice. I will never forget a woman in her 50’s who – at a trauma training – burst out with, “You mean maybe this didn’t need to be my life?” She had been diagnosed, medicated and hospitalized for many years and had never heard there were any other options for what her story could be. To hear that there were other choices that she perhaps could have entertained catapulted her into a grieving process that was profound. One has to wonder how many others have had this experience.
Dehumanizing: I’m not personally interested in the word or concept of ‘stigma,’ (see my post, ‘Anti-Anti-Stigma,’ if you’re so inclined!), so you’ll have to find someone else to argue with about that one. However, I am interested in the concept of dehumanization. When someone is diagnosed with migraines, they don’t become ‘a migraine.’ No one goes around saying, “Hi, my name is X and I’m a migrainiac.’ Whereas, it is QUITE common for doctors to refer to people with a psychiatric diagnosis as if they ARE that diagnosis. (He is a schizophrenic. She is bipolar.) In turn, it’s also quite common for people who have been diagnosed to refer to themselves in that way. So, there is a dehumanization of people that happens. But, perhaps more importantly, what leads to the dehumanization of the whole person is the dehumanization of human experience. Hearing voices doesn’t have to represent pathology. It is within the spectrum of human experience, and is often quite connected to what has happened to someone in their lives. The same could be said of so many other ‘symptoms’ that lead to diagnosis. Are you not able to see how it might be invalidating to someone to have a reaction to a real trauma in their life treated as if it were not on the spectrum of ‘normal’?
How do we define ‘benefit’: Toward the end of your response, you said, “over more than 25 years of practice, I witnessed many more patients benefit from psychiatric treatment than were harmed by it.” It’s hard to know how to proceed with this without understanding how you might be defining ‘benefit’ and ‘harm.’ As aforementioned, I acknowledge that many people have reported feeling helped by psychiatrists, therapist, medications and so on and I will not deny them their stories. However, sometimes words like ‘benefit’ and ‘harm’ are defined differently within the psychiatric system than they are elsewhere.
Take, for example, the incredibly depressing way in which one Connecticut-based clubhouse seems to define a ‘recovery model of care’:
“[We] embrace a “recovery” model of care which holds that people with mental illness can and do adjust to their disabilities by an ongoing process of acceptance and adaptation, the development of a positive self-image, and the reformulation of their life aspirations.”
Every time I read that statement, I experience a rush of sadness. Adjust to their disabilities? Reformulate their life aspirations? But there you have it. That is one whole organization’s apparent definition of recovery.
Similarly, I recently heard a man speak up at a town hearing and offer that he had been in ‘recovery’ for over two decades. But how did he define recovery? Well, he hadn’t been working, but had been taking his medications consistently in spite of all the physical and cognitive effects that were evident in his speech. While I don’t want to take anything away from him or how he chooses to tell his story, I can’t help but ask, is THAT what we mean when we talk about ‘recovery?’
And what of the studies that seem to indicate that people treated within the psychiatric system show greater improvement than others in the first few months, but then seem to hit a threshold that they can’t quite ever break through? Is THAT what we mean when we talk about positive outcomes?
Or how about the people who maybe manage to stay out of the hospital, but die 25 years younger (as is the average number of years lost off of life expectancy for people receiving services in the mental health system)?
So, it would be helpful if you would define ‘benefit,’ for me because all too often, I have seen people refer to the ‘benefits’ of various elements of the psychiatric system based on their own priorities and goals.
I suppose, while we’re at it, could you also define what ‘respectful’ and ‘careful’ diagnosis might look like? Is it when you do tell people that you’re not sure if this is really the answer? When you share with them the possible other answers? When you are transparent as to the purpose of the diagnosis and involve them in the process? When you let them know the risks and benefits of having a diagnosis on file? What does it look like, exactly?
And one final question: Your main argument seems to be that diagnosis can help guide someone toward the ‘right’ treatment. How does a one or two word diagnosis do that any better than a description of the person’s actual experience?
Sincerely,
Sera Davidow
“I am aware that the theoretical legal safeguards for those diagnosed with mental illness
are not always put into practice, and that some individuals facing civil commitment
are not adequately represented by legal counsel–despite requirements
for due process of law.”
I very much disagree with everything that Mr Pies represents, but here is 100% right. And he is giving the hint that most psychiatrists in the US would backpedal if they felt that their victims could fight them on the legal front effectively. So there you go!
Implicit in referring to survivors of forced psychiatry as having had a “bad experience” is the suggestion that it is possible for the government detaining law-abiding citizens, forcibly altering their brains with tranquilizer drugs, and slapping a stigmatizing label on them to be a “good experience”, as though, through tweaking and reform, the government entering your brain against your will could be perfected so that nobody found such biological violence against them a “bad experience”.
“and that is the decision of a judge–not a psychiatrist or other physician.”
Empty. We know around the world success rates of convincing a judge you are not brain diseased, in the face of a psychiatrist petitioning a judge to have the citizen’s right to own their body stripped from them, is like 3%. Numerous well done jurisprudence studies from top scholars have shown the “rubber stamp” judicial decision in commitment hearings to be perfunctory at best. The power imbalance, is plain for all to see. The judge is adjudicating a fight for liberty between a targeted person on what may be the worst week of their lives, they are extremely traumatized and distressed, even drugged and tranquilized, and they must somehow, make their case to a judge, in the face of a so called “biological” psychiatrist, who is seen by society as a wizard who can diagnose brain disease without even examining brains. To claim the psychiatrist isn’t the one initiating the legal jeopardy, and that the psychiatrist doesn’t hold 97% as much sway as the judge does, is just a blatant obfuscation. His appeal to “blind justice” is a completely offensive claim.
“I do not defend this system as ideal or always in the best interests of the patient – nor was it a system created by psychiatrists”
Governments worldwide didn’t just institute laws that allow the forced flooding of law-abiding citizens brains with toxic drugs out of thin air. They were convinced by so called “biological” psychiatrists that mentally and emotionally distressed citizens were a biological underclass unworthy of basic human rights. Biological psychiatry did this. Psychiatry whispered in government’s ear, and behind every single push for more involuntary psychiatry laws, you can find top psychiatrists and their professional associations advising government, lobbying government, how the dishonesty of Mr. Pies “don’t blame us” shtick, this “who me?”, kind of stuff, can be swallowed by anyone, is just amazing to me. I suspect it won’t be swallowed by everyone.
“Indeed, over more than 25 years of practice, I witnessed many more patients benefit from psychiatric treatment than were harmed by it–”
As though a “doctor” who forcibly initiates the doctor/patient relationships he pretends to unbiasedly critique can report on outcomes as though coercion doesn’t color them.
It is a well-known fact among people who live outside the bubble of so called “biological” psychiatry’s fanaticism, that over a psychiatrist’s career, he witnesses coerced, compelled, and forced people, who he forced a “doctor/patient” relationship on against their will, appear thankful, just so they can win their freedom and get the hell out of there. It is also a fact, that many of a coercive psychiatrist’s former detainees, will avoid them like the plague for the rest of their lives, because they live in fear of their former government imposed psychiatrist. Like neocons who were the architects of the invasion of Iraq, they only have ears to hear, and eyes to see, the people who are happy that Saddam is gone. The collateral damage is always ignored. And of course, they’ll say “it was the President’s decision”, just like the psychiatrists hide behind the rubber stamp of the judge who comes to the hospital for a perfunctory “hearing” initiated by a psychiatrist who seeks to drug the targeted individual based on the psychiatrist’s religious beliefs about “brain diseases” they can’t even prove exist in the targeted citizen’s body.
“Alas, I do not have confidence that further exchanges on the MIA website are likely to be fruitful or respectful. My experience with the MIA website – and based on the experience of one of my colleagues, who used to post on MIA – has not been positive. I believe that the profusion of anonymous and insulting comments – poorly-moderated by the website administrators – makes for a very unhelpful and demeaning forum.”
Oh, a dig at both the administrators AND the audience. I do not have confidence that any interaction between psychiatry and I will be fruitful or respectful. My experience with psychiatry, and based on the experience of millions of people forcibly detained and meddled with by psychiatry over the last couple of hundred years, has not been positive. I believe that anonymity is not a crime. In fact in the words of late Aaron Schwartz “In 1787, when America’s framers wanted to argue for its Constitution, they published their arguments (the Federalist Papers) anonymously. Whistleblowers have released everything from the Pentagon Papers to the Downing Street Memos. Anonymous speech is a First Amendment right.”
“I do understand that many on the MIA website have had very bad experiences with psychiatry, but that is no excuse for the abusive (and usually anonymous) comments that are often posted in the MIA forums.”
Mr. Pies exercises the freedom of association his profession denies to others, he has the right to walk away, he has the right to not have our words go into his ears, enter his brain. The people who have had much more forced into their brain than mere words, well, he’s “sorry you had such a bad experience”. The people asphyxiated to death by psychiatric nurses during forced drugging take downs, who now lie in morgues with toe-tags on, they had a “bad experience”… Going to a concert, or a museum, is an “experience”. Having your brain assaulted, violated, damaged, by an out of control profession of fanatical drug company money soaked wannabe neurologists, posing as real doctors, who possess nothing but labels and drugs, and how see people as nothing but brains, having your very humanity denied, by goons armed with syringes who swarm you, hold you down, ignore your please for mercy, and brutally steamroll your consciousness because they view as a defective being, having your good name wrecked and stigma heaped upon you for life, having your entire family and everyone you know indoctrinated to view every word that comes out of your mouth as the meaningless chemical soup of a “brain disease”, is not a “bad experience”, Mr. Pies, it is the wholesale devastation of an innocent human being’s life.
In my opinion it takes massive hubris, and deep, 25 year long indoctrination to talk like Mr. Pies does. So called “biological” psychiatrists, simply need to be stripped of the right to enter people’s biology by force. We won’t have to worry about stopping them testing or examining anybody’s biology by force, because these people simply don’t examine biology in clinical practice at all, they only flood never-proven-diseased biology with drugs. They don’t know what they are doing, and they are very dangerous to others. Will they go to their graves never admitting they were wrong?, never admitting they used the violent force of the state to impose their ridiculous and false “brain disease” quackery claims on others against their will? Never considering for one moment, that freely made decision they made in medical school to specialize in psychiatry (something fewer and fewer medical students find a compelling route), the freely made decision they made when young, to accept psychiatry’s belief system, is not a fait accompli among the public? Will “drug and label” psychiatrists admit that to force their beliefs on the public, physically force, their beliefs, into the bodies of the non-consenting, is a deeply unethical thing, a human rights abuse among the worst in history? People should have the right, to say no, to having their brain altered, by so-called biological psychiatrists, who don’t even examine biology! How did we get this deep into Alice in Wonderland?
I live in fear of men like Pies. This constant fear isn’t an “experience”, it’s NOT some “thing that happened”, it is life under the forced psychiatry regime, life in a society that forces this quackery on people by force. It is daily life. Daily, I am forced to live in fear because my right to own my own body, can be ripped away from by a “brain disease” doctor who doesn’t even examine brains. So enjoy that freedom of association, that freedom to walk away from a dialogue Mr. Pies, that freedom to set the terms of the debate. I only wish I had the freedom to ignore your profession. Sadly, denying choice to the people psychiatry labels “patients”, is one of the first rites of initiation into the profession of psychiatry. The few med students who actually do find psychiatry a compelling specialty to enter, quickly learn that what those labeled “mentally ill” say or want, is irrelevant, the most important thing is that drugs get put in their “diseased” brains, regardless of what the targeted person has to say on the matter. 25 years living in the bubble where its completely normal for drugs and ideology to be forced on any stranger dragged into a psychiatric facility, it’s easy to see why Mr. Pies doesn’t appear to understand where the survivors of his profession’s actions are coming from.
Hi Anonymous,
I really appreciate your taking the time to respond to Pies’s letter and I love how you paint the image of the imbalance in the court experience. It’s right on! Thanks for reading and responding.
[[personal attacks removed]]
“I do understand that many on the MIA website have had very bad experiences with
psychiatry, but that is no excuse for the abusive (and usually anonymous)
comments that are often posted in the MIA forums”
Mr Pies, what you call “insulting” is nothing compared with the stigmatizing experience that comes with a psychiatric diagnosis and the abuse that follows. You claim that anonymity is a problem. Let me help you understand something here. Unlike the victims of rape, or other horrendous abuses, there is a social stigma associated with psychiatric abuse. Our abusers are regularly “praised” on national TV for having abused us. Who in his/her right mind would like to expose himself/herself to such public scorn? When a rape victim explains her/his case in public, usually all sorts of supportive messages follow. Not with us.
In fact, Sera and the other victims that have no problem with fighting with there real names at MIA are my heroes. If only I had the courage to follow their lead, I think I could contribute a lot. In the meanwhile, the system of which you are part, forces me to make my comments anonymously.
“In the meanwhile, the system of which you are part, forces me to make my comments anonymously.”
Huh???
Cannotsay2013,
That one sentence of your comment, I’ve quoted, as it jumps out, at me; for, it is directly contradicting what you posted in a comment, just a couple hours ago.
You wrote (April 12, 2013 at 3:19),
“My approach is to let it be known to wanna be abusers that there will be retaliation, in a legal sense, if they ever dare do to me what they did to me in Europe […] . So far, it has worked perfectly.”
http://www.madinamerica.com/2013/04/too-much-pies/#comment-22652
You will, “let it be known” anonymously! HA!
🙂
You have given me an idea for a fun blog…
What if I were to call myself, “All-Powerful.”
Of course, I’d remain anonymous, necessarily.
These would be the first words, on my ‘About’ page Introduction:
🙂 “Let it be known that I am all-powerful…”
(That seems to be your overall message; and, of course, it’s delivered anonymously!)
All I am saying is this…
Apparently, cannotsay2012, you are *not* nearly so confident, in your power to legally retaliate, against potential psychiatric usurpers, as your words implied…
If I am wrong about that, then, quite simply: I challenge you to unveil yourself!
Meanwhile (as I do not expect you to unveil yourself), I should emphasize this: I do deeply respect any psychiatric survivor in the U.S. who remains anonymous — because I do *not* believe that anyone is safe from psychiatric abuse in the U.S.; certainly, one can make oneself relatively safe — if one has no psychiatric record.
But, anyone who has ever received a psychiatric ‘diagnosis’ and who has been forcibly ‘committed’ to psychiatric so-called “care” is going to be scrutinized, henceforward.
Neither you nor I can be completely safe from Psychiatry.
Really, there is little complete safety against unwanted psychiatry, in almost any country — especially, once ones own family has become determined to have one “hospitalized”.
In almost any country, the best possible protection becomes physical distance — and hiding oneself — away from psychiatry.
Anonymity helps (especially, when revealing ones ‘history’ of having been abused by psychiatry) online.
So…
Cannotsay2013, I can only understand your desire for anonymity as reflecting a concession, that the de facto powers of Psychiatry, in the U.S., are far greater than you are willing to openly admit.
Legal ‘tools’ to protect you against unwanted psychiatry do *not* actually exist in the U.S..
They do exist in Germany.
On that score, I’ve offered further explanation; it’s offered in my response, to you, under that above-mentioned comment, of yours (follow the link I have offered, above).
You can find your way to that response, of mine, quite easily, by using that link I’ve provided (above); it will take you back to our conversation, beneath Sera’s preceding blog post; scroll to the bottom of your April 12, 2013 at 3:19 comment; there, you will see my replying comment, including my emphasis on the real safety (for now) in *Germany’s* legal system.
Germany has allowed for a real remedy to psychiatry’s so-called “involuntary care”.
Respectfully,
~Jonah
Jonah,
You are confusing the legal tools, that are here as Mr Pies himself attests, with public stigma. I never said that public stigma is lower in the US than elsewhere. All I said is that the tools are there to fight psychiatric abuse that are non existent in Europe, including Germany.
This is my challenge to you. Go to the European Union country of your choice, make the statements you are making here peacefully, to the psychiatrist of your choice (ie, that you stopped your meds and that you consider yourself to be an innocent victim of psychiatry and its invented disease), etc. I can tell you that the likelihood that you will be civilly committed is very high (for your own good without need to show dangerousness).
I know particular cases of American parents who, advised by NAMI, sent their children to the UK so they could be treated there (meaning “forcibly treated”) because in the US it was impossible to make them compliant (ie, to make them take drugs against their will).
As to your insistence with the German case and how different it is from the general European reality, unfortunately, the reality is quite different,
http://www.ncbi.nlm.nih.gov/pubmed/22116739
“German practice of involuntary commitment at both federal and state level after introduction of the Guardianship law (1992-2009)].
Given the steady rise of psychiatric coercive measures in Germany, the question arises whether this development is significantly influenced by the corresponding legal basis or through epidemiological, socio-economic or socio-structural factors.
METHODS:
Based on full surveys of the Federal Ministry of Justice we examined the development and associations of 10 indicators of coercive psychiatric measures over a period of 18 years. Time trends of all indicators have been descriptively analysed. Statistical associations between time trends and between involuntary and admissions economic indicators were analysed by regression models.
RESULTS:
All annual involuntary commitment rates have increased, judicial ordered physical restraint measures particularly strongly (848%). The rate of judicial rejections of applied involuntary measures showed the lowest increase. ”
Believe me, the idea that the European countries signatories of the European Convention on Human Rights are “freer” for psychiatric survivors than the US is pure fantasy.
“…the idea that the European countries signatories of the European Convention on Human Rights are “freer” for psychiatric survivors than the US is pure fantasy.”
Cannotsay2013,
That may or may not be true, in various instances; but, note: I never said *anything* about the European Convention on Human Rights.
That convention does not appeal to me, as providing proper/adequate protection, against psychiatry.
(I referred favorably to the UN’s Convention on the Rights of Persons with Disabilities. That’s different. That UN convention will provide protection against psychiatric intrusions, once it is adhered to…)
You write, “As to your insistence with the German case and how different it is from the general European reality, unfortunately, the reality is quite different…”
Cannotsay2013, I believe you are wrong there — factually — beginning with those words, “As to your insistence with the German case,” your entire comment becomes misleading (I believe).
Beginning with your reference to Germany, you are presenting uninformed data, in my view.
You cite a study that utilizes statistics from 1992-2009, and the study itself begins with the following identifying info: “Fortschr Neurol Psychiatr. 2012 May;80(5):267-75. doi: 10.1055/s-0031-1281739. Epub 2011 Nov 24.”
(Such is to say, the study was first published, online, in late November, of 2011.)
There is a problem with your study, primarily in that it does not isolate instances in which individual “patients” provided advance directives.
There is a second problem in that it fails to take into account anything that has transpired, in German law, after late November, of 2011.
Notably, in mid-December, of 2012, the German High Court, “declared two regional state laws legalizing forced treatment in forensic units and on grounds of ‘dangerousness to others’ as being irreconcilable with the constitution and instantly nil – this court ruled that such danger is prevented by the incarceration, so no forced treatment, meaning bodily harm, can be accepted.”
http://involuntarytransformation.blogspot.com/2012/07/german-supreme-court-decision-on-forced.html#.UWi1ZHnKiSo
Furthermore, “In all the years from 1987 to 1994, if the Psychiatric Will [i.e., an Advance Directive] was written correctly and a lawyer and the assigned persons of trust have been active to enforce the written will of the inmate, no psychiatrist has risked violating the Psychiatric Will. In 1990 the first leader of a Berlin psychiatric institution promised publicly, that in his institution Psychiatric Wills would be accepted without any discussion. Judges explained that they would not and could not impose any treatment-guardianships upon inmates, if these resist treatment but have a Psychiatric Will written well before commitment to suppose a different will of the so called psychotic subject.”
http://www.peter-lehmann-publishing.com/articles/lehmann/pdf/enusp-newsletter12-9-11.pdf
Certainly, I am no expert on German law (nor either an expert on the law of any country).
Truly, I know only a *bit* about the law, here in the U.S., where I was born and raised; but, at least, I can read English, so I can learn about the law in the U.S., via the Internet.
And, something I know about laws, generally speaking, is that wherever they come to exist, *changes* in those laws are bound to occur, afterward (at least, gradually).
So, here, I must honestly confess to not knowing enough about German law (especially, as I cannot read German); and, yet, I believe that carefully worded advance directives (rejecting psychiatric ‘treatment’) have, in fact, been rather widely honored, in Germany.
Late this past year, there was a German High Court decision demanding that lower courts *honor* advance directives; I would love to know more about that…
But, in any case, what I do know is that such directives were being *fully* honored in Germany, beginning late last year and up until recently.
And, I believe this news brought the beginning of something very good (in terms of a creative idea) to many psychiatric survivors who learned of it; the way to providing effective individualized protections against psychiatry, in my humble opinion, is advance directives…
Carefully worded advance directives (a.k.a., a “Psychiatric Will” and/or a “Living Will”) calling for the *refusal* of psychiatric ‘treatment’ — e.g., in the case of any and all supposed ‘psychoses’ — could eventually become perfectly *key* to protecting thousands (and, even millions) of individuals against unwanted psychiatry, in the U.S. and elsewhere.
That is my belief.
Meanwhile, there is no certain protection from psychiatry, in the U.S. (that’s for sure); I believe you well understand this very last point I am making; and, so, I take it you are remaining anonymous (as am I).
Respectfully,
~Jonah
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Cannotsay2013,
Considering that the blog on this Web page is a tribute to the spirit of online dialogue, I feel it fitting for me to say the following, to you.
I deeply appreciate this back-and-forth dialogue between you and I (i.e., our dialogue in the comments, on this page and in comments beneath Sera’s preceding blog) — quite like I appreciated our previous back-and-forth dialogue, posted in comments under Laura Delano’s February 23, 2013 blog post.
February’s dialogue began, as I respectfully aimed to seriously question (and, if possible, correct) your somewhat rosy views of so-called “civil commitment” laws, here in the United States.
I call your views “somewhat rosy” because I believe you are inclined to view U.S. ‘mental health’ law (and, especially, so-called U.S. “civil commitment” law) from a POV of personally biased optimism.
Your experiences, in having been “committed” in a non-specified European country, were so totally aversive (and, clearly unjust), that you felt a need to leave that country and come to the United States.
You feel safer here (and, really, I believe that you *are* safer here) due to the fact that U.S. ‘mental health’ law generally requires an official claim that the so-called “patient” is a ‘danger to himself/herself and/or to others’ as a supposed result of a so-called “mental disorder”.
You insist that you have carefully studied these matters; I, too, have studied them.
(Most specifically, I have been striving — for a couple of years — to understand the practical differences between U.S. and U.K. so-called “mental health services”.)
You have written, emphatically (on April 12, 2013 at 7:50 pm),
“…the idea that the European countries signatories of the European Convention on Human Rights are “freer” for psychiatric survivors than the US is pure fantasy.”
As mentioned, above, I do not deny there is truth to that statement.
But, you and I have agreed, that: the practices of psychiatry, throughout the E.U. are not actually uniform, nor are the practices of psychiatry uniform throughout the United States.
We both realize that much.
I would add, as well, that whatever may exist, in the form of protections against so-called ‘mental health’ system human rights violators, are both class-based (i.e., they are socioeconomically determined) and race-based (or, determined by ethnicity).
There is immense prejudice inherent in so-called ‘mental health systems’ (everywhere).
From this point of view, I submit to you, that (from my studies of these matters, it is the case): some E.U. citizens are, ultimately, far more protected against the potential harms done by Psychiatry than are some U.S. citizens.
And, some E.U. countries (at some times, in some provinces) perpetrate fewer violations of human rights, per capita, than some States, here in the U.S..
But, yes, generally speaking, in the E.U., the ‘legal’ criteria for enacting a so-called “civil commitment” (a.k.a., “sectioning”) is looser than here in the U.S..
But, ‘mental health’ law in the U.S. is not at all just.
It is a separate ‘legal’ system — being that it is somewhat akin to criminal law (because the consequences of getting caught up in it are truly punishing) but *without* any officially designated crimes; it is, ultimately a Star Chamber, in that the accused are provided little or no genuine protection from the U.S. Constitution’s Bill of Rights.
(See “Star Chamber” http://wordnetweb.princeton.edu/perl/webwn?s=star%20chamber )
Similar to most Star Chambers, anyone who is fortunate enough to be both (A) well-informed *and* (B) possessed of considerable means ($$$) shall stand the best chance of avoiding any sort of ‘mental health commitment’ procedure. (At various points, in your comments, on this website, you’ve alluded to this fact — by admitting that the U.S. government does *not* provide competent legal assistance, to those who’ve been ‘committed’.)
At last, for now, I am taking a break from our dialogue, as must tend to matters closer to home.
Note that, like most people, I have limited time to engage in discussions, online; but, this second dialogue between you and began, as I felt ultimately *compelled* to step in and post my respectful objection to a certain line that you offered Sera (in your comment of April 11, 2013 at 12:36 am); in your first comment posted under Sera’s preceding blog (“Too Much Pies”), you wrote,
\\…Now, we’ve heard stories of forced drugging in the past in the US but usually, when they come to light those responsible are held accountable. Not to mention that in the US, the SCOTUS has made it very difficult for that to happen “legally”…///
http://www.madinamerica.com/2013/04/too-much-pies/#comment-22599
That line of yours was (in my view) really terribly misleading.
Thus, I hope you will go back and carefully study that John Breeding video which I recommended; and, I hope you will take to heart that one comment by Daniel Daniel Fisher, M.D., Ph.D. (posted beneath Sera’s preceding blog, on April 12, 2013 at 6:15 am.).
I hope you will listen carefully to those who have recently suffered and to those who are continuing to suffer, upon having been captivated by the U.S. ‘mental health’ system.
I deeply pray you will be enlightened by their testaments.
After all, your line, above, paints such an incredibly *rosy* (which is to say, positive and inaccurate) picture of the current status of U.S. ‘mental health’ and/or ‘civil commitment’ “patients,” I can’t even begin to imagine what you were thinking, as you typed and posted it…
Hopefully, our dialogue has done something to clarify these matters.
Respectfully,
~Jonah
Excellent point about the praise of those who are on the giving end of psychiatric abuses, cannotsay! And I appreciate your ongoing efforts to explain why so many choose to post here without identifying information.
Thank you, Sera.
I really appreciate your thoughtful and ongoing commitment to challenging long-held cultural, scientific, linguistic and other assumptions, including your own.
As long as continue listening deeply and inviting dialogue, we have an opportunity to grow past out of all these ill-fitting, thread bare costumes we keep trying to dress each other up in.
