Winners of the American Dream

Alice Keys, MD
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62
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Since I left the psychiatric prescribing trenches and came south for the winter, I’ve been staying in a beach town within driving distance of a technology metropolis. I take breaks from my writing and walk to the beach. There, I meet and talk with the winners of the American dream. They are intelligent, highly educated and financially successful. They take their beach vacations here.

One woman I meet at the beach calls her kids over from the sand so she can cover them with sunscreen. After we sit near one another for a time, we begin to talk.

She’s a busy professional who drove over with the kids for a few days off. Her father is scheduled for a procedure soon. She’s surprised when I understand the medical lingo. So I reveal that I’m a doctor.

I also tell her I’ve stopped working.

“Medical practice has turned into pills and tests. It’s not medical care any more. There’s no time allowed to talk to patients.”

I watch the calculations behind her eyes.

“That’s a long time in school,” she says. “Expensive to throw away.”

“Yes,” I say. “It is.”

She tells me she’s lucky she has a primary care doctor who doesn’t believe in tests and pills. Her doctor is a rare gem.

We trade mom stories for a while.

“What kind of doctor?” she asks.

“Psychiatrist,” I say. “Pills are the only thing left in psychiatry. So I stopped working.”

“I’m not a pill person,” she says.

“That’s good,” I say. “Our country has the highest rate of antidepressant use in the world.” I shake my head.

“Yes.” she says. “Almost everyone I know takes antidepressants. Even my sister takes antidepressants.”

It must have shown on my face.

“But she has a clinical depression” she assures me. “She needs hers. They had to try all kinds of things to find a combination that would work.”

Then she tells me that almost everyone she knows has a child on psychiatric drugs.

I tell her that there are schools in the U.S. where 40% of the kids have been diagnosed with attention deficit disorders. I tell her how much putting drugs into developing brains frightens me.

Psychostimualants. Methamphetamines. Speed. Antidepressants. Antipychotics. Benzodiazepines.

She smiles and nods.

She’s really not a pill person.

She’s skeptical.

But her son is anxious, has trouble sleeping, needs to be reassured, forgets things. He has an education therapist at school. She’s been told her son has serious problems with his brain connections.

“He has ADHD,” she confides.

They’ve scheduled a consult with a psychopharmacologist. She’s grateful to have access to specialists through her insurance.

“He just needs something to break the cycle,” she tells me.

“Do more reading before you change his brain with drugs,” I suggest. “Drugs are hard to stop. There are serious withdrawal symptoms.”

I review for her the financial conflicts of interest that make it unlikely that she will receive an unbiased medical opinion of her situation: pharmaceutical money in medical education, drug research, FDA drug approval, NAMI and pervasive drug advertising.

Her eyes look increasingly worried as I go through my litany. I sound like a conspiracy theorist. And I’m just some random person she met at the beach.

She will come out of her psychiatry consultation with drugs for her son. She has health insurance. She is among the winners of the American dream.

 

* * * * * * *

Thanks for reading, thinking and writing.

Alice Keys MD

***

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

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62 COMMENTS

    • Poet,
      Thanks so much for reading and commenting here. I appreciate your support of my writing. I love to write.

      We’ve let go of the old life and live in a temporary rental till we sort out what to do next.

      I hope to find ways to have a positive impact on how things are done in medicine.

      All the best.
      Alice

  2. Gosh, it’s time to read Brave New World again.

    I’ve had that, “Clinical depression,” talk before. The one I remember was with someone who said her breakdown was, “Endogenous,” a term that has gone out of favour. It meant her depression and mania were not due to her situation. She then went onto tell me that she had an unhappy childhood, her husband was unfaithful and had given her the cold shoulder in bed. She was working full time, bringing up two children and involved in political campaigning when she first had a breadown. She hadn’t been been serioulsy depressed or manic for a couple of decades. But it was all chemical and she needed the lithium, the anti-depresent, and the sleeping pills and probably would for the rest of her life.

    Well that’s what she said.

    Then her kidneys started to pack up.

    • John, I don’t think I could handle “Brave New World” again right now. I’m just recovering from my re-read of “Grapes of Wrath”. I realize we are much more under the thumb of unfettered global capitalism than I thought.

      I have no idea how our “anti-trust” laws were removed. I was taught back in school that these laws would protect us so we didn’t need to worry about huge corporations gaining too much power. Ooops. The laws are gone. I wasn’t watching and worrying because I thought we were protected by the laws and the government. Big Ooops.

      Yup. I remember “endogenous”. This was supposed to mean that there wasn’t anything one could do except take drugs to feel better. It always seemed, well, wrong to me.

      The incidence of kidney failure from psychotherapy