Thanks for reading and commenting, Jen! I feel greedy this week – like I’m taking up too much space with all these Mad in America posts! But I hope people do generally feel like the exchange is worth seeing. I don’t know that this particular dialogue is moving toward anything so much, but I certainly have to keep believing that we are moving forward – however slowly – in the bigger picture.
Excellent exchange. I agree, his idea of, “Recovery,” is frightening. Congratualations for being so persevering.
Thanks, John and thanks for continuing to read! 🙂
Sera, thank you for sharing Mr. Pies’ letter to you and your incredibly restrained and informative response to his rather inarticularly rendered provatations. He apparently thinks anyone taking issue with his worldview is vituperative and insulting. Apparently he has little understanding of the effects of the power dynamics within the system or he would not be surprised that people who have been harmed might be a bit upset about that.
Pies very clearly stated what his purpose was in writing to the NY Times: “My letter to the Times was aimed at asserting the medical and ethical legitimacy of the diagnostic process in psychiatry.” And this, clearly, is where many MIA readers have a fundamental difference in worldview with Pies. Despite what he says, he has not offered any proof that there is any legitimacy in the psychiatric diagnostic process. Just repeating over and over again that it’s legitimate is not proof.
I have had four diagnoses in my life. My psychiatrist thinks I’m better and ‘in remission’. I think I would have a hard time finding a mainstream psychiatrist to ever agree with his trauma based opinion. Once broken, always broken, doesn’t believing in the chemical imbalance theory imply that?
Sera is very kind in her response to you, Dr. Pies. I can not find that kind of grace yet. For seven years on typical antipsychotic thertapy I experienced the total lose of relating to my to family (I stayed in my room or at the hospital), to myself (I hated waking up in the morning), my lost loved ones (I didn’t cry on the anniversaries of the death of my husband or my eight year old little girl). That was not all. I experienced the dearest loss of my intimate, personal relationship with my Creator. And that was to be my sentence until my death according to your belief system, sir.
The patients who keep going back to you don’t know what’s happening to them, don’t know what they have lost. We at MIA do.
Maybe it’s time you listened to us. Psychiatry is killing people before they are dead.
I should have said ‘some people’ Or rather maybe I should have added, “It kills some people more slowly than others.”
Medications that are designed to cross the blood brain barrier in order to alter emotions and behavior for more than just a short period of time are just wrong doctoring.
Dr. Pies, why don’t you get into thyroid, adrenal, hormone balancing? Psychiatric medicines usually make these systems run a muck. Or learn how to take patients off medications, working in tandem with a psychotherapist or an Emotional Freedom Technique practitioner of course. I bet that might make a rewarding change of pace, a very rewarding profession it would be.
Both treatment modalities can take a couple of years for each patient. You would have no need to keep patients for all of their lives. New patients would line up, I tell you. Those skills are in big demand. My psychiatrist is booked solid.
Thanks, Darby! Indeed. For any progress to be had, definitions of terms like ‘benefit,’ legitimate,’ etc., simply need to be discussed. Unfortunately, I don’t think we will be reaching that point here, but it’s been an interesting exchange (for me, anyway) nonetheless.
I attest that I was moderated before :D.
[[Removed speculation into an individual’s motives and intentions. Please stop posting this way.]]
Hey Matt, I did indeed pass this along directly. 🙂
However, as Dr. Moffic found, you need to speak sense to this crowd. Posturing and claiming authority doesn’t cut it.
I don’t know which psychiatrist wrote it, but on the cover of Psychiatric Times there was a review of Anatomy of an Epidemic. Dr. Pies may have penned it. reading it encouraged me greatly. It ended with a sentence like this (This is not an exact quote.) The humble doctor wrote that all psychiatrists should read Anatomy. If we can not dispute it, we need to change our ways of practice.
Dr. Pies, if you didn’t write this review, you published it. I don’t see you here refuting the evidence in ANATOMY. You’ve resorted to name calling yourself.
You say you have seen people improve through your treatments. Yeah, canotsay2013, he doesn’t want a discussion of research. He can’t dispute the evidence in Anatomy. More research is being published right now that back up Whitaker’s conclusion: Long term psychiatric drug therapy is detrimental to recovery rates. Why don’t you talk in facts, statistics, and research findings that prove him wrong?
You are protecting a way of life. That would be fine, live and let live. It’s a free country. The only problem with your way of life is that it is hurting a lot of people. Hurting is too soft a word. Exploiting? Yes.
Maybe you are being exploited too. I’m sure some psychiatrists are.
“Yeah, canotsay2013, he doesn’t want a discussion of research. He can’t dispute the evidence in Anatomy.”
Of course, it is one thing to attack some Scientologist quite another to attack the body of evidence compiled in “Anatomy of an Epidemic” as well as other books like Irving Kirsch’s “The Emperor’s New Drugs”. In fact, so called “scientific” psychiatry does not dispute Kirsch’s findings, they have an argument with him over what “statistical significance” means vs “clinical significance”. Their shaky reasoning that one could call “appeal to clinical practice” (it’s a name I have invented for their preferred fallacy, named after the logical fallacy “appeal to popularity”) is self defeating.
To validate the cause effect lack of insulin-diabetes there is no need to “appeal to clinical practice”. We have blood tests to measure sugar levels in blood, we have observed the effect of insulin in those sugar levels.
So on one side they tell us that psychiatry’s chemical imbalance model is like diabetes, on the other hand they do constant “appeal to clinical practice” fallacious reasoning when the data does not back up their claims. Which way is it, is it like diabetes, or is it not like diabetes?
So I would submit that it is impossible to reason with somebody like Mr Pies. They believe one thing (that depression is like diabetes) and the opposite (that depression is not like diabetes, appeal to clinical practice). They hold simultaneously views that are contradictory. The rules of Aristotelian logic do not apply to them, so all hope of rational debate is lost.
Thanks for continuing to read and offer your insight here, Maxima. 🙂 I really need to go back and read the Psychiatric Times Anatomy article. I’ve heard so much about it at this point!
Is Carlat right? Is psychiatry a profession in crisis? Maybe for the exploited young medical talent who got persuaded to become psycho chemists by their Big Pharma-bought professors.
My old pdoc is like that. He is panicked. He told me he knew the chemical imbalance theory was not true. He told me psychiatry was not going to last another ten years as it is today. Was he changing his methods? No.
He changed his profession from being a lawyer to being a psychiatrist in his forties. He said law was a soul-stealing profession. Poor thing.
He’s close to retirement years. He doesn’t want to learn anything else. He’ll go down with the ship. He won’t read ANATOMY, the copy I gave him. He does read my emails.
But for more than a few I’m afraid, it’s “Me thinks the lady protests too much.” Spin, baby, spin. Throw lots of sawdust on the blood.
Come on, Dr. Pies. Put down the smoke and mirrors. Use no more hyperbolas. Tell us exactly where Whitaker is wrong. What page? Which paragraph? Cite some research, will ya?
Darby Penney said,
“He apparently thinks anyone taking issue with his worldview is vituperative and insulting.”
Totally agree and actually, that is pretty true of alot of psychiatrists in my opinion. Any criticisms are always deemed in negative terms even when they have been respectful and have not been inflammatory.
The other issues that keeps arising with Dr. Pies and many of his colleagues is that you are an anti psychiatry nut if you fail to remember that there are good psychiatrists when you dare utter criticisms. Well, in my opinion, because of the brutality that many have suffered under psychiatry, that would be like telling a woman who was raped by a man, that not all men are bad. Sorry, I know this is graphic but this is the best way I know how to make my point since many people have described forced drugging as chemical rape.
But then again, just like when rape victims were blamed instead of their assailants, that is what occurs in psychiatry which Dr. Pies refuses and his colleagues refuse admit. If someone complaints about a chemical assault, they were just too sick to realize they needed help. If someone complaints about being restrained or excessive force, well it is for their own good and those hospital workers have a tough job.
Finally, Can’t say mentioned in a response that it is impossible to reason with Dr. Pies. Actually, I feel it is impossible to reason with most psychiatrists other than the ones who post here or who have been involved with the MIA movement.
Completely agree, AA.
Thanks for posting, AA! I completely agree that phrases like ‘anti-psychiatry’ are thrown around quickly and easily as attempts to discredit.
Your also reminding me of my fave new vocab word of 2012: Anosognosia. I guess I DO have something to thank the Treatment Advocacy Center for, since they’re the ones who really taught the word to me. Who knew there could ever be such a medicalized word for what often amounts to disagreeing with the doctor’s view and interpretation of one’s self!
-S
First they ignore you, then they laugh at you, then they denigrate you, then they say maybe you were right but more importantly things are different now and they have changed things (but not in any real way) so shut up and go away. Then (fingures crossed), with much persistence, you win.
The fact that a member of the psychiatric establishemnt is prepared to debate these matters in public shows that this movement is having some success in challenging mainstream psychiatry. If not in day to day practice then in the ideas that are in circulation, and that is an important precursor to real change.
Thanks for continuing to read and post, John and I certainly hope what you say in your last post is true! 🙂
Sera, Hello. Your response to Dr. Pies is excellent!
I want to personally thank you for this post because reading it helps me to more clearly understand my own experience with/in mental healthcare.
I have plenty of feelings about the past decade of which I have gone through such trials and tribulations trying to be what psychiatrists told me I needed to be if I was interested in helping my adult son, all the while, I had an alternate set of feelings that didn’t coincide with what they were saying. I’ve been the “Fence Sitter,” always choosing between two evils; to treat or not to treat.
Things changed about two years ago, when an attempt to get my son help within the system went very wrong. I saw great injustice, and an almost unbearable foreboding view of my son’s future if the psychiatrists involved had had their way.
I need a way to process all of what has happened over the past ten years. I need a way to understand it, talk about it, and do the best I can to find the resources to help my son and our family move on. It is not only my son who is at risk. If we had to go through, again, what we went through the last time we sought help within the system, I’m not sure either of us would survive it.
I can honestly say that my son has had the best year of his life after firing an ACT team, and moving away from psychiatry, as much as he could. You can’t just stop the medication without help, so we are not altogether free of the system. Even the psychiatrist who has seen him has said, and written in a letter, that he is better than she has ever seen him.
The story of our lives seems to be talked about in the context of before and after that last time my son was in the hospital.
I once thought the diagnosis my son received was the worst illness a person can have, and it may well be, but part of that is because the treatment is just as bad, or worse, than the symptoms are and I’m not only talking about side-effects of medication. It is the inequality, the total loss of human rights a psychiatric patient endures and the lies and coercion that exists in the practice of psychiatry.
I have personally witnessed psychiatrists and their colleagues lie and use coercive methods to get a ‘consumer’ to become compliant. The ones I’ve dealt with, most of whom are considered to be the best in their field, are not ashamed of lying. They say they do it because it is in the best interest of a patient/consumer.
NAMI’s Family-to-Family program teaches family members how to stretch the truth, or lie if necessary, to get a commitment order. The program teaches that a person diagnosed with a mental illness may go through repeated commitments before becoming compliant, and that all this is normal and necessary for the consumer’s well-being. I remember hearing stories of people being committed forty or more times in their lives, but finally, finally, they came around!
About hospital court rooms. There is not any justice happening there! Personally, I have not heard any psychiatrist, nurse, social worker or any other person who had power within a hospital court room to help get a patient committed, either short-term or sent to a long-term unit/institution/facility, who did NOT either brag about how they always win or admit that the hearing is a simple and easy process (for them to get what they want). I’ve been told not to show up to advocate for my son’s rights, because it wouldn’t do any good if I am not in agreement with what a psychiatrist is going to ask for. If judges in a hospital court room sincerely listen to and/or ever take the side of patients, that is absolutely rare.
The so called best psychiatrists that I’ve met and know are not reading Whitaker’s book. They do not want to have the conversation about the content.
The most recent time I mentioned to a psychiatric provider that many people do not agree with the notion that a person must take toxic drugs every day for the rest of their lives, I was told that I was, “poor,” and that, “poor people must rely solely on medication.”
The inpatient psychiatric team who were ‘treating’ (making my son very sick), threatened us the day he left their facility. They initially had him committed by telling lies and distorting any facts available to them. Their actions were most unethical. He was not anywhere near a danger to himself or others, but they nearly got him committed long-term because they said, “They hadn’t tried it with him before and that he could be a role model for their other patients, the latter of which would increase his self-esteem.”
The attorney who was supposed to be representing my son agreed that they (the psychiatrists) were the professionals. He also agreed that the reasons the psychiatrist used in hopes of the commitment she desired was illegal.
They did release my son, but not because of fair or good legal representation. The discharge was only after several members of his family, an outside psychiatric provider who had been seeing him for over a year, a nurse and myself, all showed up for a meeting to dispute their wishes for a longer commitment and offer instead, a humane plan for his treatment and recovery, which existed in the community. We knew the facts, and we knew what they were doing was illegal. They did not discharge my son because it was the right thing to do or because they had done wrong. I believe the people who showed up at the meeting did surprise them and make a huge difference in the outcome, but in reality, I suppose we were lucky he made it out alive!
“If you ever need to come back…” the psychologist, who was acting as secretary to the psychiatrist, said to us in the meeting, “If you ever need to be hospitalized again, we will make sure your Mother can’t help you. We will keep you a long time.” (This threat was made to their, “star patient,” as they called him).
I hope I didn’t stray too far off subject. Thank you for the space to talk about these issues.
I think Dr. Pies ought to be willing to comment here on MIA. Saying you can publish his response, but if I understood correctly, that he will not be further responding, is really not cool.
Michelle, Thanks so much for reading and more importantly, sharing so much of your story. It was really powerful to read some of the specific examples of what you and your son have experienced, so no worries at all for being a little off topic (and you really weren’t off topic anyway). What you are sharing needs to be heard just as much – if not more – than you may need to say it.
-Sera
Michelle,
The best news I’ve heard today is that your son is doing so much better than two years ago. I’ve been following your blog for quite a while, and I know how hard the journey has been for both of you. This is good news indeed.
…Rossa
Dr. Pies
Just to remind you, not everyone participating on the MIA website is a psychiatric survivor. Many of us work within the mental health system and we see on, a daily basis, the current content of the work done by your psychiatric profession.
I have worked in a community mental health clinic as a licensed mental health counselor for over 20 years. I have witnessed, first hand, how Biological Psychiatry’s disease/medication model has completely taken over all aspects of so-called treatment.
This particular medical model has become an unmitigated disaster for most people seeking desperate help, and has seriously handicapped well meaning caregivers attempting to support people in extreme states of psychological distress.
Dr. Pies you attempt to portray yourself as one of the more enlightened doctors within your profession who is critical of some of the more extreme examples of misguided care. Sera Davidow has, in her usual eloquent fashion, challenged you regarding the inherent power differential of psychiatrists when it comes to the issues of psychiatric diagnoses and forced treatment.
As someone who is not anti-psychiatry, but most definitely is anti-Biological Psychiatry, I want to challenge you on these additional critical questions:
Where do you stand on the takeover of your profession (over the last 40 years) by the Biological Psychiatry disease model of treatment? (Biological Psychiatry defined as: the wedding of genetic theories of “mental illness” with Big Pharma, the leadership of the APA, and the major training institutions of modern psychiatry)
Where do you stand on the mass drugging of today’s youth with stimulants, antidepressants, and,increasingly, with antipsychotic drugs?
Where do stand on the new evidence that antipsychotic drugs (now the largest selling category of medication at 18 billion per year) clearly cause far more harm than good and worsen the long term life outcomes for millions of people diagnosed with major “mental illness?”
Where do you stand on the corrupted nature of almost all drug research, where it is controlled and manipulated by Big Pharma with ghost writers and buried studies that show lack of efficacy or actual harm done to patients?
Where do you stand on the fact that there are no scientifically proven genetic markers for “mental illnesses” and no credible evidence for the still widely promoted “chemical imbalance” theory?
Where do you stand on the fact that the current institutions training psychiatrists have a (genetic/disease/drug) curriculum completely controlled and dictated by Big Pharma?
And lastly, where do you stand on the current prescribing pattern of today’s Biological Psychiatrists?
Honestly, Dr. Pies, how many patients have you treated with the symptoms of depression, anxiety, and other extreme forms of emotional angst at living in the current world, who ended up leaving your office without a script for psych drugs?
How many did you actually only prescribe regular exercise, meditation, and active placeboes, such as fish oil and other over the counter vitamins?
How many patients did you make an effort to give them the scientific evidence that these non drug approaches actually work better without all the side effects?
How many patients have you told that antidepressants are no better than placeboes and are actually addictive for some people with often brutal withdrawal syndromes?
How many patients have you told that Benzos, outside of a hospital setting and beyond 3-4 weeks of use, are perhaps the most dangerous category of drug in the world and are highly addictive and cause far more harm than good?
Dr. Pies, if your honest answers to some of the above questions is that you DO speak out against some of the problems with Biological Psychiatry’s control of your profession and DO promote nondrug approaches, then I say how much do you speak out and where? These are not intellectual debates; these are actual life and death (and brain death) questions for millions of people.
We had an expression in the 60’s: “If your not part of the solution than your part of the problem.”
If activist psychiatrists (there are a few that write at MIA) and other “enlightened” psychiatrists do not seize back control of their profession from the current dictatorship by Biological Psychiatry, then it will surely be swept into the dust bin of history.
Dr. Pies, if you, and others in your profession truly cared about the damage being done by the today’s (disease/drug) medical model, then you and your colleagues should be currently plotting (and taking the risks) to wreak havoc within the APA and other psychiatric organizations to isolate and defeat Biological Psychiatry’s dictatorship.
Dr. Pies, if all new psychiatric drug prescriptions were suspended today (clearly a demand that could be easily defended) there would be, at least, several decades of valuable work that knowledgeable and empathic psychiatrists could do to help people safely withdraw and learn to how to live with less damaging psychiatric drugs.
Dr. Pies, where do you stand on the questions I have raised about Biological Psychiatry?
Finally, Dr. Pies, in the 1960’s many rightwing critics of the activist movement would shout at us: “Love it or Leave it.”
I will refrain from shouting at you, but will instead whisper our response and the appropriate answer to the current state of your psychiatric profession; “Change it or Lose it!”
Many of us are prepared to work with you to “change it” for the better; this will require all of us to go through major transformations in both thinking and being. Some of this struggle could, at times, be emotionally painful. But it is absolutely necessary, and the goal of a truly humane system of support and healing will be more than worth the effort.
Dr. Pies, if you and your colleagues choose not to work with us to “change it” (Biological Psychiatry) and end up ignoring our critical analysis, then you should know that we are clearly building a movement that will gladly be prepared to “change it” for you.
Richard D. Lewis LMHC,CAS
Thank you for reading and replying here, Richard! Your questions are great and I only wish there were going to be answers. I appreciate your offering of a new, whispered chant, as well. 🙂
BeyondLabeling a.k.a. Jonah on April 13, 2013 at 9:55 am said:
I am replying here because it is becoming difficult to reply above.
I think that we both agree on the fundamental point,
But, you and I have agreed, that: the practices of psychiatry, throughout the E.U. are not actually uniform, nor are the practices of psychiatry uniform throughout the United States.
We both realize that much.
Correct, which is why, to make an apples to apples comparison we need to look at the hard data on the rate of civil commitments per 100000 inhabitants, which I have provided several times, and the legal frameworks (and that would include the relevant case law from the supreme court on the land on these matters, SCOTUS in the US, ECHR in a European context) instead of speaking of anecdotal cases. Don’t take me wrong, I am not saying that individual cases are not important. They are VERY important for the individuals who have been at the receiving end of the abuse (you, me and the vast majority of MIA readers). However, they do not matter when it comes to analyzing differences in legal frameworks and their effect in the prevalence of abuse.
Then you say,
(Most specifically, I have been striving — for a couple of years — to understand the practical differences between U.S. and U.K. so-called “mental health services”.)
If the reason you are doing it is because you think that moving to the UK will make your life easier, that would be a very important mistake. You’d be safer moving to a US state where protections are higher, such as the one where I live in.
From a different MIA entry,
http://www.madinamerica.com/2013/02/25842/#comment-20424
“These attitudes have negatively affected our concept of patient need to the extent distorting our views on the need for detention under the Mental Health Act. Legally, patients should be detained to hospital if they are suffering from a mental illness which may represent 1) a risk to self, 2) a risk to others or 3) a deterioration of their illness if left untreated. When deciding on which course of action to take, I have been amazed at the number of times that i am met with the question of “why on earth do you want to admit them, they’re not suicidal or homicidal.” It is almost as if we have forgotten about the third criterion completely-we have a duty to provide timely and effective intervention to prevent further deterioration in a patient’s underlying mental illness, IRRESPECTIVE of the presence or absence of risk!!”
That’s the legal framework in the UK. They don’t have capacity to commit whomever they want, but they do have the legal right to do so. So your choice!
As I said I know cases, through my ex wife attendance to NAMI meetings, of American parents that send their children to the UK on “vacation” only to have them committed there to force them into taking drugs because in the US it was impossible. And we are talking about highly educated/upper middle class parents/children here.
So you move to the UK at your own peril!
Cannotsay2013,
I appreciate your kind attempt to warn me against moving to the UK; but, please, understand: I have *zero* intent (i.e., no such intention whatsoever) of that kind.
Nor am I seeking a ‘safer’ state in which to live…
Simply, in recent years, it has been a hobby of mine (largely to moderate my sense of having been deeply traumatized and permanently stigmatized, by psychiatry) to spend hours, on the Web, comparing various so-called “mental health systems”.
My ultimate focus became that, of comparing and contrasting the U.S. and U.K. so-called “mental health systems”; this was simply an outgrowth of the fact, that greatest amount of *online* info (a truly amazing abundance of English language ‘data’ on the subject of Psychiatry) regards those two systems, in particular.
Respectfully,
~Jonah
P.S., I found this April 13, 2013 at 11:59 comment of yours, to be somewhat confusing, at first — (i.e., difficult to read) — as you’re using italics instead of quotation marks.
Italics may be fine for other purposes.
When it comes to offering quotations, in comments, on this site and elsewhere, I do my best to stick with quotation marks.
(Sometimes, when the excerpt already contains its own quotation marks, I may use this notation \\…// to contain that excerpt.)
P.P.S. — Based on my personal experiences and my informal studies, all things considered, I strongly recommend steering clear of *any* and *every* so-called “mental health system”; in my view, no government should be charged with the tasks of defining and enforcing ‘normalcy’.
Now that’s a topic worthy of discussion. Where should people with emotional distress go for help if not the current system?
Million-dollar question, David Ross. Million-dollar question. Ideally we would have supportive, interdependent communities where we could get emotional understanding & guidance from ‘real’ people, not paid ‘professionals.’ But that would be in a sane, emotionally healthy world…. Not the one we’re living in.
“Where should people with emotional distress go for help if not the current system?”
David,
You speak of “people with emotional distress” — asking: Where should they, “go for help if not the current system?”
And, ssenerch,
You say, “Ideally we would have supportive, interdependent communities where we could get emotional understanding & guidance from ‘real’ people, not paid ‘professionals.’”
Personally, I believe it’s important, in the context of discussions, on this page, to admit, the following simple fact: Individuals may experience varying levels and kinds of emotional distress, and some levels and kinds of emotional distress do call for the help of specialists.
In my view, true *experts* in this field — (in terms of knowing how best to cope with, live through, and get beyond extraordinary emotional distress) — are those who have learned about the ins and outs of relatively ‘unusual’ emotional distress, from first-hand, personal experience.
Here I am referring to levels and kinds of emotional distress that seem ‘extreme’ in the eyes of most people.
As a rule, psychiatrist call such emotional distress, “pathological.”
(Note: Dr. Ronald Pies is no exception. Just Google and read his two blog posts, titled, “Why Panic Attacks Are Nearly Always Pathological” and “Context Does Not Determine ‘Disorderness’ or Normality”.)
Essentially, psychiatrists attempt to do the work of the shaman, but they fail miserably, because their medical model refers to any and all relatively unusual kinds of emotional distress, as pathological (labeling it a type of, “illness” and/or “disorder”); they turn to prescribing mind-numbing, brain-damaging drugs.
They typically mean well, when doing so; but, they are erring, terribly…
Such is how so many (young people, especially) wind up labeled, in ways that imply they are afflicted with so-called, “serious mental illness.”
In one of his most famous essays, Joseph Campbell quoted one unusually insightful observer, of this phenomena (Dr. Silverman), who explained, “in a culture that does not provide referential guides for comprehending this kind of crisis experience, the individual (schizophrenic) typically undergoes an intensification of his suffering over and above his original anxieties.”
Campbell explained:
“The shaman is a person (either male or female) who in early adolescence underwent a severe psychological crisis, such as today would be called a psychosis. Normally the child’s apprehensive family sends for an elder shaman to bring the youngster out of it, and by appropriate measures, songs, and exercises, this experienced practitioner succeeds.”
(Source: http://www.mindspring.com/~berks-healing/campbell-schiz.pdf )
To get a very basic and abbreviated sense of what a shaman is, here I’ll take the liberty offering sociology(dot)com’s entire entry on the subject:
“Shaman”
“The term Shaman refers to a man or woman who serves a society as a part time religious practitioner. In many societies the shaman is not required by his profession to do more than perform routine rituals.”
“Among the Eskimos shamans are numerous almost every family will have one and there may be several in each village. They are paid for their services however there are none who devote full time to shamanism. Shamans are older and highly respected within the village community.”
“They may be described as part time specialist in religious functions unlike the priest who devote all his working time to these ends. The shaman performs his religious duties in addition to others necessary to make a living.”
“The shamans receive his power either through direct experience with supernatural beings in dreams or visions or from another shaman who has had such direct experience.”
“Shamanism involves direct contact with supernatural beings; the shaman is usually a person who is emotionally less stable than his followers and so more than susceptible to visions and dreams.”
“Shamans usually function in small relatively private ceremonies given at the instance of a single supplicant who is in difficulties.”
P.S. — I should add this, egarding one line that I quoted, above, from sociology(dot)com’s entry on the “shaman”:
Explaining that, “the shaman is usually a person who is emotionally less stable than his followers and so more than susceptible to visions and dreams,” is potentially (quite) misleading.
In fact, the shaman’s life is journey, in which s/he may become, ultimately, much *more* ’emotionally stable’ than the average person in his/her community.
Roger Walsh M.D., Ph.D. has elaborated upon on this, in his focus, on shamanism…
http://www.amazon.com/World-Shamanism-Views-Ancient-Tradition/dp/0738705756
David, I so agree… and one question that I feel like we’ve really done a poor job of answering is ‘Where should people go when they really are in such a distressed state (due to extreme trauma, withdrawing from medications or for any other reason) that they are acting out toward others?’ Many of the alternatives that now exist (most of which are still funded by and thus technically still a part of the system) operate on values and expectations that do not allow someone in that place to remain in that space and understandably so… And yet, at some point, we need to have better answers when we’re saying ‘No forced hospitalizations, but you can’t stay here.’
Sera,
I appreciate what you say to David, above (April 14, 2013 at 8:26 am), about one question that you feel is not being well answered:
“…one question that I feel like we’ve really done a poor job of answering is ‘Where should people go when they really are in such a distressed state (due to extreme trauma, withdrawing from medications or for any other reason) that they are acting out toward others?’”
Where should people go when they are feeling so distressed, that they’re “acting out toward others”?
That’s an excellent question.
Of course, “acting out toward others” is a very *vague* phrase.
To my mind, it speaks roughly of ‘anti-social’ behavior; but, that word (“anti-social”) is almost equally vague; and, in some instances, “acting out toward others” might *not* be ‘anti-social’ — as much as it is, simply, being demonstrative.
Therefore, to answer your question in a meaningful way requires taking care, to differentiate between various kinds of ‘acting out’ (and, between various degrees of ‘acting out’).
Hopefully, I have not told the following personal story too many times, on this website; certainly, some of what I am going to describe here, I have never before posted anywhere previously…
Almost precisely 25 years ago, I was forcibly “hospitalized” *twice* — for taking myself off the daily regimen of psych-‘meds’ that I had been forced to take.
Each time, I was *falsely* accused of being a “danger” to myself. (Such was the psychiatrists’ ‘legal justification’ for ordering my “hospitalizations”.)
It was 25 years ago, this past February, I was called a “danger” to myself because I’d flushed the ‘meds’ down my toilet — and had confessed that, in confidence, to a trusted relative, who passed along the information, to the rest of my family and the psychiatrist…
That relative of mine well knew (because I had explained this to him, very carefully): I had flushed the ‘meds’ down the toilet because, had I not done so, I might have taken them all at once.
I had explained to him: I flushed the ‘meds’ down the toilet because I felt they were dulling my mind and destroying my creativity.
(At that point, I’d been on them for two years — from the time I’d been forced onto them, at age 21 and 1/2.)
*Never* in my life — previous to being forced onto psych-‘meds’ — had I ever seriously imagined killing myself; never before being introduced to psychiatry; but, I did begin imagining doing that after being introduced to psychiatry — and forced onto ‘meds’.
The fact that I’d flushed the ‘meds’ down the toilet meant I was *not* going to take them all at once; I was *not* going to kill myself.
I was saving my life by flushing them down the toilet.
But, in the mind of the psychiatrist who had been assigned to me and who heard of my “acting out” that way, I would be perceived as a “danger” to myself.
He would “hospitalize” me against my will, force me back onto ‘meds’ — and, after a few weeks, send me on my way, re-‘medicated’ (with some of the same old ‘meds’ – and some that were new to me).
I would, soon thereafter, take myself off that latest ‘meds’ regimen he was prescribing… (Yet again, I would flush them down the toilet.)
As there were more ‘meds’ than before, so the *withdrawal* effects were more severe.
In fact, at one point, in rather extreme distress, from withdrawals, I punched a window, and it broke.
No one else was around at the time; however, my family would learn of what had happened; they would find out, that I was not following the “doctor’s orders”; and, so, again, I would forcibly “hospitalized” — to be forcibly put back on ‘meds’.
According to the psychiatrist, supposedly I was a “danger” to myself because I’d broken that window.
I was not really a danger to myself, of course.
Was I “acting out toward others”???
No one accused me of doing that, and I don’t believe I was doing that; however, I was perceived as “acting out” — not only because I’d repeatedly flushed ‘meds’ down the toilet and wound up breaking a window — but, also, because I was engaging in rather dramatic *debates* with my family (perfectly *non-violent* arguments), regarding my unyielding desires to free myself of psychiatry and its ‘meds’.
My family had come to know me by the label, which Psychiatry had dealt me two years prior; and, that label (especially, back then) implied: ‘Constant medication is vitally necessary.’
I had been passed from one psychiatrist, to the next, for a couple of years; each one simply accepted my initial so-called ‘diagnosis’ and insisted that it meant I *must* be ‘medicated’ in order to be “stabilized” and survive.
Supposedly I was afflicted with a, “serious mental illness”; my family was fully on board, with that psychiatric mythology.
Eventually (after a bit over three years and four unwanted “hospitalizations”), I realized that successfully freeing myself from psychiatry and its ‘meds’ would require distancing myself from my family, completely (at *least* for a few months).
I finally survived withdrawals without breaking any more windows; I deliberately immersed myself in daily routines, of going to work (and barely holding myself together there), then going to 12 Step meetings — and Buddhist meetings.
(At one point, I confessed to my boss, at work, what I was going through — how I’d separated myself from my family — how I was experiencing withdrawal effects; and, he kindly took me to his church pastor; he knew I was not a ‘believer’ — in any traditional sense of that word; yet, as his church was very non-traditional, his pastor’s way of counseling was quite understanding.)
I filled my days, 5 days a week, with work — and my evenings and weekends, mainly with Buddhist meetings and *many* 12 Step meetings.
Some of those 12 Step meetings were E.A. meetings (Emotions Anonymous); however, by far, the most helpful 12 Step meetings I attended were CODA meetings (Codependents Anonymous).
Always (in one way or another), *codependency* plays an huge role in the forced medicalization of a family’s identified “patient” of psychiatry; so, learning about the dynamics of codependency (and, that includes discovering how one may transcend ones tendency to feed codependent relationships) can take one a long way toward peacefully ending the kind of drama, that may well be described as “acting out” within a family system.
I offer a bit more of my experiences and observations, regarding 12 Step programs, under a recent MiA blog post by Daniel Mackler…
http://www.madinamerica.com/2013/02/components-for-a-good-neuroleptic-withdrawal-program/#comment-20756
Thanks for present me an opportunity to share all this, that I’ve shared here!
(Note: I see what I’ve shared as being directly related to the topic of Dr. Pies’s letters — especially, as it illustrates the amazingly divisive power of psychiatric labels suggesting so-called, “serious mental illness.”)
Respectfully,
~Jonah
You guys are relentless. 😉 Just sayin’! Carry on, though.. as long as you keep it reasonably cordial. 🙂
Hey Jonah, For whatever reason, the system doesn’t seem to be allowing me to respond directly to your comment, but hopefully you’ll see this. Admittedly ‘acting out toward others’ is a weak term, and I could have done better though I struggle with what exactly that is… I, too, have been a victim of people forcing things on me because of their theory that I was a ‘risk to self.’ But I hope you’ll understand that my actual point was that sometimes people really are acting violently toward others .. Now, I tend to believe they’re often doing that because of how traumatized they’ve been (including by what happened to them in the system) and/or because they’re withdrawing from medications, etc BUT the problem is it DOES happen…
And so what I really struggle with is that some of the environments we’re creating… like peer respites, etc. that work wonderfully for so many people… still might not be the right environment for everyone, and so what is? I don’t feel like we’re talking enough about what happens when someone really is in a violent place and particularly when they’re in that place because of trauma or a process of withdrawing from the ‘treatments’ of the system…
I just think that sometimes we overlook that conversation and the chasm that sometimes exists between our ‘no force’ decree (with which I very much agree) and the fact that many of our alternatives (peer respites, supportive environments outside of the system, etc.) aren’t equipped to move through a violent place with someone.
-S
Sera,
Thanks for the reply.
It’s hard for me to know how to respond, as I have no context for understanding the issue you’re raising. You know of instances in which people in peer respites have become violent???
(I have never heard of any such instance; but maybe that is because I don’t have direct contact with people involved in peer support.)
You write, “sometimes people really are acting violently toward others .. Now, I tend to believe they’re often doing that because of how traumatized they’ve been (including by what happened to them in the system) and/or because they’re withdrawing from medications, etc BUT the problem is it DOES happen…”
Sera, it seems to me virtually inevitable, that most people who are withdrawing from ‘meds’ will experience a roller-coaster of emotions (usually, for a number of months).
And, at certain points, most people who are in drug withdrawal of *any* kind will experience flashes of consuming anger (even rage).
But, who becomes violent???
It has been my second-hand ‘observation’ (i.e., what little I know from listening to others’ personal accounts) that, generally speaking, people who become violent in *institutional* settings (e.g., in so-called “psychiatric hospitals”) are those who feel trapped.
If there is coercion involved, there will be violence.
But, if one is creating a peer respite, there should be absolutely no ‘trapping’ people, ever — no coercion. (At least, that is my firm belief.)
Everyone involved must feel perfectly free to come or go, whenever s/he likes, as s/he pleases. It should be considered purely a privilege to be a member of the community.
Of course, there should be clearly articulated ‘rules of conduct’ — including, of course, a strict policy of no physical violence.
Meanwhile, I believe it would be good to provide physical outlets — e.g., treadmill, stationary bike, punching bag, etc. — for helping to ‘manage’ difficult emotions.
And, there should be a fair deal of tolerance toward verbal venting (as long as it does not amount to threats of physical violence against any person).
Make it perfectly clear, to one and all, that whoever becomes physically violent toward any person will be ejected from the program.
I’d think no one would become physically violent toward anyone, given such provisions.
I cannot imagine anyone becoming violent in a peer respite where there is no ‘trapping’ allowed — and policy, clearly articulated, of zero-tolerance for physical violence against others.
If you could, please, offer any example(s) of the kind of violence you have encountered, I would greatly appreciate it — because I am curious as to what your concerns are, exactly. What happened, in terms of violence, against others, that you know of? And/or, what incidence(s), of that kind, have you imagined happening, at worst?
Without your offering details, I truly can’t imagine…
Respectfully,
~Jonah
Jonah,
No, I am not aware of people becoming violent at respites, but I am aware of people not having access to peer respites because they have been recently violent toward others.
In general philosophy, I agree with you.. That most people people are violent out of desperation, a sense of being trapped, a sense of being attacked and needing to self defend (and many of these senses are quite accurate to what is actually happening).
The community that I most regularly operates pretty squarely in (which includes a peer respite) the philosophy that if you treat people respectfully, offer respectful and safe spaces, and have clear expectations for EVERYONE (no matter what emotional state they’re in) holds responsibility for owning and holding the values… then generally people really won’t interact in a violent way.
In our now six years of existence with four centers, lots of events and connections happening in the community, and most recently, a peer respite we’ve never really had any violent incidents to speak of. This is true even though we’ve had hundreds upon hundreds of people in varying extreme states come into our spaces in varying levels of upset.
That said, there’s at least one situation I’m aware of where we did not invite someone to come stay at our peer respite because of violent acts in another voluntary and supportive setting. (In that instance, that person was also quite recently withdrawing from heavy duty medications.) I’m also aware of people who living in community settings who have spent so many years being institutionalized that the way they continue to interact with people can very quickly have a violent edge to it. And I’ve certainly had conversations with others who have experienced similar. I’m reluctant to get more specific than that for privacy’s sake.
The point being that these instances are comparatively rare and often the outcome of treatment in a traditional system, and I could go farther than I have to critique why the things that happened that I am aware of did happen even in the absence of forced settings. (It’s also very clear to me that just because violence occurs with someone who has been diagnosed or experienced extreme state that it does NOT necessarily mean that that violence occurs BECAUSE of that diagnosis or extreme state.) However, we’d be sticking our head in the sand to say that there isn’t something real about these situations, regardless of how relatively rare they might be. And so, I feel like we need to have SOME conversation about what else we might be offering people if we want to continue saying ‘no force’ and also not turn our backs on people that often have been so hurt by the system that they need more time to find some peace.
“I just think that sometimes we overlook that conversation and the chasm that sometimes exists between our ‘no force’ decree (with which I very much agree) and the fact that many of our alternatives (peer respites, supportive environments outside of the system, etc.) aren’t equipped to move through a violent place with someone.”
Naive self-defense is what sparks most violent incidents in a forced psychiatry setting (state hospital etc.). People in extreme states who are swarmed by those wishing to carry out forced drugging often try in vain to ward off their attackers. This gets called “agitation”. It’s a completely understandable reaction to being assaulted by the staff and treated like a subhuman.
I am not against an alternative place having physical immobilization as a last resort. People in any environment have the right to defend themselves against someone INITIATING violence. The medicalization, the biologization, however, of control, is completely unacceptable. We should monitor, avoid, and only in very rare circumstances deploy physical force to defend against physical violence. Biological violence, touching the INSIDE of someone’s body, should be illegal.
Holding someone still, immobilizing the outside of their body, by touching the outside of their body, is not a human rights abuse in the context of physical violence self defense.
Raping the person’s biology with the forced administration of drugs to control them, is 10,000 times more violent than immobilizing a violent person in a non biological way, and well and truly a human rights abuse and one of the most disgusting things a human being can do to another.
I think rage-rooms, rubber bats, punching bags, and calling the cops when someone’s actively planning a crime, are fine, not ideal, but they aren’t forced drugging.
Deterrent factors, believe it or not, do work, even the most “disturbed” people soon learn in a forced psychiatry environment that resistance to their forced drugging attackers is futile. Rules and consequences for rule breaking do deter most people. Credible threats of repercussions for behavior do get through more often than not to most people.
Ideally people should have understanding, able-bodied family members willing to be them through a crisis, to take time off work, and keep the government out of it. Keep strangers out of it. People need people they know and trust around them when they are in an extreme state.
Practically anything would be better than the current situation where families just defer to “bio”psychiatry quacks and have their “loved one” shipped off to a facility for forced drugging and labeling. It’s psychiatry’s violence against millions of people it has coerced in its past and present that doesn’t get 0.000001% as much play as the violence a minority of mentally distressed people commit.
Forced psychiatry IS institutionalized violence against the people who are targeted.
Anonymous, The ‘reply’ button isn’t appearing on many comments.. not sure why, but this reply is in response to your comment.
I agree with everything you said, and certainly your assessment of the current system being a system of institutionalized violence however much people might think they’re dong things for someone’s ‘own good’… And I also agree that what you said here should be talked about and through through: “I am not against an alternative place having physical immobilization as a last resort. People in any environment have the right to defend themselves against someone INITIATING violence.”
I tend to agree that this in response to an attack is okay as a HUMAN response, but the moment it becomes written down as a part of any policy and becomes a systems response people tend to jump to it out of fear rather than reality and then – as the system does now – provoke more violence as a result.
I think part of what I’m looking for is the opportunity to have other places that can offer support to people for longer period than peer respites that aren’t typical system places, too… Soteria offers something longer, but generally geared toward people having first experiences. What about places really geared toward people withdrawing from medications, etc?
What does it all look like? That’s part of what I’m talking about.
I agree with you that ideally this would all happen in people’s own families and communities, but then there’s the reality that people either don’t have those families or those families are immersed in the same trauma and difficulties that led to the situation at hand in the first place…
There’s lots of places to look and learn… Soteria, Open Dialogue, peer respites, etc… But still more work to be done on so many levels.
-S
Sera,
Thanks very much for replying (above, April 15, 2013 at 6:13 AM).
Regarding the concerns you’re conveying, you’ve now made yourself a good deal more clear (but maybe not 100% clear?); hopefully, I’m understanding you better…
You, personally, have been involved with hundreds of people in voluntary peer respites; and, yet, you are, “not aware of people becoming violent at respites.”
Great. That’s pretty much what I’d expect; being that you are clearly a very awake/aware person, you’re setting clear boundaries, so your respites are safe-havens; I picture them voluntary ‘escapes’ from the miseries of Psychiatry, which very naturally put people on their best behavior; everyone involved is grateful to be there.
However, you are concerned in being, “aware of people not having access to peer respites because they have been recently violent toward others.”
That’s understandable — as we are referring to a population which includes many who’ve are coming directly from experiences of having been *institutionally* trapped and, most probably, abused.
[A large majority of people in institutional settings have experienced abuse, as kids; that’s widely known; but, moreover, in my view, *everyone* who has been forcibly drugged, has, thus, been abused; the forcible drugging is *extremely* abusive, whether or not the victim of such fully realizes it is; after the experience of being forcibly drugged, any failure to realize that was abuse, is merely the effect of (A) social pressures, the need to conform to the expectations of those who wield power — and (B) indoctrination/’brain-washing’ …that leads one to ‘believe’ that it was actually ‘necessary’ “medical care”; i.e., All Hail The Medical Model of Human Distress… that is instilled by Psychiatry.]
You add, “there’s at least one situation I’m aware of where we did not invite someone to come stay at our peer respite because of violent acts in another voluntary and supportive setting. (In that instance, that person was also quite recently withdrawing from heavy duty medications.) I’m also aware of people who living in community settings who have spent so many years being institutionalized that the way they continue to interact with people can very quickly have a violent edge to it. And I’ve certainly had conversations with others who have experienced similar.”
Sera, when you say some who’ve spent years institutionalized may act in a way that, “can very quickly have a violent edge to it,” I presume you mean to say their behavior often seems to have a *threatening* edge to it (not a “violent” edge to it).
Violence is violence. I would tolerate no violence in any respite; but, some people who come from institutional settings will communicate with a threatening edge. (All depends on what kind of institutional setting they are coming from. I will get to that, in a moment.)
I am careful to make a clear distinction between, on the one hand, behavior that *is violent* and, on the other hand, behavior that *seems threatening* (i.e., is potentially predictive of *possible* future violence). It’s an important distinction — which many people fail to make.
If I am understanding correctly, you have two concerns — one regarding the simple (and understandable) fact that, of course, applicants *must* be screened before being accepted into any respite; and, that screening is really about determining: Can this person be trusted, to be self-responsible? Is s/he a safe person to bring into the respite?
Some relatively small percentage of people who are withdrawing from ‘meds’ have reportedly, recently been violent; typically, such people must be rejected.
This goes back to an issue raised by Ron Pies, in his April 11 letter, to you; he writes of,
//…a broken-down “non-system” of mental health care in the U.S., which has also transformed the U.S. prison system into the nation’s largest de facto psychiatric “care” facility–as detailed in the 4/11 New York Times re: California. I was frankly surprised that this injustice was not addressed in your own letter to the Times…//
Sera, Ron Pies is a true believer in Psychiatry (with a capital “P”); I know that from reading his blogs, which is to say, I could go on for days, describing my distaste for his views, on human behavior (he essentially makes a “disease” out of every kind of suffering and/or distress); but, he raises an important issue here…
As I’m sure you realize, the U.S. imprisons far more people, per capita, than any other country; and, now, a *majority* of those people are said to have “mental health problems”.
Here is a good graph, to illustrate the fact of how many people, per capita, our country imprisons (in comparison to other countries): http://www.nationmaster.com/graph/cri_pri_per_cap-crime-prisoners-per-capita
So, it is frequently said that an *huge* percentage of people in the U.S. prison system are “mentally ill”; e.g., from a posting, in 2006, by Human Rights Watch,
“New federal statistics reveal that the number of mentally ill inmates in U.S. prisons and jails has quadrupled over the past six years, Human Rights Watch said today. More than half of all prison and state inmates now report mental health problems, including symptoms of major depression, mania and psychotic disorders, according to a just-released federal Bureau of Justice Statistics (BJS) report, Mental Health Problems of Prison and Jail Inmates.”
Note prominently, that final reference to *where* such stats are being derived; and, quite important to note, what is *not* mentioned, in that excerpt, is this fact, that: Drug and alcohol addiction are counted, in those statistics (i.e., addictions to ‘street drugs’ and/or to alcohol are counted as “mental illness”).
Our ‘mental health’ system, with Psychiatry leading the way, labels “addiction” a “mental disorder”.
This will be all the more true, come next month, with the publishing of DSM-5.
Such is Psychiatry’s way of ‘helping’ those who’ve been caught up, in our government’s long-running battle against ‘street’ drugs.
Please, excuse me now, as I may, at first, *seem* to be going off, on a tangent. (In fact, this is not at all tangential; this is going to the heart of your above-mentioned concerns, I believe. This is about why most people, on the streets, homeless, who are seemingly threatening, wind up called “mentally ill”.)
Unfortunately, for decades now, our country has been fighting a so-called “Drug War” — not only abroad, but within our own borders; major ‘drug kingpins’ are seldom captured; but, many, countless, very small time dealers, who are mainly working to support their own habits, are imprisoned — as are many people who simply were users. And, the rate of recidivism for these people is very high. (They circle in and out of prison.)
Of course, it is really a war against people of color — especially, blacks; but, many Hispanics are targeted, and other people get caught up in it, too. Mainly, people who are economically deprived.
Our prisons are teeming largely with ‘poor’ people who’ve been systematically railroaded into doing years of time for what amount to rather petty ‘drug offenses’; the result includes hard-core separation from the community, at large, once they are out… (After all, few want to deal with “ex-cons” — convicted “criminals” — “felons”; indeed, maybe that would be your concern, too – especially, if they have been violent; and, yet, with your natural sense of compassion, I’m quite sure you would be sincerely concerned for their well-being…)
Being drug and alcohol addicted, they wind up introduced to psychiatric meds — once they’ve been caught up, in the Prison System… largely because it is socially acceptable to assuage ones pain with psych-meds.
They are *praised* for accepting the ‘medical care’ of Psychiatry, *and* their sentences may be reduced if/when they agree to be “compliant patients”.
Thus, they were drug users before, and they are drug users, still; but, now they are *prescription* drug users.
*Why* were they drug users, before? …In most instances, it was because they had no real opportunity to be anything else.
Many of these people came from severely impoverished neighborhoods and most from violent home lives. The drugs assuaged the pain of a neglectful, if not also abusive, upbringing.
All that many of them have known, of self-protection (especially in prison), involves communicating in ways that *seem* — at least occasionally — *threatening*; and, occasionally, *some* of them do become violent.
Can peer respites help such people???
In my opinion, only people who can *honestly* say, “I’ve been where you are,” can help – and only after doing some significant measure of self-healing. (People with experience in ways of self-healing, from particular kinds of trauma, offer their experiences to others… That’s the way that healing from trauma happens. There are very few exceptions to this rule, in life, I believe.)
If your peer respite is run only by people like me (middle-aged, middle-class, anti-nuke, white guys, who never had any problem with ‘street drugs’ or alcohol), then your respite may not be the best place for a *supposedly* “mentally ill” person, who’s come from the Prison System — because that person will, almost certainly, be naturally edgy, in a way that seems threatening to me, never having come from the Prison System.
Though I could say more, I won’t; I will stop for now — because I feel I’ve made my primary point (which is that, basically, people can help people who’ve come before them, rising above *similar* trials and tribulations).
As I am really not at all sure that what I’m saying helps you, so I’ll stop now…
Respectfully,
~Jonah
P.S. (a few additions before finally posting) –
Sera, that 1st concern, of yours, regarded matters of screening (I believe); i.e., it seems to me, that, perhaps, you are asking for a discussion on how to draw a line between who is or is not truly threatening? I did not address you with any answer to that, directly; but, I suppose the answer is largely intuitive — such that ‘rejection’ of a person would come from an honest sense of feeling, toward an applicant, “Sorry, but no one *here* can deal with your issues, of having recently been violent.”
As for my 2 cents, on the question, of where to send such individuals…
Were I you, I would seek contacts in other healing communities, sending whoever seems prone to violence, to someone creative, in his/her vicinity, who has been trained in non-violence; also, I would do whatever I could to introduce him/her (at least, informally) to the principles of “Choice Theory”.
“Choice Theory” was developed by a very *unique* psychiatrist (William Glasser); if you don’t know of him, I suggest Googling his name and exploring his views; they are all about learning to become self-responsible and *effectively* identifying, communicating and meeting our own personal *needs*; he’s a psychiatrist who does *not* care for psych-meds (nor for psych-labels) – and, indeed, famously published a book titled, “WARNING: Psychiatry Can Be Hazardous to Your Mental Health.”
To whomever I was sending away, I would offer a message about *Mainstream* Psychiatry (i.e., *not* the psychiatry of William Glasser, but the Psychiatry of Ron Pies); I would insist it is but one ‘Way’ amongst many ‘Ways’ which one can choose to follow; and, it is a *violent* way; it imposes itself, by violence.
I would suggest s/he deliberately seek and explore *non-violent* ‘Ways’ of life…
Along those lines, as I have connections to Buddhists, dedicated to non-violence; were I in your position, I might introduce him/her to the most basic principles of Buddhism, regarding ‘right action’ – and, might seek to introduce him/her to Buddhists who’ve experienced a similar sort of upbringing, as s/he.
Thank you for bearing with me, in this long comment. Hopefully, it was not too long. This is an important conversation you’re raising, and I deeply appreciate your raising it.
I tip my hat to you, for the work you are doing. From all that you say, it’s truly excellent (and, much needed) work; hopefully, it will be emulated by many others.
Respectfully…
~J
From the work of William Glasser, M.D.:
The Ten Axioms of Choice Theory
1. The only person whose behavior we can control is our own.
2. All we can give another person is information.
3. All long-lasting psychological problems are relationship problems.
4. The problem relationship is always part of our present life.
5. What happened in the past has everything to do with what we are today, but we can only satisfy our basic needs right now and plan to continue satisfying them in the future.
6. We can only satisfy our needs by satisfying the pictures in our Quality World.
7. All we do is behave.
8. All behavior is Total Behavior and is made up of four components: acting, thinking, feeling and physiology
9. All Total Behavior is chosen, but we only have direct control over the acting and thinking components. We can only control our feeling and physiology indirectly through how we choose to act and think.
10. All Total Behavior is designated by verbs and named by the part that is the most recognizable.
Hey Jonah,
Just a quick note to say that I’ve got kids today and can’t really read and adequately take in long responses at the moment…
But did want to say I am not speaking in fear of someone coming to the peer respite that is part of the RLC and being violent… We have a process that is working for us in that regard.
What I guess I’m really saying is that I think there is need for MORE options…
It’s great if we can establish that someone isn’t a match for the respite, but when they’re not because of issues around violence, or whatever how do we NOT turn our back on them and offer ANOTHER option.
What I see happening to those people who are determined not to be a fit either because of a ‘screening process’ or because they go to a place and it doesn’t work out at the present moment is that they get filtered back into the system …
I’d like us as a community to challenge ourselves further than that and have a greater diversity of options and have some really hard conversations about how we do handle violence when it arises.
Anonymous, so well-said. I hope to god Ronald Pies is reading all of this. There is more thoughtful, coherent, & right-on-the-money education on this page than in all his years of psychiatry school. If only, if only, if only they would get their heads out of the sand and open themselves up to reading, listening, and learning what they really have to learn.
“I’d like us as a community to challenge ourselves further than that and have a greater diversity of options and have some really hard conversations about how we do handle violence when it arises.”
Sera,
What violence arises???
Still, you have offered zero examples…
You say you have heard of violence arising once.
Once, you heard of one incident of violence arising in one voluntary respite.
And, yet, apparently, you feel that cannot be discussed, out of respect for someone’s privacy.
With all due respect, I now introduce you, briefly, to the workings of my mind…
I sincerely wonder:
‘How can we possibly have these discussions which Sera is calling for??? She refers to a need for, “really hard conversations about how we do handle violence when it arises,” yet she says she has never encountered any violence — only has heard of one instance of it; and, there is zero discussion from Sera, about that incident; hence, I have no clues as to what violence she is referring to…’
Sera, I know you mean well, and I know you are a generator of truly creative discussions, so I would love to find you furthering this discussion — whether it be with myself or with others.
Hopefully, when you do further it, you will offer *examples* of whatever violence it is, which you are aiming to address.
Honestly, by this point, I am *totally* baffled, as to what is the violence you are talking about…
As you’ve mentioned, that you’re busy now, caring for kids, I pray you will *not* answer this comment until later.
:)Respectfully,
~J
Jonah,
You’re twisting my words. I am aware – fairly closely – of a recent incident of violence where people were trying to support someone to withdraw from meds and go through their process and there was violence and they felt stuck with limited options and that person ended up back in a traditional setting for lack of other apparent choices. I don’t see the need to give further detail on it. I am also aware of other people who have struggled to create opportunities outside of the system who have had issues of violence come up and felt stuck. When do they call the police or do they never? When do they self defend and what does that look like? Is it better to have people trained in self defense or just acting in human ways in the moment? When is what happens too much and the person can’t stay? I have my own thoughts on many of these questions, but not a full answer. Again, I don’t see the need to tell specific stories here.
I believe we are in agreement that violence is relatively rare in consensual, respectful settings.
I believe we are in agreement that when violence occurs in the system, it is often in settings where people are defending themselves, feeling trapped, etc.
I believe we are in agreement that fear of violence often drives people to act, and that there is often a huge gap between fear of violence and actual occurrences of it.
I believe we are in agreement that the relationship between violence and psychiatric diagnosis is a myth, and that examples of violence that are products of many other things are often used as the supposed proof of that link but it is misguided.
Here’s where we diverge.
When we create alternatives, sometimes we cross paths with violence. Why? Not because people with psychiatric diagnoses are naturally dangerous, but because people have often been institutionalized, traumatized, and treated chemically in ways that have serious impacts on who they are and how they act. (I can’t claim that these are the only reasons, but they are certainly prominent and obvious ones.)
At this point, I am seeing and hearing enough about this issue that I think it does need to be acknowledged and discussed. I feel like it’s a little too convenient for us to say ‘no force’ (which, again, I agree with), ask people to leave our communities when they cross a line (which, again, I agree with) and never bother to talk about what we actually think should happen in the gap there.
You certainly don’t need to be a part of the conversation, if you don’t want to be… But I don’t think it can be entirely ignored. You can continue to question me for specific instances of violence and act as if they don’t occur, and I will continue to agree that they are comparatively rare but relevant. The most obvious gap I feel like I am seeing is the potential need for places that offer space for longer periods of time that are built around the idea of withdrawing from medication or other longer processes. Perhaps those alternatives, properly developed, would serve to make the violence I do hear of even lesser. Who knows. I don’t. And I don’t really experience it getting discussed…
I’d like it to be… Though not particularly here, in the middle of a totally separate blog. 🙂
Thanks,
-Sera
Sera,
You begin your latest reply saying, “You’re twisting my words.”
Well, I am genuinely sorry for any way that I may have done that; certainly, I was not aware of twisting your words; and, I would not intentionally do so; I say that with all my heart and the utmost respect; for, I do not deliberately twist anyone’s words, and it’s clear that your work is quite good and important, benefitting the well-being of hundreds of psychiatric survivors (at the very least); so, I deeply wish to avoid misrepresenting you.
In fact, I feel perfectly sure that you are bound to help many thousands during the course of your lifetime, so I am humbled, even just having this brief online exchange with you.
(Note: However, because I don’t know how I twisted your words, all I am saying is that, if I did so, I regret it!)
OK…
So, now, being very careful to avoid any possibility of twisting words…
I begin anew…
Thank you, Sera, for offering a bit more of what your concerns are, as related to reported incidents of violence.
Sera, the following line, that you’ve offered me, feels somewhat hurtful: “You can continue to question me for specific instances of violence and act as if they don’t occur, and I will continue to agree that they are comparatively rare but relevant.”
Sera, quite honestly, while you say I, “act as if they don’t occur,” I must tell you, quite seriously, I am not acting, and I have no intention of denying any reality.
E.g., I would *not* “act as if” violence doesn’t occur.
I have only been — quite honestly — insisting, that: I don’t know what violence you are referring to.
About your saying, “You certainly don’t need to be a part of the conversation, if you don’t want to be…”
I would love to be a part of any serious online discussion(s) about reducing violence in the realm of Psychiatry; of course, that includes the daily violence committed by psychiatrists, by psychiatric “hospital” staff — and, no less, the occasional violence that’s committed by some so-called “patients” and former so-called “patients” of psychiatry.
Hopefully, that sort of discussion can be advanced, via this website — including through your blogging.
Indeed, the discussion is being advanced here, as you mention, “a recent incident of violence where people were trying to support someone to withdraw from meds and go through their process and there was violence and they felt stuck with limited options and that person ended up back in a traditional setting for lack of other apparent choices. I don’t see the need to give further detail on it.”
As I am typing now, writing these words, in this sentence, I am deeply *praying* that you will, please, not presume I am “acting” as if violence didn’t exist, in that instance — even as, simultaneously, I am *feeling* somewhat skeptical, wondering what exactly was constituting the reported ‘violence’ which was experienced there?
I am not meaning to imply that violence didn’t occur; I am just needing a fairly detailed description, with verbs (and, hopefully, adverbs), of that person’s observed behavior, which is being called “violent” — as well as fair details of what incident(s) apparently led to that behavior.
Please, excuse me, my need for details: this is simply how I would approach such a discussion.
As my life has been so *severely* impacted by people misjudging my behaviors (and, as I know there are countless instances in which people are falsely viewed “dangerous” by psychiatry), I don’t just take someone’s word for it, when s/he’s claiming that a “patient” of psychiatry has been “violent”.
I can’t possibly just take your word for it, that some person was violent in a voluntary setting — not because I don’t think that’s possible, but because I’d need to know what happened, before agreeing that s/he was truly violent.
Since you are wanting to protect the privacy of the individual(s) involved, in my view, what could be most helpful is if you took some time to think about what happened (as it was reported to you), then offer your own completely made-up story with what you consider to be a roughly equivalent *degree* of ‘violence’ — a fictionalized *hypothetical* situation…
Please, understand, by offering such a suggestion, I am not trying to be difficult; simply, I can’t imagine how this could become a truly productive, problem-solving discussion, without referring to *clear* specifics.
Of course, you should feel no need to reply now — nor even soon.
My way of discussing (asking for details, to address a problem, before offering a solution) may not be your way; and, for some people, it is not easy to make up hypothetical stories.
Should you be willing to offer a detailed *hypothetical* — just, please, take all the time you may need for dreaming it up.
I look forward to reading any response you may offer; but, I won’t expect one any time soon…
Very Respectfully,
~Jonah
Jonah, Okay, fair enough. I’m sorry for projecting any thoughts I may have been having about your being intentionally difficult here. 🙂 I can understand why you would feel the want to push for clarity rather than the psychiatric system’s tendency to speak about violence as if it did happen and was clearly due to the person so labeled, when so often that’s just not true or nothing actually happened at all. (I give one such example in the original text of this blog post, actually.)
That said, I really don’t want to get into details of some of the few actual situations I’ve been aware of over the years as there are too many people who would be quite familiar with them, but they are actual situations that involved people putting their hands on others in ways that have left marks, etc.
When I brought this up in a reply to another person’s comment I have to be honest that I hadn’t anticipated having the whole conversation out right here and now. I’ve mostly been fantasizing about in-person gatherings where we talk about really difficult topics like suicide and where we really stand on supporting or not supporting choice in that instance, and violence and what we support doing when it actually does happen or the options we feel are missing that are leading to it happening where it does…
I’m also open to having some of those conversations on-line, but that does feel trickier to me for a number of reasons… and especially when buried in the middle of an unrelated blog.
Perhaps there can be a new blog post on this topic where such a conversation would make more sense or perhaps there’s another place altogether?
-Sera
Sera,
Great. I quite appreciate your expressed understanding, there’s been no intent, on my part, to be difficult.
(For, really, I’m not trying to be difficult.)
Hence, from all you’ve just said (on April 15, 2013 at 1:45 pm), I feel we’re all clear.
🙂
So… Moving forward, you’re wanting to generate discussion on, “violence and what we support doing when it actually does happen or the options we feel are missing that are leading to it happening where it does…”
(To be perfectly clear, here, I’ll add, that: Presumably, you are referring, very specifically, to the possibilities of violence occurring in *voluntary* settings that are designed to help people to ‘detox’ — going through ‘withdrawals’ — from *psychiatric* drugs.)
RE your reference to, “actual situations that involved people putting their hands on others in ways that have left marks, etc.”
…Yes, that would be violence, in my view, definitely; of course, questions still arise (e.g., I think to myself, ‘There’s a difference between a small, superficial scratch that’s left by ones fingernail, as opposed to a bruise or a welt or a fingernail scratch that draws blood, etc..’); however, from what you’re saying, now, I’m inclined to feel you are, in fact, referring to some degree of violence, and I would not tolerate that in any respite setting.
You refer as well, to your desire to discuss, “really difficult topics like suicide and where we really stand on supporting or not supporting choice in that instance…”
You say, “Perhaps there can be a new blog post on this topic where such a conversation would make more sense or perhaps there’s another place altogether?”
My sense is that it would be great to encourage all such discussion, in the comments accompanying a related blog; because these matters are on your mind, and you are clearly experienced in providing peer support, I nominate you to write a blog, regarding these concerns of yours.
🙂 I think it would be great if you began a discussion, focused by a new blog post on these matters.
🙂 No need to rush it; I know you are busy with kids; but, consider yourself officially nominated because you have experience developing respites, and people respond to your blogging, and few people visit or use the MiA forums.
Respectfully,
~Jonah
“None of these issues was the focus of my Times Dialogue, which simply asserted that a psychiatric diagnosis is not, in itself, “stigmatizing” or dehumanizing; and that, when carefully and respectfully carried out, diagnosis may lead to appropriate treatment and relief of the very substantial suffering often accompanying serious mental illness.”
This statement assumes that an outside observer can really understand someone else’s internal experience. Human beings are deep. It is belittling to have someone who only observes your behaviour from the outside to go and conclude that you are deficient in, say, mood regulation.
I found it extremely insulting to be diagnosed with bipolar disorder. It did not help me understand why I was having the problems I had. All it did was tell me I had “moods” that were beyond my control, that could only be “fixed” with drugs. But really, the apparent “moods” were just the surface of much deeper issues.
For a few years, I subscribed to the medical model, and in those years, I took less responsibility for myself, lost dignity in my own eyes and others, and took on the role of permanent mental patient. I tried all the major so-called mood stabilizers and read workbooks which didn’t really explain or help me at all. In those years, I was hospitalized MORE times than before I had “insight”, and I didn’t work or go to school, had trouble thinking and feeling, and lost touch with a lot of friends.
Now, as I become stronger and live a life as a real person, not a “bipolar” person, the only way the label is useful is when I remind myself to not act in ways that make people describe me that way. I find the diagnosis profoundly insulting. I would never, ever, ever want to be called “bipolar” or to be seen as “suffering from bipolar disorder”. To me, the label makes people make unacceptable assumptions. It compromises one’s identity.
If, instead, someone had recognized that I had a problem transitioning from my childhood coping methods to the adult world, we would have made progress a lot sooner. I think that my upbringing and the perfectionism, fragility, dependence and fearfulness I developed were largely responsible for those difficult years struggling to grow into an independent life. I relate to Ty Colbert’s article, NAMI parent’s false hope, http://beyondmeds.com/2009/04/26/nami-parents-false-hope/, because I see aspects of myself in those children.
Psychiatric diagnosis never grasped the real nature of my suffering, and simply added to the burden of already feeling inferior and defective.
The “treatment” that followed the diagnosis was based on a purely mechanical model, that if we found the “right medications” I would magically be “stable” and everything would be fine. That model never panned out in practice. It only meant being drugged into an oblivious stupor and released, on multiple occasions, because of course “bipolar disorder” is “biological” and requires “medication” and “stabilization”, not love and empathy and understanding.
“Mania” is not something that happens because of life circumstances and coping, no, it’s just a malfunction, and it’s okay to drug someone into oblivion because we need to bring them down. I even had a nurse say that they hoped people would forget being injected in the hospital.
When someone has “bipolar depression”, the answer is to just stick them on antidepressants, not consider that the heavy “mood stabilizers” or “antipsychotics” are adding to the dysphoria.
Eventually I started regressing from all the trauma. I didn’t go into the system suicidal, but I started thinking about it after a few years. There just seemed no way out. I had lost all my dignity and passion in life. I lived in a hopeless, drugged fog.
Diagnosis had everything to do with my poor outcome. If “bipolar” hadn’t been slapped on me in the first place, if my breakdowns were seen as continuous with my life experience, if I’d had a counselor who could help me make some of the insights I’ve struggled to make on my own and gain responsibility for my life, I could have saved a good 8 years. Instead I almost ended up like those NAMI kids in Colbert’s article.
Excellently stated, S.A. As Lucy Johnstone argues in “Time to Abolish Psychiatric Diagnosis?” (http://www.madinamerica.com/2013/01/time-to-abolish-psychiatric-diagnosis/),
“‘Diagnosing’ someone with a devastating label such as ‘schizophrenia’ or ‘personality disorder’ is one of the most damaging things one human being can do to another.”
I.e., insulting doesn’t even begin to cover it, for many people.
She continues, “Re-defining someone’s reality for them is the most insidious and the most devastating form of power we can use. It may be done with the best of intentions, but it is wrong – scientifically, professionally, and ethically. The DSM debate presents us with a unique opportunity to put some of this right, by working with service users towards a more helpful understanding of how and why they come to experience extreme forms of emotional distress.”
Have you read Ty Colbert’s “Depression and Mania: Friends or Foes”? He is currently my favorite psychologist/mental health writer for his very simple, clear, and compassionate explanation of the issues involved in mental health: the emotional pain which overloads one’s ability to cope, and the love and care which is the only true way for people to heal from these conditions.
Thank you for sharing some of your story here, SA. A part of your story reminds me of someone who also shared with me recently that the most serious suicide attempt they ever made was directly following being released from a long-term hospitalization where he was being kept ‘safe.’ Traditional perspectives might suggest that they therefore released him too soon and he was still unsafe. However, I (and he) would argue that the ‘safe’ that they identified was only an illusion or a visual construct of concrete walls, but on an emotional level it was their actions that created the true lack of safety and led to the actions that followed.
I’ve heard it said that no one can make you feel inferior without your permission. Once upon a short while ago I used to go to my psychiatrist to label and drug me for my supposed inferiority of being genetically bipolar: a lifelong condition requiring lifelong treatment. I became very, very sick through this model.
Through a series of events that I regard as nothing short of miraculous, I got a chance to walk away from psychiatry and rewrite my life story. Dr. Pies, if you do not care for the discussions found in the MIA forums, then I would suggest that they were not written for you to reinforce your sense of self in your profession. They are written primarily by folks like me whose narratives have been dismissed by the greater society as anecdotal and inconsequential. For myself, I no longer grant a psychiatrist the authority to define me nor alter my consciousness with powerful dependency forming psychotropic drugs.
“For myself, I no longer grant a psychiatrist the authority to define me nor alter my consciousness with powerful dependency forming psychotropic drugs.”
Thanks for this Emily, it reinforces a point I’ve been trying to make, to limited success, for some time now. No doubt you had someone/s in your life that were supportive of you and cared about you. Being empowered to make decisions about your own life has to be a cornerstone to health no?
Best,
D
Nicely said, Emily. 🙂
Sera,
I really appreciate you pointing out to Dr. Pies that in further defending his initial assertions about the value of diagnosis, that his original point was pretty meaningless. He basically was saying, just from a linguistic standpoint divorced from lived social and historical context, diagnosis is not inherently stigmatizing. You can say this about anything. Without context, things don’t have meaning, thanks for that lesson, Dr. Pies. However, diagnosis exists in a particular context moderated by systemic forces that are difficult to challenge to their overt and covert penetration into our institutions, daily lives, and even subjectivities/identities, so his whole assertion does not move a discussion anywhere, just obfuscates it.
I would also entreat Dr. Pies, as it seems that many critics of contemporary psychiatry and mental health practice more broadly and psychiatrists agree that poorly informed policy and conflicts of economic interest create a context where diagnosis and treatment can be quite damaging, please rally psychiatrists to lobby agressively and for change. This is ultimately in psychiatrists interest, as given the condition of the state of psychiatric science, public trust in their competence, ethics, and knowledge is really the only thing that gives psychiatrist any meangingful healing power, and that is eroding rapidly. Whether psychiatrists like it or not, your practices and research are severely limited by state intrusion, uninformed funding priorities, and ties to some of the most reprehensibly greedy and profitable and exploitative corporations to ever exist on the planet. You are your own best advocates, and no group of anyone has more influence to do this than psychiatrists, please work with yourselves and folks you purport to want to help to make systemic changes that lead to more helpful and just care and living and limit oppression and hurt at the deepest psychical levels.
Thank you, Nathan and thanks also for reading and posting! I really like how you expand upon and explain the relative meaningless of the basic premise offered at the start of this whole dialogue.
Thank you, Sera, and Darby and Richard. This is a fascinating discussion, although reading Pies’s words is beyond depressing.
Thanks for reading, Dorothy and so glad you’ve overcome whatever technical difficulties were preventing you from posting!! 🙂
I met Matthew on Friday night and he fixed the problem. Very nice.
As someone who was diagnosed “psychotic,” and was very easily and legally declared “incompetent” for being “psychotic,” with only two colleague psychiatrists and a parent signing on the dotted line of a single piece of paper, I think of diagnosis as nothing but a weapon that was easily and effectively wielded against me. I am sure my records also say I “benefitted” from treatment, drugs chosen for me that on several occasions caused me to stop breathing. But where’s the harm in that? it’s been pointed out to me. Breathing isn’t more important than not being “psychotic.” So what is someone whose diagnosis is hurting them supposed to do? There is nothing they can do. Nothing at all. Pardon this “psychotic” for remaining anonymous.
Thank you for reading and posting, Cataract. The image of diagnosis as a weapon is powerful!
Thank you, Sera for your thoughtful and articulate communication with Dr. Pies. Psychiatry’s reaction to questioning and criticism reminds me of the responses of white people when black people challenged racism, and those of men when women began speaking out against sexism. (By the way, I am white, male and 68, so am old enough to have lived through these exciting and challenging events).
It is hard for those in power to have a clue about what they and their system look like to those who are systematically mistreated. Forceful statements from “below” are usually dismissed as extreme or abusive. The powerful try to re-cast the debate into bland terms that essentially neutralize or trivialize any criticism. Dr. Pies seems to be doing this by statements like, “the theoretical legal safeguards for those diagnosed with mental illness are not always put into practice, and that some individuals facing civil commitment are not adequately represented by legal counsel”, and by other euphemistic language – sort of like in birthing classes where “pain” is referred to as “you may experience some discomfort.”
This kind of neutering euphemism can – understandably – drive those who’ve suffered in the “mental health system” up a wall, and they express themselves even more forcefully – which then makes people like Dr. Pies dismiss their criticicism as shrill, abusive, irrational or “anti-psychiatry.”
I find it’s most effective to follow the advice I have been given – “Lose the zealotry, but keep the zeal.” When I’m tempted to just explode at psychiatry, I try to get specific and cite chapter and verse of what I have observed. I refer to my 9 years running a treatment foster care program, in which psychiatrists in prestigious institutions conducted entire med checks with their backs to their patients, or who never looked up from their lap top. I cite times when I asked meetings of foster parents how often psychiatrists explained adverse effects of psych. drugs, and received the near unanimous response, “never.” I cite times when we reviewed children’s files and found psychiatrists had changed a child’s diagnosis four times in four years, went from one med to another without knowing that previous psychiatrists had already tried and abandoned the same meds and dosages. I love how Robert Whitaker uses psychiatry’s own studies and pronouncements to expose psychiatry’s unfounded assumptions and conflicts. For instance, we should be hammering away at the use of antidepressants to prevent violence and suicide – when the FDA requires black box warnings about suicide, and clear warnings about aggression that can be caused by these drugs. The list of shooters who were on antidepressants makes this clear.
People with lived experience have a huge amount to say that everyone else needs to hear, and clearly some of that isn’t going to be pretty or polite. But I would also love to hear a lot more from those in the recovery movement – real specifics about things you have accomplished in your lives, things you are proud of, others you have helped, things that give you great pleasure, your aspirations. That’s inspiring to me, and it also counters the “mental health” system’s assumption that those in the system are fundamentally different from other people. I think what makes us all most human is our capacity to be inspired and to inspire, and the more we share those things about us with each other, the easier it becomes for people on the outside to look at ‘mental health” mistreatment and say, “Of course that shouldn’t go on.”
Thank you for reading and taking the time to respond in such detail. What you share about what you’ve observed in the past is saddening but not surprising and important to hear. I also really appreciate how you articulate the historic experiences of trying to speak about power imbalances to those with the power!
To Jonah’s point above (a good one), one of the many many advantages of not pathologizing normal human suffering and distress is that it broadens the base of who can be a “helper.”
Since all of us experience varying degrees of suffering/distress, we all have some capacity, if we choose to develop and use it, to help others.
It seems to me we will always have need of “real doctors” to ensure that real biological conditions are not the cause of a persons distress or suffering. The Wall Street Journal did a piece on this a couple years ago: http://online.wsj.com/article/SB10001424053111904480904576496271983911668.html
So how do communities begin to develop a capacity to help others who are experiencing suffering and distress? Should basic guidance like eCPR be taught more widely? Probably. Can we have community education on becoming “trauma-informed?” Should we set up support groups like Mother Bear? http://www.motherbearcan.org/index.php/aboutmbcan-1.html
You bet.
There are many discussions on MIA that help outline how we might all collectively move forward to develop caring communities of people, not “professionals.”
David
Thanks, David. All pieces of the puzzle – sharing and recognizing what has happened, establishing and strengthening the values that underlie how we want to move forward, and identifying the tools and supports to actually move are all equally important.
Dear all (who have made it this far down in the comments section of this blog),
I would like to share that – while Ronald Pies and I have had some very brief and cordial subsequent exchanges via e-mail – he has decided (at least for the time being) to retire from this exchange.
I do not know if he has read through all the comments here, but I sincerely hope that he has as many of you have share powerful stories and/or asked important questions. Please, of course, feel free to continue to use the space to do so and I will let you know if anything changes in terms of Pies’s willingness or time to participate!
Thanks,
Sera
Thanks for letting us know Sera and I am glad your exchanges with Dr. Pies have been cordial.
But based on his past history and the current tone regarding his response to you, I doubt anything is going to change with him. All you have to do is read his past blog entries in various places and it is the same old theme which I have addressed previously.
Oh, I agree, AA. I don’t think anything has shifted as a result of our conversation, which is too bad but not unexpected.
Sera,
In the fourth paragraph of his April 11 letter, Dr. Pies states that a doctor can enact an involuntary committal when he believes that “the patient represents an immediate danger to himself or others.” In Colorado, where I live, and I believe in other (perhaps all) states, there is an additional requirement; namely that the individual has a mental illness. In other words, he must have a diagnosis. For this reason, it seems to me that Dr. Pies is being less than honest in casting psychiatric diagnosis as the innocent bystander and the legal system as the villain.
Also, his insistence that psychiatric diagnosis involves more than assigning a DSM category is pedantic and unrealistic. In the past three decades, I have never encountered, or even heard of, a psychiatrist who conceptualized his initial evaluation as anything other than assigning a DSM “diagnosis” and prescribing a drug.
Very good points, Philip, and thank you for making them.
Much of the argument he makes seems a bit (and often a lot) detached from the reality of what is actually experienced.
Agreed, Sera.
Philip has raised good points, by focusing upon the fourth paragraph of Dr. Pies’s letter. In various ways, Dr. Pies is denying reality, in that paragraph.
Most grievously, Dr. Pies fails to acknowledge how easy it is to make the so-called “involuntary patient” *seem* ‘ill’ and/or ‘dangerous’ by way of heavily drugging him/her.
Dr. Pies refers to, “emergency (involuntary) hospitalization–lasting usually no longer than 48 to 72 hours – when the doctor believes that the patient represents an immediate danger to himself or others…”
Well, then, let’s consider the first hours and days of one experiment, in which Richard Bentall (Ph.D. in Experimental Psychology) and other grad students experienced the effects of so-called “antipsychotic medication”:
“…most of the healthy volunteers who took the antipsychotic became so unwell, let alone do the cognitive tests, that meant the study couldn’t continue. One psychiatrist became suicidal and had to be put under observation.”
(Source: http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10565099&pnum=0 )
Dr. Pies refers to various failings of so-called “mental health care in the U.S.” and says, “these are not failings that can be laid at the feet of psychiatrists or psychiatry.”
Like most psychiatrists, Dr. Pies deflects responsibility by insisting that psychiatrists and psychiatry is not the problem. (And, of course, it is not the *only* problem; but, it is the *main* problem, I believe — in that it forwards a *false* view of human distress, via its medical model.)
Having read through his April 11 letter a couple of times, I see no willingness, on the part of Dr. Pies, to assume any responsibility for the harms done by his profession.
Thus, as he says, “Indeed, over more than 25 years of practice, I witnessed many more patients benefit from psychiatric treatment than were harmed by it,” I seriously wonder: If he is so sure that psychiatric ‘treatment’ is primarily helpful, why is he mainly *unwilling* to engage in discussion with psychiatric survivors?
He is offended by, “vituperative character attacks against psychiatrists or psychiatry.”
(Sera, I presume you have made him aware, that the moderators at MadInAmerica(dot)com are diligently deleting any comments that contain even the least hints of personal attacks.)
Fascinating, to me, is the fact that Dr. Pies is so very concerned, about the reputation, of psychiatry; and, meanwhile, he offers no sense of realizing how victims of psychiatry are frequently crushed by the effects of being labeled by psychiatrists. (So-called “involuntary patients” are tagged by psychiatry, in ways that their reputations are essentially destroyed…)
However, I believe Dr. Pies is correct, about one thing: Enacting the initial “involuntary hospitalization” may not require the work of a psychiatrist.
State laws may vary, on this point, but in his state (New York), anyone who is alleged to be “dangerous” to himself/herself or others as a result of *presumably* being “mentally ill” can be forcibly “hospitalized” for a matter of days.
In the state of New York, “anyone alleged to be mentally ill and in need of care and treatments’ may be involuntarily hospitalized upon the application of several statutorily designated individuals. The application must be accompanied by two physician’s certificates prepared on the basis of examinations conducted not more than ten days prior to the making of the application.”
(Source: http://digitalcommons.pace.edu/cgi/viewcontent.cgi?article=1577&context=plr&sei-redir=1&referer=http%3A%2F%2F )
In fact, *quite* frequently, in the U.S., ones first official psychiatric ‘diagnosis’ (of a supposed “mental disorder”) comes days or weeks *after* the initial “involuntary hospitalization” begins.
Respectfully,
~Jonah
“character attacks against psychiatrists or psychiatry.”
What does it say about the character of anybody who would enter someone’s body against their express wishes? To strip people naked, hold them down, ignore them pleading with their attackers to stop, stabbing them with hard steel, flooding their bodies with brain disabling drugs? Traumatizing people for life?
What is the character of someone who justifies this biological violence? What is the character of someone whose BMW repayments are paid for with the screams of helpless forced drugging victims?
What came first? A centuries long record of human rights abuses against people labeled mental patients, or the people labeled mental patients responding?
Amen, Amen, Amen. Talk about blaming the victim. This has got to stop just as much as rape-victim-blaming and so many other crimes have to. It has been said before that psychiatry is a form of rape, both of the body and soul. And we are letting them get away with this with impunity, even approval – why?
While one title was “Too Much Pies,” I actually think this approach of “More Pies, Please!” may work best. Inviting psychiatrists to dialogue with survivors follows the successful model of Open Dialogue, where minds are harmonized by harmonizing social relationships. Why doesn’t this important purpose motivate him to continue working with us, even occasionally, from the comfort of our own computers? Doesn’t he have the healthy attitude that we have a productive outcome to work toward together?
Dr. Pies characterizes comments here as “insulting,” “hateful,” “personal attacks,” and “abusive.” Is that a false characterization, or why doesn’t he cite supporting evidence? Even if he thinks we might be ordered into treatment rather than convicted, does that make it healthy (or legal?) if he misrepresents this community as often “abusive”? Matthew Cohen attests MIA now has “responsive moderation.” Evidence to settle this is likely easy to obtain, as this text is probably logged in the cloud.
When psychiatrists assess unhealthy aspects of our minds, they call it healthy. Yet, when we assess unhealthy aspects of their minds and methods, do they call it abusive? Is that not an unjust, hypocritical double standard, which calls us unhealthy for the same thing they do to us?
It can be healthy to avoid disharmonious social situations. Harmonious interactions enable harmonious, healthy biorhythms. Still, the overall harmonious purpose of improving treatment and harmonizing relationships makes this opportunity for dialogue harmonious overall. When the important purpose of overall health and safety was at stake, I even put up with situations where I was often abused (called the 5-letter “b”-word, though I focus on being very kind and peaceful).
One can make it through rather gut-wrenching experiences to achieve a productive outcome, if one keeps the larger perspective focused on a higher purpose that’s beneficial overall. Surely a psychiatrist should value working through potentially emotional situations toward an overall healthy result! Here many of us are, open to bonding from the heart, with our deeply felt intentions and serious positions stated honestly upfront. So, there’s no chance of one’s heart being otherwise violated or deceived. Our heartfelt positions are as we state, so heart-to-heart connections can develop to bridge the chasm between our different experiences.
It’s probably not a bowl of cherries for any survivor to converse with psychiatrists who seem predisposed to not see the validity and importance of our viewpoints. However, it’s a very healthy purpose to work toward social harmony, which is critical to mental health. So why not even work with us in ways which respect the integrity of our knowledge that treatments could improve?
Pies may not see himself as having no stigma against us in concept, but if he won’t even interact with us, might he be seen as having a stigma against us in experience, excluding us like that? Doesn’t stigma manifest, in experience, as a lack of desire to harmoniously connect? Underlying concepts, are emotions. Left-brain capacities develop out of connections with the right-brain, emotions, and heart. The concepts in which Pies speaks should at least convey his heartfelt desire to improve treatments for those having a below-average to average experience. If he can’t enthusiastically manifest his desire for more people to experience excellent results, does his concept that most get “average” treatment belie an emotional underpinning that’s defensive of his personal career status? Is such defensiveness not overcome by a more selfless desire to serve people better, as well as possible?
People who express a desire to do better, because they care so much, are ultimately highly respected. If one doesn’t feel one would be supported/respected to admit one could do better, it may at first feel almost unbearably vulnerable to admit progress is possible. However, the strength of one’s love to serve people as well as possible results in the strongest respect. That strong love is the strongest position upon which to stand. It gives one the strongest power to sustain the social harmony and order, working lovingly for and with others. It motivates one, having put oneself publicly on the spot to serve better, to find better treatments. Those improvements bring ever more respect, because they have ever better effects – the best possible!
Without the ability to publicly express one’s emotional desire to serve better, one is never as much on the spot — in the situation where one is so strongly motivated to find the best treatments. In that case, mental care doesn’t advance as much as it could. Psychiatrists should at least tell judges the whole truth, if they’re emotionally blocked from improving care because they mistakenly think that sustaining the social order requires defending the treatments already in place, rather than championing their effective desire to continually find obviously superior advances. Do psychiatrists even tell judges the whole truth about how often their assessments are inaccurate?
Hopefully people enjoy MIA’s facebook page too, where it’s fun to be able to “like” people’s comments! And our friends can see what we say, spreading the enthusiasm for better care!
Does anyone have the recipe for humble pie?
Irene, I found your post inspiring! Perhaps what we need to do is start using the “stigma” language to insist on real dialog with the oppressive elements in the monologue, by stating that not to consider the point of view of the recipient of your ‘services’ is perhaps the essence of stigma. The “clients” or “consumers” or whatever word they want to use are categorically viewed as “different” in the sense that somehow “they” are defacto assumed to be unable to provide any legitimate feedback on the “treatment” that they are receiving. If the psychiatric labeling process isn’t inherently stigmatizing, then why are the views of this group of people, who have in common only their having been labeled by the profession, considered inherently invalid?
Thanks for providing that point of view – we have to choose not to stoop to the level of assuming ill will, but instead model what we want to experience, namely being treated as individuals of value, regardless of our views and experiences. I will definitely take this viewpoint into my next discussion with those who appear to be married to the current paradigm as a means of “reducing stigma.”
— Steve
Steve, Thanks for the positive feedback! It’s good to know when beneficial effects are occuring! If we know part of the whole truth that others haven’t recognized, I think it’s good whenever we can stand up for it! The whole truth enables justice, which works to protect people. It’s very important that the whole truth be clearly revealed in ways that people can understand and support! I believe we all have a very important and valuable life purpose. I believe we’re motivated to fulfill it through the situations we find ourselves in. When we stand up for the truth, we also stand up for others in similar situations.
@Sera
Thankyou for posting the below.
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When we create alternatives, sometimes we cross paths with violence. Why? Not because people with psychiatric diagnoses are naturally dangerous, but because people have often been institutionalized, traumatized, and treated chemically in ways that have serious impacts on who they are and how they act. (I can’t claim that these are the only reasons, but they are certainly prominent and obvious ones.)
At this point, I am seeing and hearing enough about this issue that I think it does need to be acknowledged and discussed. I feel like it’s a little too convenient for us to say ‘no force’ (which, again, I agree with), ask people to leave our communities when they cross a line (which, again, I agree with) and never bother to talk about what we actually think should happen in the gap there
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My thoughts are that to often as a community profoundly unhappy with the way mental health services respond to extreme states we sometimes try to wish away some of the complexity around the issues we are talking about.
It’s one thing to have absolute clarity in hypothetical situations and have clear red lines from the safety of our arm chairs on the internet. It’s quite another to be faced with real life complexity and difficult decisions.
As people with lived experience begin to create alternatives or work in services and encourage them to work differently we are going to have help come up with some of the answers to the difficult questions and moral dilemmas that people in crisis present society with.
For example some people when they are in crisis/spiritual emergency/experiencing a psychotic episode/lack capacity have the habit of hitting themselves full in the face and body with their fists with great force, all the while oblivious to their surroundings. Everyone is going to draw their boundaries in a different place but their comes a point when no amount of lived experience is going to inform whether or not restraint or chemical or physical is the right response when all (I do mean all) else has failed. Eventually we are all in the same boat faced with the same ethical choices irrespective of life experience or training.
My specific example might not please everyone but situations similar to this do occur and one way or another short of leaving the person to ravage themselves someone has to decide on a course of action.
I’m not suggesting I have all the answers but I do think it’s important to have these conversations along side the conversations about injustice.
Just my thoughts.
Theinarticulatepoet offers a hypothetical, explaining, “For example some people when they are in crisis/spiritual emergency/experiencing a psychotic episode/lack capacity have the habit of hitting themselves full in the face and body with their fists with great force, all the while oblivious to their surroundings. Everyone is going to draw their boundaries in a different place but their comes a point when no amount of lived experience is going to inform whether or not restraint or chemical or physical is the right response when all (I do mean all) else has failed. Eventually we are all in the same boat faced with the same ethical choices irrespective of life experience or training.”
@ Theinarticulatepoet,
My lived experience of forced drugging informs me well enough to know that I cannot condone forced drugging.
Therefore, I assure you that I have no trouble whatsoever in stating, categorically, that: I, personally, would *never* condone forcibly “medicating” such person, as you’re describing.
I deeply believe that forcibly tampering with people’s brains is *always* wrong; it is *always* a violation of ones human rights.
Meanwhile, of course, if that person wants to be “medicated,” I would be willing to support him/her in that decision — but only after doing my best to offer other, basic forms of *genuine* comfort.
Notably, in your hypothetical, you refer to, “when all (I do mean all) else has failed…”
From that point of view, I highly recommend studying the following sixteen minute Youtube video (most especially, two minutes of it, from minute 4:00, to minute 6:00):
http://www.youtube.com/watch?feature=player_embedded&v=CdCrPBqQALc
In that video (titled, “Patch Adams, M.D. – Transform 2010 – Mayo Clinic”), you will see the testimony of one doctor, whom I trust, beyond any shadow of a doubt, would *not* need to ‘medicate’ your hypothetical (or, hypotheticals) whom you’ve identified as “some people…”.
And, frankly, I don’t believe that some people behave the way you are describing unless or until they have found a very considerable *lack* of human warmth (i.e., no loving care), in their immediate surroundings. That is to say, those who behave that way are feeling isolated — even if people are around.
And, if people are around, most probably, they are utterly *incompetent* ‘carers’ — at best, responding from a place of overwhelm and fear that is devoid of understanding; at worst, those surrounding people are tormenting abusers.
Again, I highly recommend, when you have a moment, watch that Youtube, which I’ve recommended, above…
Focus on minutes 4-6.
Respectfully,
~Jonah
@Jonah
OK..well you say you wouldn’t medicate that person (just brought to a facility by a family member for the sake of argument).
I totally get that it’s against your principles. Forced medication is against mine as well. I’m not trying to play of game of holier than thou…
The situation i’m describing is one that by any stretch of the imagination or definition the person is not able to give consent…
Now if that person is beating themselves black and blue I don’t think we can call the people incompetent unless we can posit an alternative course of action.
I totally understand that a lack of human warmth may be a distinguishing feature of that persons life and certainly it is incumbent on “caring professionals” with lived experience or not to fill that gap as best they can.
Ive watched the video. If you are saying that you would cuddle the person for ten hours (as Patch said he had done in the past) then that’s fine answer.
We have something like that in the UK it’s called gentle holding. Generally it only works were the gently holder (cuddling person) is bigger and stronger. There comes a point when that’s just using force. It’s really just restraint. Pretending it’s not using force isn’t really being serious…it’s just playing with words…
I’m taking it that in this case you recommend restraint (holding/gentle or otherwise) rather than medication.
All i’m saying is that practically its one or the other in some cases.
Unless i’ve misunderstood you.
@ Theinarticulatepoet, thank you for taking the time to watch the video I recommended.
Patch Adams was inspired to become a doctor, as a direct result of experiencing, first hand, what is to be a locked up “mental patient” — “hospitalized” by psychiatrists, as a young man.
I do not know if he was forcibly drugged, but I’m sure he saw many who were — as his descriptions of that ward, which he experienced, are akin to descriptions of the ward (especially, the first ward) that I experienced…
I saw more than a few people (euphemistically called, “patients”) who were suffering terribly; one elderly lady tried to hang herself, repeatedly, by way of pulling out the full length of cloth towel, from the cloth towel dispenser — and making a noose of it.
What was wrong with her? Essentially, she was being *tortured* with psychiatric drugs; it was perfectly plain to see — by watching the way she moved (the stiffness of her body, the parched mouth, lips that could barely move to form sentences).
Most of the “patients” were on high doses of Haldol (as was she) and, thus, being tortured, chemically.
The “some people” whom you describe, in your hypothetical, could easily have been in that “hospital”.
And, I believe that anyone who comes to the point of behaving, as you’ve described “some people” do, has lived through serious abuse and neglect — such as that sort of drugging.
Psych ‘meds’ — especially neuroleptics (so-called “antipsychotics”) are a gamble, always; they can have ‘paradoxical’ effects, rapidly *creating* exactly the condition which they are supposed to be ‘treating’.
They can easily drive one mad — in the worst ways imaginable.
(What’s more, I know, from personal experience, it does *not* necessarily take high doses of psych ‘meds’ to drive one mad; some people have horrendous reactions, being driven mad, even by ‘small’ doses of neuroleptics; I know that to be a fact — because, after a couple of years, it happened to me. I know what I experienced on those drugs. I know how my mind cleared, forever, only *after* I got them fully out of my system. Thank God I have been free of psych ‘meds’ — and free of Pyschiatry — for nearly a quarter of a century!)
That elderly woman (the one who kept attempting to hang herself) needed loving care — *not* drugs.
My experiences lead me to know that forcibly drugging a person can easily amount to torture — regardless of any and all *good* intentions, on the part of those who’ve initiated that drugging.
So…
You write, “I’m taking it that in this case you recommend restraint (holding/gentle or otherwise) rather than medication.”
Absolutely correct.
Respectfully,
~Jonah
P.S. — Of course, as I wrote these following lines, about Patch Adams…
\\…Patch Adams was inspired to become a doctor, as a direct result of experiencing, first hand, what is to be a locked up “mental patient” — “hospitalized” by psychiatrists, as a young man…//
…I should have explained, that: he was inspired to become a doctor, in the hopes of one day overturning the existing System, which he’d observed, in that psych “hospital” to which he’d been subjected. He had a dream of some day putting an *end* to the extraordinary inhumanity of it.
I’m sure that is the goal we all have in mind.
It takes people with blue hair and a penchant for baggy trousers to lead the way sometimes…
I don’t doubt the sincerity….I just question the idea that restraint is somehow always a superior more ethical solution to some situations than medication.
“some people” hit themselves in the face? I’ve never heard such a situation unless the person was already provoked into such things by being locked in solitary confinement by the staff. Desperate people to desperate things. If the face-puncher is on the outside why is he choosing to punch only his own face? Did you ask him? When you saw such a person, did you ask them anything?
“The situation i’m describing is one that by any stretch of the imagination or definition the person is not able to give consent…”
What’s the protocol with people who are too drunk to consent to sex?
You don’t enter their body. What if they accidentally walk in front of a car? You might touch the outside of their body.
Blockade of brain function using forced drugging as a way of defending oneself or “protecting someone from themselves”, takes you far beyond helper and into date rapist territory.
By the way let’s not pretend the government cares in all cases if someone harms themselves or takes risks. Society has very LIMITED set of harms they will intervene upon. The face-puncher (if he exists anywhere but in solitary confinement and provocation) is allowed to commit a slow suicide with overeating, oversmoking, overdrinking, solo hiking, extreme sports, etc. etc. etc. and none of the “front line heroes” of mental health will feel entitled to chemically lobotomize him.
The human right to be free of someone forcibly messing around with your brain should apply to all humans.
If you can’t see why a world free of forced drugging would be ethically superior to a world where forced drugging is still in the “toolbox” for controlling people, then well.
I think you just defended forced drugging, using a hypothetical story about extreme human behavior.
For thousands of years human being have lived in close quarters to one another without raping brains as a method of deleting problem behavior from the scene.
Chemical restraint vs. physical restraint is about the profound violation and difference between having the outside of your body touched by others who have a reasonable right to self defense, and the profaning nature of wholesale biological violence against a person’s consciousness.
Extreme behavior is going to be responded to. It is not so much about what you would want, or your preference. If you commit a crime you could to prison OR get the death penalty needle stuck in you. That won’t be your choice. It is up to society to decide how inhumane they want to be toward people who become a problem. I would like to see a world where there is respect for the human right of people to not have their biology entered as a response, whether it be death penalty or forced drugging. There are non-invasive ways to deal with these problems.
If you’re for invasive ways of dealing with these problems… invasive forced drugging, then fine. I’m against forced drugging.
The argument from “it would cost too much” to have a less invasive system is the argument from expediency. It is an argument that says if we can just pickle a human being’s brain so they shut up and stop doing anything, and drugs are cheap, quick, and easy, we should just tranquilize people like they are zoo animals. I don’t like being treated like a zoo animal.
You may “chose acuphase or similar…until someone can come up with something better.” I want a world with choice.
@Jonah
I’m sure we have all seen countless shocking circumstances and observed painful situations, seen contemporaries die one by one and all manner of horrors.
It’s good to remember these things and remind each other of them from time to time.
Fair enough you would restrain the person with your own body for as long as it took in the hope that it would achieve the outcome you desire….
It would still be non consenting act…how ever “loving” and not one that you could be certain they would approve of.
In the real world can you say that you would be prepared to do this for every person you have ever met or seen in the street….somehow you would have to wrestle them to the floor for the “cuddle” session first for one thing…
I can’t see this working for the general population with “cuddlers” on standby at accident and emergency departments…
I feel a ten hour cuddle/restraint from Patch could also reasonably be described as torture as well…
A cuddle/restraint is just as potentially deadly if not more so in the short term….
I do respect where you are coming from but I think you are just avoiding the use of force issue…
Given the choice between Patch sitting on me (in that specific circumstance) and acuphase I would chose acuphase or similar…until someone can come up with something better.
[[personal attacks removed]]
P.S. — @ Theinarticulatepoet
Regarding that last line of yours, “Given the choice between Patch sitting on me (in that specific circumstance) and acuphase I would chose acuphase or similar…until someone can come up with something better.”
Of course, I figure you *must* be joking when you offer your reader(s) your image of Patch sitting on you.
You are joking, surely, at that point, I presume.
And, that’s fine; it’s your sense of humor; I *don’t* appreciate it — (because it seems to be humor coming at the expense of others’ sufferings) — but I accept it.
That’s just how you communicate (at least, online).
OK.
Likewise, I accept that you can imagine hypothetical situations in which *you* would choose to be shot up, with acuphase.
I can accept that, it’s possible for you to picture yourself wanting that “medical” treatment…
But, what’s really curious to me is how your mind works, beyond that point…
How do your decisions, regarding your potential choice, wind up steamrollering the realities of sufferings which such a drug has caused me? How does your choice wind up translating itself, in your mind, to a choice that (apparently) you would consider *imposing* upon me, against my will (and/or, …upon anyone else who, like me, prefers to say “No!” to acuphase)???
I wonder: is it possible for you to simply respect my right (and, anyone else’s right) to say, once and for all, a forever “No!” to acuphase and to other psychopharmaceuticals???
Thank you for bringing up the subjective experience of neuroleptic torture, Jonah. I, too, have felt this awful experience Bentall describes, as if being completely shut down but completely in despair, and it is a waking torture. It is the most awful feeling in the world. You’re right, no one describes akathisia properly. They don’t get it at all.
Having Patch Adams cuddle (and presumably talk with me) for 10 hours to give me love and care would be far, far better than any drug torture. The first time I was hospitalized, I was very open and emotionally vulnerable, and if anyone had come along and really gotten through to me with hugs and conversation, my tears would have flowed and I could have had a transformative experience. Instead, I was tricked into a little observation room, where I was locked in like an animal.
When I asked to leave, they didn’t let me. So I became more and more worked up. This led to them forcing drugs on me. When I wouldn’t take the pills, they held me down and gave me a needle. It was terrifying. Their logic was that I was “manic” and “psychotic”. Such violations are carried out under the guise of “calming” and “stabilizing”, even “treating”.
When you’ve been through them two, three, four or more times, you become severely traumatized. Then you start to lash out sometimes, during your breakdowns. My first few “psychotic” experiences were quite joyful. After that I started getting angry when I broke down. I even started talking about suicide where I hadn’t before. The existing emotional problems were compounded by the trauma of having been repeatedly violated by the system.
I don’t believe violence arises in a vacuum. The sensitive, vulnerable human being is hurt, is broken, and sometimes the result is lashing out. But responding to this with even more violence – what does it do to help the situation? You end up creating an even more angry, violent psychiatric patient, who takes it out on themselves if not others. I think this, combined with the effects of neuroleptics and other drugs, causes some people to commit suicide. Others somehow manage to stay “stabilized” by being on such high doses of drugs that they stay permanently numbed and docile.
Perhaps “joyful” isn’t quite the word to describe my first few experiences of what got called “psychosis”. They were attempts at spiritual journeys, at solving difficult emotional problems through a metaphorical quest. Probably an avoidance of pain and grieving, hoping to magically solve problems instead of descending into dark feelings. But nonetheless, they had a purity that none of my later “episodes” had, and I think that was largely due to the traumatizing experiences in the mental health system. I was by that time behaving much more like they expected for my diagnosis, more self-destructive. It didn’t help that the drugs were making me feel awful. Far from curbing violent tendencies, the whole situation was setting me up to become permanently dysfunctional.
@ S.A.,
Thanks for sharing your experiences and observations. You say much with relatively few words — which is a skill I’ve yet to master; I shall, here, attempt to emulate your brevity, by cutting to the chase, addressing something bothering me about your comment (directly above); it is all good, until the very end, as you write, “Far from curbing violent tendencies, the whole situation was setting me up to become permanently dysfunctional.”
I think I know what you’re aiming to say there…
From all you explain, in your comments, on this page, it’s clear you *extracted* yourself from that situation, so you’re *not* meaning to say that you now have violent tendencies and are permanently dysfunctional, yet it almost seems you’re saying that, in your last line, because of the way it’s worded…
So, hopefully, you won’t mind my offering a few *brief* lines — additionally — to relay a bit of what I know about my situation, which I feel may be fitting, toward describing yours, too, by this point.
(At least, I think maybe these lines are fitting for you — as I read further details, regarding your experiences, in your first comment, on this page, to Sera, as well.)
And, OK, here goes (you can repeat after me — *only* if you like what you hear and can apply it to yourself):
Through my great fortune, of finding that growing glimmer, of insight, which is necessary, to free oneself from the forcibly embedded illusions of psychiatry’s medical model, I let go of an utterly bogus ‘diagnosis’ and its standard (horrible) ‘prognosis’; only with that gift of true vision could I forever *reject* a life-denying, daily regimen of ‘meds’ — which, had I not rejected it, would have left me permanently dysfunctional.
Fortunately (for reasons unique to each individual), you and I and a growing number of others do see completely through — and rise entirely above — *all* psychiatric flimflammery…
Evermore grateful to be one such person now finding kindred spirits, online — I am finally off to sleep for the night…
🙂 Respectfully,
~Jonah
====
From all you explain, in your comments, on this page, it’s clear you *extracted* yourself from that situation, so you’re *not* meaning to say that you now have violent tendencies and are permanently dysfunctional, yet it almost seems you’re saying that, in your last line, because of the way it’s worded…
====
Jonah, what I meant was that there was a time, a period of a few years where it looked like I was headed down that path permanently.
Extracting myself from it was not as simple as having insight that psychiatric diagnosis and treatment was bogus.
I never agreed with being labeled or drugged. For the first 4-5 years of my diagnosis, I was put in the hospital against my will every 1-2 years, and would promptly stop taking drugs and get back to my life when I got out. I thought it was horrible and abusive what happened to me. I managed to live my life most of the time, more than in the years that followed.
In 2006, a doctor kept me in the hospital for so long and drugged me so heavily that he broke me. It was only at that point that I started truly believing I was ‘mentally ill’.
But being broken in that way was profoundly damaging, and coupled with the heavy drugs I was on and the experience of ending up on social assistance, it was almost too much for me. I regressed to the point where I had few friends, no interests, didn’t work or volunteer or anything. During that time I started feeling like I was doomed to not have a life at all. I was on the path to lifelong dysfunction.
Getting free of all that meant having a series of insights, not so much about psychiatry (which I’d always thought was garbage, before they broke me), but about myself, my feelings, my behaviour. And also, I had a good environment, with a supportive partner who, while he had gone to a judge a few times when things were really out there with me, was not quick to do such things, and had the respect and patience for me to sit and listen and encourage me in life even when I was lowering the drugs. If I hadn’t been in such a supportive atmosphere, combined with the insights I reached that allowed me to prove to people that I could stay out of the hospital, I could still be a zombie. So it wasn’t just saying ‘no’ to psychiatry (I had trying doing that over and over for years and ending up in psych wards involuntarily), but also proving that I was capable of controlling my own behaviour.
It helped to start seeing what was happening to me as a form of punishment for breaking unwritten social rules, and that the way out of being tortured by drugs was to prove I could behave properly with less of them. A pretty degrading situation, but nonetheless where I found myself.
Unfortunately, a lot of people are never given the “dignity of risk” to choose to lower drugs and prove they can follow social norms. I could never phrase it as “coming off meds”, it always had to be “lowering” them to be more functional. I’m not entirely off them yet (down to 100 mg Seroquel and no other drugs), but they are well below the lobotomy threshold.
“Getting free of all that meant having a series of insights, not so much about psychiatry (which I’d always thought was garbage, before they broke me), but about myself, my feelings, my behaviour.”
I sense you have a real sense of personal responsibility about helping yourself. I love seeing stuff like this. Congratulations on getting free and crafting for yourself, a solid foundation on which to live your life.
You gave yourself the dignity of risk and it sounds like your partner did too. That’s a beautiful story.
@ S.A.,
Thank you so much for sharing more of your personal journey.
Reading each of your comments, on this page, offers yet more understanding, of where you have been — and how far you have come.
It is very gratifying to read your words; and, really, I am somewhat at a loss of words, feeling I cannot *adequately* convey my appreciation, so I will say, first and foremost, that: I agree *entirely* with the responding remarks of -Anonymous; i.e., he has expressed my sentiments exactly (on April 16, 2013 at 12:38 pm).
Personal responsibility *is* key.
Recounting the events which led to my ‘introduction’ to Psychiatry, I see (and do aim to readily admit) that I had scared my family and friends, by suddenly breaking a bunch of dishes; though scaring them was not my intent, it was the effect of my chosen behavior, my *decision* to ‘act out’ unexpectedly.
(I.e., smashing the dishes was unexpected in the eyes of my family and friends, but it was ‘premeditated’ by me; the only problem was, I did not properly envision, in advance, the results it would yield.)
You speak of “dignity of risk” …yes.
In fact, it is very well-known that teenagers are generally prone to taking risks, that their parents find troubling.
I had taken certain risks, as a teen — but only outside the view of my parents.
Unlike my siblings, I had never before ‘rebelled’ against my parents (who, very important to note, were *never* abusive toward us).
In any case, quite simply, teens *should* act out, in ways; it’s quite natural and necessary for them to do so; meanwhile, I had assumed this ‘role’ of being the ‘good son,’ the ‘easy kid,’ and I was feeling a need to break out of that role.
My decision to, all of sudden, act ‘impulsively’ led to *much* instantaneous reactivity, within my family system; my being *seemingly* ‘crazy’ (as I smashed a bunch of dishes against my parents’ garage door) was actually my fault.
I know that some people wind up seeming ‘crazy’ in ways that they did *not* consciously choose; i.e., they ‘act out’ truly unexpectedly — even in their own eyes; they are overtaken by impulses, which they had not foreseen.
But, I believe that there is much more deliberate choice in most ‘crazy’ acts, than people will typically care to admit.
So, I take responsibility for having wound up involved with psychiatry — even though I (like you) was always a skeptic of psychiatry.
That is to say, I do not blame my family and friends, at all, for pressuring me into an E.R., where I’d be introduced to medical-coercion.
They felt they were protecting me, by doing so…
However, I have observed some people choosing to assume responsibility for the deeds of their victimizers.
That is going too far, I believe.
In fact, because there is such an overwhelming power differential between psychiatric so-called “involuntary patients” and their captors, it may be difficult (but important) to sort out who is truly responsible for all the *many* damages that typically are incurred, when one who is ‘acting out’ falls into the grip of the Psychiatric System.
Really, there is far more power granted to psychiatrists than to prison wardens — considering their power to drug people into submission.
In my view, the main problem there is that most people don’t see through the illusions of psychiatry’s medical model.
Respectfully,
~Jonah
P.S. — I am reworking my earlier post (of April 15, 2013 at 10:28 pm), which was removed. I will re-post it (somewhat modified) at the bottom of the page.
Indeed, any further comments in this conversation may need to be posted at the bottom of the page, as I believe we may be running out of reply buttons up here…
He still sounds like he’s writing from a position of power and privilege that kind of sets my teeth on edge. I don’t think he really gets it.
@Stephen
What would you do then?
A young woman brought by her family to a mental health facility unable to give consent as they temporarily lack capacity who is beating themselves with some force alternately in the face and other body parts. Otherwise they are doing nothing else.
No amount of getting close or gentle touching to get them to acknowledge you is making any difference. They are sitting apparently oblivious to their surrounding and occasionally hitting themselves with considerable force.
It’s physical restraint or chemicals. Unless you can come up with a magic third way its one or the other.
What course of action do you recommend?
Your Jack Bauer ticking time-bomb esque extreme thought experiments are the sorts of “ammunition” thrown at opponents of forced drugging all the time.
http://en.wikipedia.org/wiki/Ticking_time_bomb_scenario
“Others point out that the ticking-bomb torture proponents adopt an extremely short-term view, which impoverishes their consequentialism. Using torture—or even declaring that one is prepared to accept its use—makes other groups of people much more likely to use torture themselves in the long run. The consequence is likely to be a long-term increase in violence. This long-term effect is so serious that the person making the torture decision cannot possibly (according to this argument) make a reasonable estimate of its results. Thus the decision-maker has no grounds for certainty that the value of the lives saved from the ticking bomb will outweigh the value of the lives lost because of the subsequent disorder. She or he cannot arrive at a successful accounting of consequences.”
Just like ticking time bomb justifications of torture, justifying forced drugging any circumstance sends the message to others that forced drugging is acceptable and increases use of forced drugging.
You assume a psychiatric facility is the best place for a family to take the young woman. This assumes a society in which families are taught to seek out psychiatry in times of crisis.
You assume that a conscious person is “unable to give consent” when we know that is just mainstream psychiatry speak for a conscious person being treated as though they are unconscious.
You assume that people would be in their own home “beating themselves in the face”. Did they stop beating themselves in the face to put on clothes and shower that day? Do they cease beating themselves in the face to go to the bathroom? That they would come with their family in a vehicle to a facility, no doubt “beating themselves in the face” the whole ride… walk lockstep with their family into the facility “beating themselves in the face”.
This utterly ridiculous story is the basis upon which you justify forced drugging laws that apply to everybody?
http://en.wikipedia.org/wiki/Hard_cases_make_bad_law
Do they stop beating themselves in the face when they are eating? Drinking? And if they do find the bathroom and some food and drink, how are they “oblivious to their surroundings”?
And if they have been without nutrition for days how do they have the energy to continue punching themselves in the face?
How do they remember where their face is but forget they need to eat?
How do they remember how to make a fist?
If getting close and gentle touching is making “no difference” how would restraint be resisted?
What I was pointing out is that the man still seems to be seeing everything from his privileged place as a white, upper class, male. He has blinders on fashioned from his position of power afforded him by his title and his white coat and diploma. He refuses to bring himself down to a more mutual position with those he’s making statements about.
I was not commenting on what should be, or should not be done. I was commenting on how he’s blinded by his privilege and power from seeing anything other than from his particular viewpoint. Proclamations made from positioins of power and provilege are not hel0pful to any discussion.
@Jonah
You wrote: “I wonder: is it possible for you to simply respect my right (and, anyone else’s right) to say, once and for all, a forever “No!” to acuphase and to other psychopharmaceuticals???”
Of course. Yes.
However in making your choice for someone else, you have imo massively underestimated the seriousness of restraining anyone. Physical restraint is as serious a violation of the self, every bit as potentially lethal as the administration of medication. It’s nothing to be done lightly. People die all the time following a period of being restrained. You seem to want to ignore this.
The other point that you might not taken into consideration is that being restrained by Patch may be culturally inappropriate for the person under consideration. As they are not in a position to give consent to either option this has to be given serious thought as well. This is even before we get on to the appropriateness of a female being restrained for ten hours by a much older man.
Another element that hasn’t been mentioned is that which ever course of action might be taken it needs to be made by a team. I get the feeling that the Patch “hospital” is probably run along the lines of a dictatorship. I don’t imagine staff who challenge Patch last long.
I think that for a floridly psychotic young woman it should be taken into account that being restrained by Patch dressed as CoCo The Clown for ten hours could be quite distressing….actually I’m fairly convinced that it could take quite a bit of getting over. Especially if the young woman put up any sort of resistance that Patch had to subdue with his “cuddle”.
Of course Patch is a family doctor so I don’t suppose he has had occasion to try out his cuddle technique on mental distressed people who just happen to live temporarily in prison. I’m going to go out on a limb and suggest he might come unstuck….
You’ve offered no justification for invasive molecular violence against a person’s brain function here. What can be achieved with as little invasiveness as possible, should be achieved with as little invasiveness as possible.
Touching the outside of someone’s body, while potentiality dangerous and potentially unpleasant, is in no way directly comparable to an invasive intervention upon brain function such as forced drugging. It’s like the difference between handcuffs and a taser straight to the heart. Night and day. And policing was carried out without “electroshock compliance devices” for a long time without recourse to such invasiveness in unarmed confrontations.
Putting a convicted spree killer in a cell until he dies, is less invasive and against human dignity than injecting his biology with chemicals designed to stop his heart and kill him.
If something can be done with as light a touch on the fundamentals of human dignity as possible, it should be.
Jonah would never ignore the many unsung killings of “patients” due to restraint in psychiatric facilities. In fact, by calling for the abolition of forced drugging, if he got his wish, the vast majority of restraint situations would disappear overnight. Because restraining people in preparation for forced injections is the primary use of restraint.
How this Mr. Pies thread turned into a restraint debate is beyond me.
I’ll give you one thing, I did smile at the imagery of a guy in a clown wig and red nose restraining someone. Let’s hope he wasn’t in full get-up. And I do agree “cuddling” is a BS term for restraint. The human right to freedom of movement is an important human right, but lower on the ladder than the human right to bodily integrity. Losing the right to bodily integrity is the wholesale smashing of human dignity.
I don’t think there is any evidence to be impugning Patch Adams as a dictator who fires staff.
You began your post with “However in making your choice for someone else”. Opponents of a system that denies choice are not making a choice for someone else.
Opponents of forced drugging would like to take away the government’s power to deny people a choice. In such a world, if you’d like to choose to take psychiatric drugs, none of the opponents of forced drugging would be standing in your way. Asking us to have our freedom and our right to own our bodies pooled with a group of people who don’t seem to mind having their to own their bodies stripped from them at a moment’s notice, is a bridge too far. Anybody who expects psychiatric survivors to accept lesser protection on their own bodies from government invasion just so those who find government invasion “good” can rapidly get their body invaded, are asking for all of our bodies to become a commons.
I will never accept being put at risk of sudden death by forced drugging, long term disablement by forced drugging, further traumatization by forced drugging, living in fear of forced drugging, just because some stranger prefers the thought of psychiatrists making a decision for them during a crisis.
If you’re into “acuphase” buy some and take it. If you want to go about your life with a safety net of coercive legal structures that make it possible for government to force acuphase into everyone else’s body, as reassuring as that might seem to fan of acuphase, feeling “safe” about the knowledge that come what may, acuphase is going to get dumped into YOUR brain, as much as I’d love to help you out, as much as I believe in your right to get whatever “treatment” you want, reserving the right to get treatment you DON’T ask for, unfortunately comes at too great a cost to me. You see, my body has to be as easily enterable as you’d like yours to be, for such a situation to exist.
People with psychiatric labels who are for forced psychiatry, can’t avoid forcibly pooling their bodily freedom with the millions of other people whose bodies have been entered by force. A military draft is some pretty serious stuff because your body and life are being put in harm’s way against your will. I consider it to be the case that my body was drafted into the pool of bodies forcibly meddled with by psychiatry. I believe this is an atrocious situation.
While fighting for your nation in a war might be an act of extreme sacrifice, I am simply unwilling to pay the price in risk that forced drugging advocates are demanding I pay by keeping my body in constant legal jeopardy. This price, is higher than any monetary amount I could ever dream of, this price, and I simply cannot say to myself “oh, it’s a small price to pay, living in constant terror of forced psychiatry, facing the potentiality of death, maiming, brain damage, so long as some stranger elsewhere in society can get his acuphase even if he hasn’t asked for it”.
Some people with psychiatric labels don’t mind being on a short leash. It’s simply indecent to externalize the costs of the provision of that short leash to others. People actually had to be killed by forced psychiatry for it to be the case that someone can pick up the phone, call 9/11, and have someone carted off to be tranquilized like a zoo animal. Very few apologists of forced drugging think about the collateral damage that ensues when they see their own legal rights as pesky “barriers to treatment”.
Pro-choice activists in the abortion debate have a slogan “If you are against abortion don’t have one”. There is another slogan “If you are against gay marriage then don’t marry a gay person”.
Nobody can say to an opponent of forced drugging “If you are against forced drugging don’t get forcibly drugged”.
@-
You wrote:
Nobody can say to an opponent of forced drugging “If you are against forced drugging don’t get forcibly drugged”.
True, but that is not the situation. It’s a choice between administering medication without consent and using force without consent.
Ignoring the distinction between what you wrote and the actual choice I have posited above doesn’t make the distinction go away.
Flooding the conversation with invective doesn’t obscure the challenge of deciding what the best course of action is when someone lacks capacity.
No one makes a choice to lack capacity which is why the challenge to respond in the most humane way possible exists in the first place.
So called “capacity” is a medico-legal judgment. We live in a world where it assumed people labeled “competent” would have no problem accepting psychiatry’s drugs.
Capacity is not even an objective fact, yet you act like it is. It is a subjective judgment imposed on a conscious person, and in practice amounts to millions of people having their clearly articulated “NO” steamrolled by people who think they know better than them.
Nobody chooses to be in a situation where violent thugs are overriding their express wishes in relation to the content of their own biology.
Deciding what the best course of action is, is simple. You listen to their wishes. If you feel you must intervene, you don’t enter their body.
@-Anonymous
That is incorrect. The fact that the person is hitting themselves is objective. That they don’t respond is objective. They have been brought to the facility by people who know them well.
Capacity isn’t just a medico legal term, it is also an easily understandable concept. Sometime people have capacity and sometimes they don’t. The extent of capacity may well be a theoretically subjective judgement. However the situation is concrete and what is happening is real. You have a real choice to make.
When you chose to do nothing you are still basing that on a subjective judgement as well.
Real life demands we make subjective judgements all the time because we can’t tell the future.
So you are still just not taking any responsibility and nothing about the subjectivity of a capacity assessment makes doing nothing any more ethical.
Here, here. Frankly, @Theinarticulatepoet & @-Anonymous, I concur with everything -Anonymous says on April 16, 2013 at 2:29 pm.
These matter-of-fact, seemingly ‘authoritative’ references to instances of people who are *supposedly* “lack capacity” is something I’ve encountered *countless* times, on the Internet.
In particular, time and again, when speaking to people who support Psychiatry in the U.K….
There is this notion, that people are or are not ‘capacitous’; that’s an utterly *bogus* dichotomy, in my humble opinion…
It is a dichotomy that makes no sense, mainly because it would apparently negate the validity of all choices that person would currently make (and, really, it is pure B.S. to think that any conscious person can somehow become utterly *incapable* of making *any* good choices).
The key to encouraging a semblance of ‘good mental health’ is encouraging people to make healthy choices; and, one will not be encouraged to do that, by anyone who is calling him/her “incapacitous” (a.k.a., “lacking capacity”).
All people can be shown to be more or less “lacking capacity” — in various ways, at various points, in their lives.
No is ever completely “lacking capacity” — unless or until s/he is rendered fully unconscious.
The ones who get officially deemed “incapacitous” are merely succumbing to the Power of Psychiatry, which strips a person of the ability to be in the driver’s seat of his/her own life; at that point, any choices made by him/her (i.e., while being a coerced “patient” of Psychiatry), must be ratified by the so-called ‘mental health’ System (which is dominated by Psychiatry).
My conclusion is this: Address people who are confirmed to be in their right minds (i.e., people ostensibly confirmed ‘capacitous’ by agreement of respected, ‘authoritative’ professionals, in the realm of psychology); lend them an opportunity to sign carefully worded advance directives — (a ‘Living Will’ and/or ‘Psychiatric Will’) — which clearly explains their desires for *how* they should be ‘treated’ in the event that they might, unfortunately, be declared, as, “lacking capacity.”
E.g., in the advance directive, there could be a check box, next to a brief statement, declaring: “I do not ever want to be ‘treated’ with neuroleptic drugs.”
I am sincerely wondering why this solution is not frequently discussed in discussions, such as this one.
Respectfully,
~Jonah
“People die all the time following a period of being restrained. You seem to want to ignore this.”
@ Theinarticulatepoet,
You think people were unwillingly held by Patch Adams?
You think they were ‘restrained’ by Patch Adams, in the sense of having had their lives endangered? Really?
Are you serious?
You think people could have died, as a result of being held by Patch Adams? (I find this to be an absurdity.)
I referred you to a video, of a talk given by Patch Adams, M.D. — asking you to, please, focus on minutes 4-6.
Your responses, regarding Patch, compute with nothing I’m seeing when I watch that video — nor with anything that I know of Patch Adams, from any other source.
You say, “the Patch “hospital” is probably run along the lines of a dictatorship.”
How can you say that, I wonder?
You see Patch as a medical dictator???
In my view, that is exactly what medical-coercive Psychiatry offers us (thousands of dictators, called psychiatrists).
I see Patch as *opposing* the dictators in the medical world, opposing their hierarchies (and, that certainly includes opposing the faux-medical ‘care’ of medical-coercive psychiatry).
Those services he describes having offered were free and uncoerced.
They were *not* government directed services.
Surely, if anyone had ever been held against their will by Patch, they could have sought help from the local authorities.
But, in fact, no way will I buy into your view of Patch (which amounts to baseless speculation, as far as I can tell) — because there is not even a scintilla of evidence, that what you are saying about him is true.
Google around on the Net. Look for such complaints against Patch. You won’t find any.
Why is that? Is it because Patch has full power over how he is portrayed, on the Net???
In those couple of minutes of video, which I suggested you should focus upon, Patch describes having worked with thousands of people who, he explains, came to him in the midst of suffering what he called “profound mental illness”; I am no fan of the concept of ‘mental illness,’ but I suppose those people were suffering in profound ways, which psychiatrists would have called “mental illness” (he does refer to “schizophrenia” — another label I could just as well do with out), and never did he prescribe *any* drugs for such sufferings.
I can’t help but wonder if *that* isn’t your foremost complaint against Patch?
This is not to say I wish to deny you or anyone else access to psych-‘meds’ — ever.
I am simply seeing a pattern in these conversations: there are those (such as I) who wish to be cared for, *without* psych-‘meds’ …Indeed, we hope to protect each other against the forced impositions of such “medications”; and, you seem as though hoping to convince the world that we are somehow wrong for taking up such a cause, amongst ourselves.
Or, do I simply misunderstand you?
Respectfully,
~Jonah
Jonah,
“You see Patch as a medical dictator???
In my view, that is exactly what medical-coercive Psychiatry offers us (thousands of dictators, called psychiatrists).”
Don’t forget psychiatry’s version of “nurses”, and social workers, too. It is bizarre, I dare say to call a doctor who who only engages in consensual relations, like Patch, a “dictator”.
@-Anonymous
Ok. First this isn’t a terribly unusual scenario. That you posit that it is suggests a paucity of experience of situations similar to this.
Secondly it’s nothing like a ticking time bomb because you have the person in front of you hitting themselves.
You can inject all the invective you like but I would suggest that perhaps what you really don’t like is that the situation doesn’t fit into the simple narrative that drugs are always evil.
I agree that traditional mental health services use restraint, chemical and physical, to often and to soon. However both carry risks, physical and psychological and situations do occur when it is a choice between one or the other.
Below is a link to the UK Independent Panel on deaths in Custody
http://iapdeathsincustody.independent.gov.uk/work-of-the-iap/working-groups/use-of-restraint/
Given the number of deaths that occur during and following restraint trying to pretend that restraint is risk free isn’t imo taking the problem seriously. That’s even before getting into the even trickier area of solutions that take into account gender and cultural appropriateness, both of which you studiously ignore.
Because you hold the position that the administration of medication should be a “never” event doesn’t entitle you to claim the moral high ground. Quite the reverse.
Taking options off the table is ceding the moral high ground if anything imo. And taking options off the table for other people certainly does.
So far you have chosen the do nothing option and the person is still hitting themselves. Doing nothing isn’t ethical it is just abrogating responsibility.
@ Theinarticulatepoet,
You write, “I would suggest that perhaps what you really don’t like is that the situation doesn’t fit into the simple narrative that drugs are always evil.”
Question: Is -Anonymous saying that drugs are always evil???
If so, then *where* is he saying that???
(I.e., please direct us to any comment, by -Anonymous, where he says that, and/or offer the remarks where he says it.)
I don’t see him saying that — at all — anywhere.
Nor is he implying it — as far as I can tell.
Respectfully,
~Jonah
@Jonah
I wrote “I suggest” that means I am suggesting. If that is not what they are suggesting then anon can say so.
“You can inject all the invective you like but I would suggest that perhaps what you really don’t like is that the situation doesn’t fit into the simple narrative that drugs are always evil.”
You can use the word “invective” twice, I don’t see where it was. Please cite the invective. What I really don’t like, is living in fear of forced drugging laws.
“Secondly it’s nothing like a ticking time bomb because you have the person in front of you hitting themselves.”
Oh so the person isn’t in danger of injuring themselves too badly then?
Involuntary labor relations, involuntary sexual relations, involuntary psychiatry relations, are always evil. You can call basic human rights for all humans a “simple narrative” all you like. Some things in morality are that simple. Either you are a slave, or you are free.
“Given the number of deaths that occur during and following restraint trying to pretend that restraint is risk free isn’t imo taking the problem seriously. That’s even before getting into the even trickier area of solutions that take into account gender and cultural appropriateness, both of which you studiously ignore.”
Like I said, most restraints happen because a psychiatric staffer has decided someone will be subjected to forced drugging. I acknowledge these deaths, mourn them, and how you got to “pretending restrain is risk free” is anybody’s guess. I have talked about the risk of restraint, in several other comments. I know that many deaths from restraint would be prevented had thugs in mental hospitals not got it in their heads that after someone saying no to pills, they had the right to restrain and inject. You want invective? You’ve accused Patch Adams of being a dictator in this thread, you’ve accused me of “studiously ignoring” something I merely ignored.
You bring up the “cultural appropriateness” (whatever that means) of restraint. You bring up gender relations in relation to your ethics of protecting people from themselves. You bring this up seemingly in contrast to forced drugging, a procedure that requires forced nakedness! Every day, women are stripped butt naked by male psychiatric nurse thugs and injected, yet you want Jonah and I to formulate some cultural sensitivity panel and if we ignore you its a “studious” ignoring? I don’t think so. You were the one who posed Patch Adams holding a woman. Is that worse than male psych “nurses” stripping a woman of her pants and injecting her in the buttocks with brain disabling drugs?
“So far you have chosen the do nothing option and the person is still hitting themselves. Doing nothing isn’t ethical it is just abrogating responsibility.”
Forced drugging isn’t ethical. Nobody has a “responsibility” to invasively blockade someone’s neurotransmission. Especially no quack who doesn’t even demonstrate disease of neurotranmission. I already chose an option, if you believe in the government having a self-harm prevention squad of some description, I said don’t enter their body, touch the outside of it if you feel you must.
Or there’s the culturally sensitive gender sensitive swarming by syringe wielding attackers, and the forced disrobing, of forced drugging.
“Taking options off the table is ceding the moral high ground if anything imo. And taking options off the table for other people certainly does.”
I had no idea, opponents of forced drugging LAWS are just taking an “option” off the table for “other people” according to you. Reminds me of those pesky opponents of China’s One Child Policy who are taking the “option off the table” for those Chinese who might like to be coerced into only having child. There is no scenario under which forced drugging is not a human rights violation.
I think our conversation is permanently done.
@-Anonymous
Fine. You don’t have an answer for the person hitting themselves then. Walk away.
If you can’t address the distinction between medicating/drugging with out consent and medicating and drugging by force a person with capacity then I can see why you don’t want to continue. The latter I agree with you about. The former you don’t want to talk about…..
You have argued yourself into a corner with the best of intentions but a corner none the less that you can’t find a way out of. imo
Jonah has decided to recommend restraint. I’m reluctantly recommending medication. You on the other hand are taking the easy option and walking away. That I would suggest is arguably the most immoral of all actions.
I do wonder how you would explain this inaction to the young womans family who came to you asking for help? Something about subjectivity?? They would just take her somewhere else….
Although I can’t see many people being so cruel imo as to allow that to happen….
Just how I see it…
Can I just paste what I already said, when I sided with restraint? Do you not even read what I said?
““So far you have chosen the do nothing option and the person is still hitting themselves. Doing nothing isn’t ethical it is just abrogating responsibility.”
Forced drugging isn’t ethical. Nobody has a “responsibility” to invasively blockade someone’s neurotransmission. Especially no quack who doesn’t even demonstrate disease of neurotranmission. I already chose an option, if you believe in the government having a self-harm prevention squad of some description, I said don’t enter their body, touch the outside of it if you feel you must.”
And then you said:
” I’m reluctantly recommending medication.”
These ah, dopaminergic system blockade drugs you refer to as “medication”, what medical disease do they correct? On the basis of what series of leaps of faith in psychiatry’s THEORIES would they come to be seen as a gold standard “treatment”?, and given the “medication” corrects no known disease process and carries risks in the extreme, how do you justify putting those drugs in someone else’s body when they have not been afforded the opportunity for informed consent?
These leaps of faith to the “medication” of problem behaviors that aren’t even proven to be medical in nature, how do they stand in comparison to an unconscious person later thanking a doctor for you giving them a blood transfusion when they were DEMONSTRABLY having a medical emergency like bleeding to death?
If you’re pro non-consensual drugging, fine, be pro non-consensual drugging.
“If you can’t address the distinction between medicating/drugging with out consent and medicating and drugging by force a person with capacity”
If you seriously, seriously believe that “capacity”, IE deciding who’s screams for mercy get listened to before the needle goes in and whose get pushed to the side, can be trusted to be determined by government agents behind closed doors in a hospital in situ, without enormous collateral damage, and you seriously believe tranquilizer drugging someone constitutes a “medical” act of “medication”, then I can’t help you sir. If it starts with restraint and ends with a drug in someone’s body, it constitutes forced drugging. If the person has their right to say no and be listened to, there right to pull away, to run away from people who want to put drugs in her body, that constitutes forced drugging.
Drunk, incapacitated people in the realm of sexual violence law can take action for date rape if someone enters their body against their will. There is a presumption of no consent when it comes to people’s bodies being entered for no medical reason.
It should be not be assumed that any government representative has the moral right to enter the body of someone to “protect them from themselves”, when not entering their body, when restraining them, will bring about behavioral control without the massive invasiveness of the government entering their brain function and treating their consciousness like something that doesn’t deserve to exist in this world.
It should be illegal for the government, or anyone acting under government law to perform brain altering interventions on people for the sole purpose of behavioral control.
You may call behavioral control “medication”, or a “medical” act, but given you’re unable to demonstrate a biomedical disease in the biology you’re commandeering, it is a “medical” act in name only.
Because if plying the face puncher with drugs is a medical act, then a date rapist slipping a roofie into a woman’s drink is practicing medicine. Both druggers of people without consent wish to bend a human being to their ends. Both druggers of people without consent, see problem behavior, wish to change it, and see the other human being’s blood/brain barrier as nothing sacred. Both don’t feel they are crossing a moral, ethical and human rights line.
If you feel any stranger dragged before you has forfeited the right to their brain being inviolable, then I can’t help you.
I will say again, and repeat like a fourth time just so it sinks in, I did say restraint would be better than meddling with the person’s brain, if anything.
I’ll take Patch Adams or anyone else restraining me, I’ll take being tied to a chair, locked in a room, over some biological rapist entering my brain any day of my life. And that includes biologically raping me when I am asleep, half conscious, labeled as having “capacity” by a biased quack, labeled as not having “capacity” by a biased quack, my body is inviolable in the absence of a bona fide medical emergency.
Such an emergency would no doubt involve being treated by real doctors who actually examine bodies and biomarkers, etc. ie: not psychiatry.
Until the day psychiatry’s BS chicanery of claiming rapid human wrangling, behavioral control, tranquilization, social control, magically becomes a bona fide medical activity, that is, when the word “medication” that you use represents the genuine practice of evidence based medical treatment of a biomedical disease, people who wrap themselves in the flag of the psychiatric lexicon to justify entering bodies without consent will not have a leg to stand on.
If drugging the face puncher woman is a medical activity, then the police tasering her is a medical activity. Both achieve the desired end of of cessation of the problem behavior, by means of invasive entering and altering of the physiology that isn’t diseased. Neither are medical activities. Both are invasive, disgusting, unnecessary acts of disrespecting the fundamental human rights of the target.
“If the person has NO right to say no and be listened to, no right to pull away, to run away from people who want to put drugs in her body, that constitutes forced drugging.”
Typo correction.
Clarification — @ Theinarticulatepoet,
You say, “Jonah has decided to recommend restraint.”
This word, “restraint,” is far too vague.
You offered a hypothetical situation, of a person apparently bent on hitting himself in the face.
Afterwards, you added that this might be a person in a *prison* setting.
What I’d recommend, first and foremost, is offering loving care, helpers who are capable of *understanding* that person.
I believe that, *almost* inevitably, he would *not* find such care in any prison “hospital” workers.
So, if and only if he is in a state of such hyper-arousal, that he can’t be soothed by any completely gentle means, a temporarily forceful, physical hold might be necessary — and, perhaps, then, best to put him a straight-jacket.
I would *not* leave that person alone.
No one should ever be left in isolation, imo.
(Sadly, many prisoners in the U.S. are in isolation — even minors. Surely, that is extremely inhumane — and can destroy a person’s psyche… such that he’d wind up striving to seriously harm himself.)
For a person such as you’ve described, I believe he’d calm down, after not too long, once placed in a straight-jacket.
Maybe he’d need to be in a padded cell for while.
I would seek to provide him constant, genuinely caring, understanding company — especially, as long as he is in a straight-jacket.
And, most emphatically, I would recommend he work with a good trauma specialist.
Of course, that sounds like a pipe dream — considering he’s in a prison; yet, I say it anyway.
Hopefully, he could be hooked up with one good person, who can spend time carefully listening to him.
Probably, good volunteer workers would be best for him.
At least, that’s what I imagine.
After all, I do *not* recommend that any of these ‘mental health services’ be government operated.
I say that largely because the government wants to apply force, as a rule — to stamp out all sorts of supposed “disorder” — even, and especially, by tampering with “offenders'” brains.
From that point of view, as I have said previously, if it were up to me, I’d put all governments out of the business of providing ‘mental health services’ — such that no government agent was ever expected to define or enforce ‘normal’ behavior.
Again, I point out: I believe a person like you describe, were he to be found in a *non-prison* situation, would be best-served by a caring, Patch Adams type helper.
I seriously wonder whether it is accurate to call that care which he was describing (in minutes 4-6 of the Youtube video) a “restraint” situation.
But, in any event (emphatically): Patch was running a non-governmental, free clinic.
Respectfully,
~Jonah
I agree with every single word of Jonah’s above comment.
Particularly this…
“I believe that, *almost* inevitably, he would *not* find such care in any prison “hospital” workers.”
Someone wants to, feels they have the right to, change the behavior of the face punching woman. The problem is not a medical problem. Any old date rapist can drug a targeted person’s consciousness into submission, it is not rocket science. It doesn’t take years of medical school to stick a needle full of tranquilizer drugs in a person whose behavior is frowned upon. Just as any marksman can shoot a tranquilizer dart into a Rhino on safari.
The use of chemicals to restrain human beings or animals whose behavior doesn’t suit, does not represent the treatment of a medical condition. In humans it represents an expedient trashing of the individual’s human rights.
I’m with you Jonah, although they have restraint chairs these days instead of straight jackets. I think people are visual and they seem to be offended by the sight of someone getting tied to a chair. I agree, it’s nasty stuff. But simply deploying invisible (to the observer) tranquilizer drug molecules to their dirty work of SEIZING the BRAIN (neuro-leptic), seems to give the controllers of strangers a feeling that they aren’t doing violence to a person. Violence against the consciousness of others seems easier to swallow, because after the initial syringe stabbing it ceases to be a “vulgar display of power”. As the inescapable forced drugging nightmare bubbles away beneath the skull, the attackers can look at their quarry and not see a degrading sight of a man strapped to a chair. This makes them feel better perhaps, but I believe it is a false consciousness to deny the rape of another human being’s consciousness.
Having government agents force the medico-legal status of an unconscious person on a conscious person, to legally enable government brain meddling, IS the Orwellian nightmare that it sounds like it is.
There exists in this world a small number of fundamentalist christian anti gay psychologists who carry out so called “reparative therapy”. Gays rail against these quacks and rightly so. I know what it is like to have well-intentioned yet fundamentally misguided quacks think they posses the “help that I need”.
Almost every single tenet and foundation upon which my psychiatric “helpers” based their alleged insights into my situation, is something I would like the freedom to run as far away from as gays have the right to be protected from unwanted interaction with the antigay “reparative therapy” quacks.
Sometimes I really do feel like I’m being stalked by cult members, with massive legal power to coerce me, and I imagine how gays feel when they are stalked by those fundamentalist self appointed saviors.
It is truly nothing to envy. It’s a wonder any of us get out alive. Instead of being chased by quacks with bibles in their hands telling us we can pray the gay away, we are chased by quacks with psychiatric bibles in their hands telling us it’s just fine that there are laws that see our biology forcibly split open to be desecrated by their guesswork pseudomedical meddling. How anyone can still justify nonconsensual drug-based psychiatry after reading the wealth of debunking on this site, is just staggering. But, such is messianic blind faith. Religious extremists of all stripes, including those in the Church of Psychiatry, have always felt the right to have a claim on the bodies and lives of perfect strangers. The desire to meddle, to “help”, even those who don’t see their “help” as help or want their help, dies hard. Tragically most of them see absolutely nothing wrong with forcing their belief system and drugs on strangers using force. Neuronal terrorists, literally. Total indoctrinated fanatics. How else could they dehumanize us so?
@Jonah
Straight jackets and padded cells…. truly I am shocked that in this day and age you suggest this….
When I think of the work that has gone into rooting these things out of mental health services and to find that they are seriously being considered on this site of all places…
I don’t know what to say….
“When I think of the work that has gone into rooting these things out of mental health services and to find that they are seriously being considered on this site of all places…
I don’t know what to say…. ”
For people that need a refresher on the human rights at play in forced psychiatry.
1. The human right to bodily integrity.
2. The human right to freedom of movement.
Handcuffs – Freedom of movement.
Shackles – Freedom of movement.
Solitary Confinement – Freedom of movement.
Physical restraint (held by people) – Freedom of movement.
Mechanical restraint (restraint chairs, straight jackets) – Freedom of movement.
_________________________
The death penalty – Bodily Integrity
Female Genital Mutilation – Bodily Integrity
Male Genital Mutilation – Bodily Integrity
A bullet in the head – bodily integrity
A taser to the chest – bodily integrity
A beating – bodily integrity
Waterboarding – bodily integrity
Sexual rape – bodily integrity
Forced sterilization – bodily integrity
Forced abortion – bodily integrity
Forced electroshock – bodily integrity
Forced lobotomy – bodily integrity
Forced drugging – bodily integrity.
_________________________
Forced removal of the human right to freedom of movement, is an infinitely lighter touch on a person’s life than shattering their right to bodily integrity.
The UN Special Rapporteur calls forced drugging torture. The psychiatric survivor movement (who have survived having their human right to bodily integrity ripped away), call it torture.
“When I think of the work that has gone into rooting these things out of mental health services”
When I think of that “work”, that so-called improvement, shifting from taking away freedom of movement, NOT entering bodies, to whitewashing the wholesale removal of bodily integrity with widespread forced drugging, even in people’s own homes, I am disgusted.
Oh I’m aware people who work in the “services” consider the move to biological violence, hidden violence, horrendous levels of molecular, constant, 24/7 intracranial violence, to be an improvement on mere freedom of movement curtailment.
They are wrong if think shifting to chemical violence against the detainees is more “humane”.
We in a fight for our right to bodily integrity, against people who think the image of a man tied to a chair is MORE distasteful than the wholesale rape of biology. Up is down and down is up in the Alice in Wonderland that is the world of forced psychiatric quackery.
“When I think of the work that has gone into rooting these things out of mental health services”
These freedom of movement curtailments were simply REPLACED with things that are 100,000 times more invasive. That is NOTHING to be proud of.
@Jonah
You wrote:
There is this notion, that people are or are not ‘capacitous’; that’s an utterly *bogus* dichotomy, in my humble opinion…
That their is a dichotomy is not the contention. That would be untrue, I agree. Capacity fluctuates and one can have capacity to decide what to have for breakfast but not the capacity to make a long term financial decision at the same time. It is certainly not a simple dichotomy.
In the most complex cases capacity decisions are made by high court judges not doctors in any case.
I agree if everyone made advance directives the world would be a much simpler place.
Many of the people on this thread will eventually lack capacity due to dementia….I wonder how many have advance directives for that….
Jonah,
“No is ever completely “lacking capacity” — unless or until s/he is rendered fully unconscious.”
Isn’t it ironic that that penalty for being caught in contempt of psychiatrist in a psychiatrist facility is being forcibly rendered unconscious by forced drugging?
There is no legally binding advance directive that can protect anybody from any forced psychiatry laws that exist anywhere in the entire English speaking world. Even so, presumed consent for biopsychiatry when biopsychiatry is harmful quackery, is an absolutely ridiculous situation. We need to move away from this idea that psychiatry has somehow earned the reserve power to enter the bodies of citizens.
What is bogus in this whole bogus capacity debate is the people who work in forced psychiatry regularly demonstrate they are willing to completely ignore the targeted person’s express wishes, clearly articulated, in situ.
In every non-legally-binding JOKE of an advance directive scheme I’ve ever seen introduced, psychiatry is there whispering in legislators’ ears to make sure the advance directives are easily overturnable by psychiatry, what else can we expect from a profession that was founded on coercion?
@Anonymous
You wrote:
“No is ever completely “lacking capacity” — unless or until s/he is rendered fully unconscious.”
Now who is making a subjective judgement? See locked in syndrome.
Fully lacking capacity is not the test as has already been established capacity fluctuates and a person can have capacity to make a decision about one thing but not another at the same time.
” a person can have capacity to make a decision about one thing but not another at the same time. ”
How is that? They can’t find the words to talk about the topic of what to have for breakfast or the topic of taking major tranquilizer drugs? Or is just that those more powerful than them legally refuse to listen to the words they speak on one topic or another?
Comparing paralyzed locked in people to the millions of people subjected to tranquilizer drug social control under the guise of psychiatry? No.
If the entire population was offered effective treatments throughout life, there’d be much less need to even consider forcibly restraining them. If people put their time and energy into finding and sharing these treatments, rather than debating about restraints, less restraints would be needed. For example, computer technology can identify well-balanced brainwaves and plays them back as sounds. This balances people’s whole brains, so all parts interact harmoniously. Then, symptoms of many mental disorders disappear. This then provides solid proof (a computer print-out of their brainwave patterns) that their brains are well-balanced. Solid, objective proof can stand up in court, so they don’t need undesirable treatments. I’m not paid to share this, but it would relieve a lot of suffering if more people knew about it. There’s data from over 50,000 people on how amazingly well it works.
If psychiatrists want to effectively help patients best, why don’t they use this technology? It’s described on brainstatetech.com — It proves it’s not true that so many people must have disorders for life. It proves balance is typically achieved when meds can be tapered anyone thinks, computers are objective, so they can settle the debate.
Psychiatrists’ brainwaves could then be assessed too, so we could see how unbalanced they’ve been, and we could then correct the source of the problem! If they want the whole truth to be clearly revealed, why don’t they use this technology? Are they hiding from it, and why?
Whoops, the last sentence of my penultimate paragraph above should say: “It proves balance is typically achieved when meds can be tapered down, just like it works better when people aren’t using cannabis or alcohol. Whatever anyone thinks, computers are objective…
-Anonymous
For clarification of the capacity concept.
Take a child with a learning disability who has the capacity to decide where to live, who to live with, how to spend the day and so on…
The child has a brother who is dying for want of a kidney.
The child cannot give informed genuine consent to giving up a kidney to the brother because they lack capacity to make that decision but they do have the capacity to make the choices above . (so the argument goes, which I agree with even if you don’t)
In this case it is for a high court judge to decide what is in the childs best interest. In this real life case the judge deciding that having a living brother was in their best interest and the child gave their brother a kidney. (or the evil state stole the kidney and gave it to someone else depending on your point of view)
The judge could have gone the other way but that illustrates the point a person can have the capacity to decide on thing but perhaps not another at the same time. And of course capacity can fluctuate over time….
As a general rule capacity is assumed to exist and the burden is to satisfy that it does not….
Regarding locked in syndrome I was pointing out that on the one hand you defended a course of action because the alternative was to rely on a subjective judgement and then switched because you alluded that being unconscious was an objective judgement when of course it is not….it is entirely subjective as well.
On the topic of subjectivity (I don’t suggest that medical explanations for mental distress are defacto the only explanations that are valid if at all) even when a doctor says you have cancer that is only a subjective value judgement. And one that is often wrong at that. We wouldn’t expect a course of inaction just because that particular diagnosis is a subjective judgement. I’m drawing that parallel to illustrate that subjectivity alone isn’t a valid reason to dismiss a course of action.
Defending my option of non consenting administration of medication in the original example says nothing about my opinion of the dopamine deregulation theory. In fact I find it entirely unconvincing but that is another matter. I believe that the over riding consideration should be how best to prevent the young woman beating themselves black and blue. Just because capacity is a subjective judgement does not rule it out as a useful principle in the case where a person is non communicative….
My belief is that a prolonged restraint is potentially more harmful in the long run than medication.
I didn’t take your suggestion of gentle holding as your option as I had earlier posited that very gentle holding was not making any difference. But if you are saying that you prefer restraint then I accept that is your preferred option. We have both made a case….I don’t believe there is any moral high ground to be had.
The parallels with date rapists imo don’t really add anything to clarify the issues at hand. The motivation of the date rapist is their own gratification. I’m taking it as a given that even actions we disagree with are not motivated by that sort of evil intent.
There are for sure people who work in mental health services who probably shouldn’t , whose motivations might be more suspect than others. Certainly some of them we might both call “sick”. Weeding these people out of the system and how to go about it is another matter.
“The child cannot give informed genuine consent to giving up a kidney to the brother because they lack capacity to make that decision”
A child is a child. Children don’t have the legal rights adults have. The constant analogies of those labeled “mentally ill” to demented old people, locked in paralyzed people, and children, is getting old.
“The parallels with date rapists imo don’t really add anything to clarify the issues at hand. The motivation of the date rapist is their own gratification. I’m taking it as a given that even actions we disagree with are not motivated by that sort of evil intent.”
The parallels with date rapists exist. Both drug people whose brains haven’t proven diseased just to control them. Evil and gratification don’t always go hand in hand. Evil and intent don’t always go hand in hand. All fanatics who believe they are justified in targeting groups, rounding them up, and “fixing them”, believe they are justified. I don’t doubt the “pure intentions” of the fundamentalist anti-gay “pray the gay away” fanatics, likewise I don’t doubt the “pure intentions” of a psychiatry true believer “here to medicate” people they consider to be literally “ill”.
You think holding someone or restraining someone for a while is the lesser evil than stripping from them the right to bodily integrity, to own their own brain, I’m afraid we are always going to disagree on that.
“But if you are saying that you prefer restraint then I accept that is your preferred option”
It’s not merely a “preferred option” sir, it’s a LIMIT on government power, and I want my preferred limit to be the law of the land. And I’m assuming you want your preferred option, drugging, to be the law. Your call involves infinitely more invasive government action.
What is a “mental health service”? You mean where the government, kind of like a state religion says unwanted behavior, thoughts and feelings are a “health” issue, and passes laws that discriminate against people with psychiatric labels, laws that terrorize them and deny them choice?
If you don’t believe in my right choose, in terms of what I put in body, you’re my political enemy, for life.
Anyone who would ever enter the body of a stranger against their will without a bona fide iron clad medical reason is not welcome in my life, in my home, in my family, and especially not welcome in my brain. Like I say, we try and make this clear to those work in “services” when we say no.
I could never live with myself if I worked in a forced psychiatry job. Never. Total moral compromise.
“There are for sure people who work in mental health services who probably shouldn’t , whose motivations might be more suspect than others. Certainly some of them we might both call “sick”. Weeding these people out of the system and how to go about it is another matter. ”
A byzantine bureaucratic government “system” founded on force, compulsion and coercion and the unearned monopoly of psychiatric ideology is a dangerous and destructive thing. The component cogs in the machine, the staff, are really just the oil that greases a machine designed for one thing only, to deliver psychiatric labels and psychiatric drugs into the lives and bodies of those targeted. The system is neither designed to, nor is it equipped to deliver anything but labels and drugs. The occasional true “human service” might be provided within that framework.
Just as any soldier in a war didn’t create the war machine, I don’t blame any one forced psychiatry worker for the system, in fact I pity any forced psychiatry worker misled enough to think they could make the world a better place by working in a system of violence. I pity anyone gullible enough to embark on a career that began with psychiatric textbooks and the lies therein.
I don’t know what desensitization it takes to witness and carry out forced drugging and not vomit and be haunted by the same nightmares the victims of it are. But I do know those who carry out this violence against us will justify it to the hilt, firing a Gatling gun of justifications and thought experiments to try and dodge the fundamental inhumanity of forced drugging. Denial. After all, if forced psychiatry workers admitted they’d carried out gross human rights abuses with their own hands, earned blood money, where would that leave them? Maybe as distressed as some of those they label “patients”.
We are fighting for our human rights. If human rights abusers didn’t abuse our human rights we wouldn’t have to. If every syringe wielding forced psychiatry worker decided not to come to work, a lot of us would feel a lot safer. It’s not “bad apples” working in forced psychiatry, it’s a demonstration of how a system can get humans to carry out violence against their fellow man and feel justified in doing so. Something to be seen throughout human history.
It’s sad that we have to fight for our right to own our own bodies in the face of violent ideologues who insist on using force to smash our will and imposing their beliefs on us using legal force. But we will continue to fight so that one day nobody’s brain gets assaulted in the name of this quackery.
I know many former forced psychiatry workers who have found a clearer conscience upon leaving coercion behind and moving into working in purely voluntary settings. When one is old and on their death bed they want to be sure they’ve done more good than harm in their lives. Forced psychiatry workers have VICTIMS. Literal victims, hidden out there in the community, assaulted, battered, tortured, traumatized for life. I’m sure glad I don’t have victims. I sleep sounder at night knowing I never forced drugs on a stranger.
Like Sera, I’m not keeping up with this entire debate, though, by scanning it, I can see meaningful points are being raised. If psychiatric workers have the best intentions, why don’t they use the best/healthiest treatments? From reading about court cases on psychrights.org (and listening to Jim Gottstein talk), I understand it’s often pretty easy to demonstrate in court that the proposed psychiatric treatment isn’t the least harmful. There’s evidence from about 50,000 people (a huge sample size!) of amazingly effective, harmless treatments that aren’t even being offered to most psychiatric patients. People who truly intend the best, indeed care about whether they have the best EFFECTS. In this way, good intents work to have good effects! I may address some other topics brought up here when they come up again on the MIA facebook page. When people “like” posts there, their friend networks can see them, so it can have more far-reaching effects to discuss how to improve treatments on MIA’s facebook.
I disagree with Mr. Pies that psychiatry is not responsible for the status quo. Where are the American Psychiatric Association initiatives on gathering post-marketing data on psychiatric drugs, for example?
Here are some more slices of Pies:
Critics of psychiatry are people who just want others to suffer:
http://psychcentral.com/blog/archives/2011/09/13/are-the-puritans-behind-the-war-on-antidepressants/
Here he embarrasses himself with the non-credible claim that psychiatrists never espoused the “chemical imbalance” theory:
http://www.psychiatrictimes.com/blog/couchincrisis/content/article/10168/1902106 (free registration required)
Trying to dig himself out of the hole he’d dug in the earlier article, he says psychiatrists lied about “chemical imbalance” only to make patients feel better:
http://psychcentral.com/blog/archives/2011/08/04/doctor-is-my-mood-disorder-due-to-a-chemical-imbalance/
And, for the whipped cream on Pies, his colleague Steve Moffic, “da man in psychiatric ethics,” on the importance of informed consent:
http://www.behavioral.net/blogs/h-steven-moffic/preventing-epidemic-psychopharmacology-lawsuits
[[personal attack removed]]
Torrey is the world’s leading apologist for forced psychiatry. If societies worldwide hadn’t been treating those labeled “mental patients” like second class citizens for hundreds of years, and if there wasn’t an ever-present supply of people willing to carry out forced psychiatry, Torrey would have less success in his desire to make it illegal for people with psychiatric labels to own their own bodies.
The banality of the evil of forced psychiatry, the desensitization of the public to psychiatry’s creation of a class seen as a biological underclass unworthy of human rights has much more to do with Torrey’s success in his quest to expand forced psychiatry than the donors.
In Nazi Germany we were life unworthy of life, and there was no short supply of well-intentioned Third Reich psychiatric nurses who were nice to their kids and their pets, willing to step up to the plate and lead people labeled “schizophrenic” out to the mobile gas vans that would come to state hospitals, “for their own good”.
Today, we are considered life unworthy of rights, and Torrey and his ilk, along with hundreds of thousands of functionaries in forced psychiatry systems worldwide, ensure those rights can be removed from us “for our own good”.
Such consistently good commentary, Anon. Wow.
Wow. I’m afraid there’s no way I’m going to be able to catch up with all of this any time soon. I’m traveling and not really fully back at home until Thursday, with children, husband and a job that will all likely feel neglected at that point. So, as much as I like to consider it my responsibility to keep up with the posts on a blog I’ve written, I’m just not seeing it as feasible right now. 🙁
That said, I wanted to at least offer a few points…
1. I am someone who has relentlessly and inexplicably sometimes punched myself. Honestly, I’d kind of forgotten about it and then it all came back to me in a bit of a rush some months back. It often happened when I was lying in bed with my ex-husband. It came in the form of a tidal wave that was like tiny but relentless emotional ‘bugs’ crawling around underneath my skin and in my head and all I could manage to do was hit myself to try and make it stop. I suppose I wasn’t doing it that terribly hard, but I would go on for a while. My ex-husband would attempt to restrain me at times. I sure am glad he never thought to go calling anyone for help.
I would tend to agree that physical restraint can be a lesser violation of one’s bodily integrity than chemical restraint. Although physical restraint brings up plenty for me, all that it takes to remove it is hands being lifted. Chemical restraint is not so permanently removed, and involves something going inside me…
I can also much more easily justify physical restraint (at least in the context of my ex-husband getting scared and attempting to stop me from hitting myself) as a very human response. I can’t justify chemical restraint in that same way.
But let’s be honest… It’s all pretty ugly, especially when we start talking about physical and chemical restraints in the context of ‘programmatic’ response and policy and not just human response.
2. I’d just like to remind everyone that what seemed to have gotten this all rolling was my spoken desire to have more conversations (at some point, not the here and now!) about those people who – for whatever reason – are struggling with violence and who aren’t necessarily in a place to hold the values of a place like a ‘peer respite’ but who we don’t necessarily want to see fall into some crack where they get no support at all or are driven back into a system of force because we have nothing else to offer… The topic I was most interested in wasn’t particularly a debate between physical and chemical restraint, but what is missing in what we offer, how we look at things, how we might still avoid force, etc. And yes, questions like when DO we just walk away, etc. may be wrapped up in all that… but just a debate between one type of force and another wasn’t really what I personally had in mind.
Anyway. All for now. 🙂
Thanks!
-Sera
Sera,
Thanks very much for sharing more of your own personal journey.
It’s always helpful to see where different people are coming from, in any one given conversation.
Any two people who may, at first, seem to have endured and overcome quite *similar* trials and tribulations, may speak of their ‘lived experience’ in a way that provides a sense of mutual understanding; yet, each has a truly unique tale to tell; in all reality, our life-history is our own.
Once we realize the extent of our *contrasting* first-hand experiences, we begin to understand more of the variance in our respective views, when it comes to discussing ‘policy’ matters.
Therefore, RE your saying,
“But let’s be honest… It’s all pretty ugly, especially when we start talking about physical and chemical restraints in the context of ‘programmatic’ response and policy and not just human response.”
I agree with that statement.
However, life has its ugly realities — which must be face; e.g., I feel it’s necessary to consider programmed responses, when discussing questions of how to treat distressed prisoners.
In prison settings, ‘programmed responses’ will *always* be par for the course. (It seems to me that one can reasonably lament this fact; however, it is is an undeniable truism.)
Some people in prison will suffer — psychologically and emotionally — more visibly, than others; some will wind up quite self-destructive. (Of course, that can be largely or entirely the effect of how one is ‘treated’ in prison.) Hence, once a hypothetical, distressed *prisoner* is discussed, there will inevitably be an airing of the relative ‘merits versus draw-backs’ of various *programmed* responses, to prisoners’ distress.
(Anyone who imagines that a prison setting can be run without programmed responses is not facing reality.)
In fact, any and every *institutional* setting will produce programmed responses — especially, programmed responses to violence.
Clearly, it was *not* your desire to initiate a conversation of that kind (I well understand that); however, once that conversation, regarding a hypothetical prisoner, was introduced, some discussion of programmed responses was inevitable.
Your desire (as expressed in the course of your comments, on this page) is to explore policy in *voluntary* care, which could hopefully prevent any need to send individuals to non-voluntary (institutional) settings.
That’s a truly beautiful desire; and, from that point of view, you are right to call for non-programmed responses…
I sincerely look forward to discussions exploring such non-programmed responses, via your future MIA blogs and comments.
Respectfully,
~Jonah
P.S. — I’m not sure if you realize, I was discussing *non-programmed* responses earlier on, in the context of voluntary care; perhaps, I was doing so too indirectly?
That was, as I addressed David and ssenerch, mentioning *shamanism* in my comment on April 14, 2013 at 1:11 am (and in the following “P.S.” comment)…
http://www.madinamerica.com/2013/04/slices-of-pies-a-dialogue-with-ronald-pies/#comment-22708
Also, I was discussing non-programmed responses (on April 15, 2013 at 10:07) in the P.S., of my rather long comment to you (which you mentioned was too long for you to read, at that time).
I don’t blame you in the least (nor anyone else) for finding that comment too long to read; but, if/when you get a chance, maybe you can check out the end of it — beginning where I say, “As for my 2 cents, on the question, of where to send such individuals…”
http://www.madinamerica.com/2013/04/slices-of-pies-a-dialogue-with-ronald-pies/#comment-22795
The references I offered there, to Buddhist philosophy and to William Glasser’s work may not be clear enough; nonetheless, the Buddhist principles of ‘Right Action’ *and* of Glasser’s ‘Choice Theory’ would *all* be foremost on my mind and key to my message, when dealing with anyone who requires counseling in matters of self-control and becoming more self-responsible…
That is to say, if I knew of someone who was not being accepted into a ‘respite’ (based, as you say, on his/her having been violent), I would at *least* hope to be in a position of offering such counseling *and/or* would hope to be in a position of suggesting others, whose work I respect, who could offer such counseling.
Offering sound guidance, that inspired his/her becoming more fully self-controlled and self-responsible would be essential, I think; and, to begin, that might be more important than finding him/her a residential program…
I.e., if I had no residential program to offer, I would do my best to stay open to that person — encouraging more dialogue — as long as s/he showed sincere interest in discussing and demonstrating the sort of ‘pro-active’ and ‘pro-social’ principles I am describing.
Respectfully,
~J
I enjoyed reading your response on the NYT and this blog. I consider myself a passionate moderate on the issue of psychiatric diagnosis (somewhere between Pies and Thomas Szasz) but wholly opposed to the nightmare that is DSM5.
To his credit, Dr. Pies is not erasing my critical posts on Psychiatric Times on the issue of stigma and DSM5. As a forensic psychiatrist, I have rather enjoyed the debate, and you might too. Please see my responses to his recent articles. I trust you will find he has put himself in an untenable position with his high minded ethics opposing stigma and “branding” while advocating what I called the ultimate branding iron.
I still have very little respect for anybody who believes that a DSM committee (be it III, IV or 5) can vote “normality” vs “non normality” based on behavior alone without any scientific basis whatsoever. We already had times where society stigmatized those who behaved differently from what committees of self appointed “mind guardians” decided. The institution that did that had a name beginning by “I”.
This is why I don’t respect Allen Frances either. I do not believe for a second the critics that see only “self interest” in Allen Frances’ campaign against DSM 5. I do see however a contest of “my criteria for normality are better than yours because I say so”. There is no room for psychiatry in an open society. We have criminal and civil laws that should be applied to everyone equally. If somebody misbehaves in a criminal way, he/she should not treated differently just because some DSM committee thinks that the guy is not “normal”. Ditto of civil laws (particularly when it comes to divorce, probate, etc).
I am mentioning this because you are listed as a forensic psychiatrist. Forensic psychiatry is yet another way the evilness of psychiatry affects many peoples’ lives be it by unfairly incarcerating people under the disguise that they are “ill”, be it by denying justice to victims under “insanity defense”, be it because it puts itself in the middle of civil law matters taking sides (and thus denying justice to one of the sides).
Ultimate branding iron! What a turn of phrase! As if a psychiatrist isn’t concept-oriented enough to know the dictionary says stigma is a mark of disease. So, the opposite of spreading stigma is to focus on people’s inner harmony/health. Reflecting their harmony back to them ultimately harmonizes the whole brain, relieving signs of disorder (literally, stigma).
People’s ethical sense becomes perverted when they’re led to feel good/harmonious about focusing their thoughts on what’s disharmonious/disordered. This disorders their ethical values. They lose their sense to associate health with feelings of excellence; instead, they feel excellent about focusing on unhealthiness. (Disorder Awareness!) So, they lose their sense of how to protect health/people. The more people spread stigma by focusing on marks of unhealthiness, the more social cover they have for doing so, but that doesn’t make it healthy/excellent.
Dr. OBrien, I see your posts on the most recent Pies article http://www.psychiatrictimes.com/blog/pies/content/article/10168/2138321 . In this article, Pies asserts what he always asserts: If psychiatry is done properly, it accomplishes “the relief of suffering and incapacity.”
This tautology, which is vintage Pies, is as circular as an argument can get. And yet he says “the medicalization narrative is philosophically naive and clinically unhelpful.”
I also see your comments on http://www.psychiatrictimes.com/blog/pies/content/article/10168/2135248 . Here Pies touts (yet again) psychiatry as a scientific “systematic methodology based on evidence,” ignoring (yet again) the extensive, indisputable findings that much of psychiatric “evidence” is pharma propaganda.
As for stigma, he maintains that psychiatric diagnoses are merely innocent words, it’s society that supplies the stigma, thereby making the terms context-free. (As though no physician ever applied a psychiatric diagnosis out of prejudice or ignorance!!)
This type of semantic reductionism is also vintage Pies. Words, e.g. DSM-5 diagnoses, are innocent! Stigma is in the interpretation!
Could someone please let Dr. Pies know words have no meaning without interpretation?
You may enjoy jousting with Dr. Pies, but be forewarned — his articles are a compendium of rhetological fallacies ( http://www.informationisbeautiful.net/visualizations/rhetological-fallacies/ ), as you would expect from someone suffering from anosognosia regarding the profession he’s spent a lifetime defending (as Dr. Nardo’s March 30 comment implies).
Thanks for letting me know, James. I can appreciate trying to find a balance and will definitely check it out. I am glad that some who have the ‘qualifications’ to post there are doing so in a thoughtful manner! 🙂
I wouldn’t be too hard on Dr. Frances right now and he can be a valuable ally because of his credentials. If you read his recent work, he’s done a major mea culpa on the excesses of DSM-4 and regrets it. This is not easy to do and I admire his intellectual honesty, though I don’t agree with him on everything.
Sure but he still believes that most of DSM-IV is “scientifically sound” whatever that means.
I am an avid reader of his psychology today columns (DSM-5 in distress and saving normal).
He has specific qualms with a false epidemic of ADHD that DSM-IV helped create but he still sees nothing wrong with “labeling” people with all sorts of labels, including the one I was given that resulted in me being civilly committed for several months because some European psychiatrist combined a DSM-IV label with that country’s “need for treatment”, whatever that means as well, standard for civil commitment. So, no Allen Frances sanctioned DSM, no me committed.
Whatever he is doing to backpedal is certainly better than nothing but I can assure you that the people whose lives his DSM-IV has ruined (including the parts of it he considers sound) couldn’t care less about his recent pronouncements. For me, it’s too little to late.
” For me, it’s too little to late. ”
And to be more specific, short of a complete denunciation of psychiatry as a scientific fraud, I don’t believe in “benign psychiatry” of a “lesser evil psychiatry”. Allen Frances made it clear what his position is with respect to psychiatry and coercive psychiatry here http://www.cato-unbound.org/archives/august-2012/ .
Having been at the receiving end of coercive psychiatry, my views are basically Schaler’s and Szasz’s. I do not think there is any room for middle ground when it comes to depriving of their freedom people who have committed no crimes but who just happen to behave in otherwise legal ways that some DSM committee finds “not normal”. We already have the criminal system to punish those who behave in criminal ways. As to the “false” pretense of “helping”, I stand by general Patton’s “May God deliver us from our friends; we can handle the enemy”. I wish I had never been “helped”, ie I wish I hadn’t had “my life ruined” by these “helpers”.
Brilliant,
http://www.cato-unbound.org/2012/08/24/jacob-sullum/the-legal-and-moral-problems-of-involuntary-commitment/
“Appealing to libertarians, Jaffe wants to flip that view of reality, saying coercive psychiatric treatment actually restores people’s freedom. One way we know this, he says, is that most people who are civilly committed for treatment of schizophrenia “retrospectively express gratitude.” Frances likewise writes that “the majority [of involuntarily treated mental patients] are unhappy at the moment when involuntary treatment is imposed on them, but they understand why it was necessary once they have recovered from their acute symptoms.” This retroactive validation of coercion seems suspect to me, not least because formerly confined patients may surmise (perhaps correctly) that agreeing they were correctly diagnosed and properly treated helps them remain free by showing they have recovered their senses.
Then, too, retrospective gratitude could be used to justify all manner of paternalistic interventions, whether or not they involve a psychiatric diagnosis. If the government began kidnapping obese people and forcing them into a strict diet-and-exercise program, how many newly thin former captives would eventually be thankful for the help? Let’s not find out.”
Other than affirming in no uncertain terms that I am not grateful that I was abused by psychiatry, I think that Jacob Sullum nailed it with his analogy about kidnapping obese people to make them thinner. In fact, I can very well conceive a future edition of the DSM that labels being “too” fat (whatever “too” is) as a mental illness in order to justify coercive measures on people who are “too” fat.
“A minority of patients is angry about the initial commitment and stays angry even after they have gotten better — sometimes feeling abused and humiliated for life.”
– Allen Frances, 2012, in his apologia for forced psychiatry. In it, we are to assume Frances has done a survey, or that such a survey could be done, and we are to assume he’s in a position to be using quantitative words like “a minority”. We are to assume “gotten better”, implies they were “sick” in the first place, and we are to assume that objective fact that people are stripped naked, held down and forcibly drugged gives rise to merely a “feeling” of abuse and humiliation. Then there’s the fact that the chilling effect coercion has on the public speech of forced psychiatry survivors precludes ANYONE knowing the true quantity of lives destroyed or “benefited” from forced psychiatry. It’s like a Stasi officer claiming “a minority of people are angry they were ratted out by informants, but most come to be thankful for being led back onto the path of righteousness”. Trusting a coercive psychiatrist to lay out the “results” of coercive psychiatry is just ridiculous.
http://www.cato-unbound.org/2012/08/08/allen-frances/a-clinical-reality-check/
Allen Frances, found the courage, from the safety of a well-funded retirement, almost 20 years after he helped unleash DSM 4 on the world, to become a supposed “critic” of DSM 5.
Allen Frances remains an apologist for his profession having the power to force itself on people without consent. Apparently abused and humiliated people are just the necessary collateral damage for crafting what he sees as “success stories”. Some lives need to be destroyed by forced psychiatry to “save” other lives. This is how most apologists of forced psychiatry think.
Anybody can be “protected from themselves” without some quack profession of brain meddlers remodeling their brain function by force. And society can be protected from violent criminals without recourse to the quack brain re-modelers too. Allen Frances is a person who is willing to gamble with people’s lives against their wishes, if you wind up abused and humiliated for life, or thankful, well that’s a chance he’s willing to take, after all, he doesn’t pay the price… he just wanted to “help” when he took your human rights away using commitment laws. He’s on record as having personally signed off hundreds of people losing the right to own their own bodies even though he never proved anything was diseased in their bodies.
He’s no “ally”. In fact, there is reason to believe had psychiatry chosen to extend the shelf life of DSM 4 for another 20 years instead of creating the new King James version of the psychiatric bible, the former King would have stayed in retirement.
I agree with CannotSay2013 about so called forensic psychiatry, the merger of quackery and the criminal justice system, and more terrifying than any prison cell on earth.
Civil commitment in the US in the 1950s was a lot higher before DSM even existed. The correlation between DSM and using diagnosis as a tool to commit is nil. The same is true of forensic psychiatry.
I cannot agree with those who say there is no such thing as mental illness or that the dangerous mentally ill should not be placed in hospitals for their own good and public safety.
If you’re going to take that position, then you are saying it is a good thing that James Hughes, the Colorado shooter, was never committed after he was identified as mentally ill and dangerous.
You will lose that argument with any rational person. Set aside your own personal feelings and look at the reality.
Your response was priceless because in a few lines you underscore the reasons why I think that working from “within” in psychiatry, with psychiatrists who have not come to terms with the fact that psychiatry is a fraudulent endeavor, from a scientific point of view, is a futile exercise.
First, my background,
http://www.madinamerica.com/2013/01/ny-times-invites-readers-to-a-dialogue-on-forced-treatment/#comment-19770
The fact that I am forced to hide my identity while you are free to openly defend your “right” to lock in people who admittedly have not committed any crimes speaks volumes.
You say
“I cannot agree with those who say there is no such thing as mental illness or that the dangerous mentally ill should not be placed in hospitals for their own good and public safety.
If you’re going to take that position, then you are saying it is a good thing that James Hughes, the Colorado shooter, was never committed after he was identified as mentally ill and dangerous. ”
This is what psychiatry does best to justify its coercive powers, playing with the worst irrational fears of politicians and those policy makers who by “all means” want to prevent the next “Aurora”. AFTER THE FACT, psychiatry takes an anecdotal case, pretends that all so called “dangerously” (whatever that means) are like him and sell the policy makers that they will be able to prevent the next or that at least will be able to preemptively lock in a superset of the same. Allen Frances, despite his own conflicts is most honest than you in the matter,
http://www.psychologytoday.com/blog/dsm5-in-distress/201212/2-weeks-post-newtown-gun-control-mental-health-and-grief
“And we will never be able to predict who will become violent and when- this is an inherently insoluble search for the small needle in the very large haystack.”
But then, Allen Frances is not a forensic psychiatrist, you are.
Then you say,
“You will lose that argument with any rational person.”
In fact, I have never read a so called “rational” argument on the matter. With respect to so called “mental illness” and its relationship with violence the reality is the following, it’s well documented,
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000120
“Schizophrenia and other psychoses are associated with violence and violent offending, particularly homicide. However, most of the excess risk appears to be mediated by substance abuse comorbidity. The risk in these patients with comorbidity is similar to that for substance abuse without psychosis. Public health strategies for violence reduction could consider focusing on the primary and secondary prevention of substance abuse.”
So the bottom line is that there is no real relationship between mental illness and violence other than what it comes from drug abuse. In other words, we can take psychiatry out of the equation completely on this matter.
From a pure rational point of view, and I have the statistics to back it up, in a US context, if you want to prevent an overwhelming majority of violent crime, you’d be better off preemptively locking in male blacks who live in the inner cities than those that psychiatrists think are “dangerous mentally ill”. Now, while rightly so, a person who has not committed any crime whatsoever cannot be preemptively locked in because he happens to be a black living an inner city, you guys somehow have managed to convince the powers that be that preemptively locking in a person that has not committed any crimes but has been labeled “mentally ill” is OK even though the statistical evidence alone would back the preemptive lock in of the inner city black while it doesn’t back up your position. Please tell me where is the rationality in your argument and where mine is wrong.
” Set aside your own personal feelings and look at the reality.”
This coming from somebody who makes a living out of coercive psychiatry sounds as close to a joke as it comes.
If you had followed the Aurora case closely, you’d know that the suspect carefully chose a theater without security among those available to perpetrate his crime.
The subject of prevention of gun crime has only found irrationality. Those on the left are advocating for gun control while those on the right are advocating for your position. None of the two tackles the issue from any rational point of view. You could have passed the bill that was defeated this week, and the Newton tragedy would have happened anyway. You could passed your dream law that would give those in your profession a right to preemptively lock in those labelled as “dangerously mentally ill” and the overwhelming majority of violent crime would still go on. As it is widely reported, around 10000 people died last year as a result of gun violence. Your law would avoid ~ 100 of those at most, while at the same time would make the life of many thousands unfairly targeted by it “a living hell”.
All civil rights struggles are first found with mockery on the side of those who perpetrate them as well as with “accommodation” by some on the receiving and of the abuses. This one is no different. I don’t suffer from Stockholm syndrome. What your colleagues did to me back in Europe was morally wrong, period. We are in a much better shape now in the US than before the 1970s SCOTUS decisions but the struggle against psychiatry continues.
I am encouraged that despite all the bullying by right wing politicians and pundits, those who think like you have not accomplished much in the goal of making preemptive lock in easier :D.
What science do you use to back up your claim about so-called “mental illness?”
It may not be easy for people abused by harmful psychiatric treatments to relate most harmoniously about that. However, the fact that they communicate in such an upfront manner attests to their effort to try to work toward better resolutions, which speaks volumes about how they care!
“Mental illness” may not be the healthiest, most harmonious concept upon which to focus the mind. Yet certainly, there are varying levels of mental health or harmony. We’ve all experienced more harmonious states of more peacefulness, relaxation, joy and love… and not. There are many proven, healthy ways to increase harmonious brainwave patterns, including meditation, music and exercise. Harmony is well-ordered.
Often, psychiatric treatments interfere with brainwaves’ ability to re-balance themselves. This is mentioned in Webinars in the “Ask Lee Library” at: http://brainstatetech.com/webinars It’s mentioned in minutes 5 and 7 of the Webinar with Dr. Cronin, and in minutes 12 and 58-59 of “A Conversation with Lee.”
Anyone who commits a harmful crime is clearly not thinking in a fully-connected way about the impact of all consequences on the lives of all concerned. Some people may act emotionally, suddenly, not connecting well with thoughts of consequences. Some people may consider some consequences, but not all consequences on the whole lives of all involved (including themselves). When people’s brainwaves are balanced, they make more fully considerate decisions, whether they were previously considered mentally ill or criminal convicts. Documentation of this can be found by googling “brainstatetech.com Nevada Prison Demonstration”, “brainstatetech.com County Probation Trial”, and by browsing brainstatetech.com in general. This technology can generally prove that people who behave poorly can benefit from harmless mental corrections. I share this unpaid, because I care!
Not sure what this has to do with coercive psychiatry. All I’d say is this. When it comes to coercion/psychiatry all I ask is to be treated like a criminal defendant instead of some kind of a lesser citizen just because some psychiatrist labels you as X or Y. As a criminal defendant, you cannot be deprived of your freedom unless there is evidence that you have committed a crime. For the initial arrest there has to be “probable cause” that a crime has been committed. For a longer incarceration, there needs to be conviction using the “beyond the reasonable doubt” standard that said crime has been committed. Since “terrorist threats” (or similar) is already codified in both state and federal laws, there is no need to invent a separate system to preemptively lock in those considered a danger.
Well, you responded! When people act in ways that are healthy for themselves and others, they should not be coerced into treatment. Healthy freedom should be protected. Brainwave technology can prove what’s healthy, and so can prevent harmful forced treatments.
Many people who haven’t experienced being locked up think it’s not similar to incarceration. “Hospital” and “prison” are totally separate concepts for them. They don’t experience any similarities, because they haven’t firsthand experience to draw from.
They feel mentally healthy to consider them different, because they think they’re doing something caring by hospitalizing people. That way of thinking is often the social norm. They feel harmonious by aligning with it. They feel well-connected to many other people whose freedom is protected because they aren’t considered dangerously ill.
To enable more enlightened social norms, it helps to understand how the thoughts of those who don’t understand aren’t fully based in the firsthand experience about which they’re speaking. So, they’re thinking about it mostly in concepts, rather than in experience. When it’s clear where they’re at, it’s easier to build a bridge to it, to enable fuller, mutual understanding.
When I say “They don’t experience any similarities” between hospitals and prisons, I mean they don’t acknowledge sameness.
Many people think they intend to care by hospitalizing people. Many may not intend to care so much when imprisoning people. They think prisons are for punishment. They want it to be clear they don’t *intend*to punish people by hospitalizing them. They also don’t want to *effect* a punishment either. They don’t want it to be considered correct that locking patients up is not caring for them.
Cruel punishment is unconstitutional. Cruel is defined as “knowingly causing distress.” Its antonym is “compassion.” For corrections to be the opposite of cruel, they must be intentionally healthy. For hospitals to properly treat illness, they must also be healthy.
I bring up brainwave technology as an example of a harmless treatment with amazingly healthy effects that isn’t being offered to patients or convicts (and some people are considered both). So, hospitals aren’t treating patients as healthfully as they could, to enable the healthiest behavior. And prisons aren’t either, in ways that can best correct misbehavior and prevent futher crimes. So, there’s lots of important points here for the public discussion that can enable positive reforms.
I don’t practice coercive psychiatry. All my patients are voluntary. I am also against gun control. And with few exceptions, I am against involuntary commitment.
Since you don’t know me you ought to be careful about making unfounded statements based on preconceived notions. I thought you were against stigma and branding? Maybe not so much.
It seems like you are coming from the position that the Aurora shooter should not have been committed. I am telling you right now that 99% of people will tune you out if you persist in that way of thinking.
Just because you don’t agree with Pies does not mean the other extreme is right either.
“I don’t practice coercive psychiatry. All my patients are voluntary. I am also against gun control”
Well, you are a forensic psychiatrist, you tell me how that is not “coercive psychiatry” http://en.wikipedia.org/wiki/Forensic_psychiatry “Forensic psychiatry is a sub-speciality of psychiatry and is related to criminology Howells K, Day A, and Thomas-Peter B. (2004). A forensic psychiatrist provides services – such as determination of competency to stand trial – to a court of law to facilitate the adjudicative process.”
If you don’t do that, then I stand corrected but then I don’t know what a “non coercive” forensic psychiatrist does, really.
“And with few exceptions, I am against involuntary commitment.”
Sure, I am against involuntary commitment, period. I’ve seen the damage that it did in my own life and I am sure that if you had been involuntarily committed you’d change your mind as well.
The criminal justice system already has figures to preemptively lock in those deemed dangerous. Depending on the state you live in you have “terrorist threats” or similar. Now, to lock in somebody for that, you need to provide evidence “beyond reasonable doubt”, which is a strong safeguard against abuses that the person is likely to engage in violence. You are labeled “mentally ill” then suddenly you are less of a citizen, and “clear and convincing evidence” is enough to lock you in. I cannot comprehend how is that you defend such injustice.
“Since you don’t know me you ought to be careful about making unfounded statements based on preconceived notions. I thought you were against stigma and branding? Maybe not so much.”
I have provided a wikipedia definition of forensic psychiatry -Wikipedia was found by a 2005 study to be as accurate as the Encyclopedia Britannica-. A forensic psychiatrist’s opinion was used to lock me in. If you don’t practice that, I am curious what kind of “forensic psychiatry” you practice. “non coercive forensic psychiatry” seem oxymoronic to me.
“It seems like you are coming from the position that the Aurora shooter should not have been committed. I am telling you right now that 99% of people will tune you out if you persist in that way of thinking.”
Sure, but that is because of irrationality, not because of rational thought. I provided you a very scientifically sound reasoning as to why preemptively locking in black males in the inner cities makes more scientific sense than your position. I haven’t read you providing a counter argument to mine. And in the Aurora shooter case, the scientific evidence that he was taking the same psychiatric drugs that had been present in the Standard Gravure, Columbine, Virginia Tech and Newtown massacres has been ignored. All of them were under, or had been taking prior to their respective shootings, psychiatric drugs. This is consistent with the Oxford study of people becoming violent under drugs. While all the science points to “stop giving poisonous drugs to people because they make them more likely to incur in violent acts” the position you are defending is identify people you think they are “dangerously ill” (whatever that means), preemptively lock him/her in, and forcibly drug her/him with the kind of drugs that are highly correlated with the perpetration of acts of violence against those taken the drugs or others.
Something tells me that your position is many things, but not rational. :D.
“Just because you don’t agree with Pies does not mean the other extreme is right either.”
This is like saying just because you believe that slavery is wrong, it doesn’t make “separate but equal” wrong. Sorry, “separate but equal” is wrong. In the matter of taking away personal freedoms without due process, there is no room for middle ground.
You want to preemptively lock in people who are likely to commit violence?, fine, apply to them the “beyond reasonable doubt” standard present in our criminal laws. Creating a subclass who are less deserving of that due process just because you say so is wrong, period.
Oh, and if what trying to say is that it is highly unlikely that I would have been civilly committed under American standards, I already know that. That is hardly going to make me sympathetic to your position. Just because I am less likely to be at the receiving end of that in the future, it doesn’t mean I can close my eyes to the injustice it represents. I am as guilty as the next person of “believing”, prior to my commitment, that psychiatry was a legitimate branch of medicine.
Unlike the average survivor of psychiatric abuse, I do have the scientific background to debunk the lies that psychiatry puts forward as “truth”. In fact, in my own area of expertise, those defending their ideas by confusing “correlation with causation”, by cherry picking data, by exaggerating anecdotal evidence or by using “after the fact” reasoning are literally expelled from the ranks. My field cannot afford to have these people on it. Planes wouldn’t fly. Bank accounts suddenly would lose money inexplicably. Cars would crash for no reason whatsoever, antiretrovirals would not have made HIV infection a chronic condition, cancer treatments would still be as effective as placebos, etc.
See, I practice true science, so I recognize pseudoscience when I see it.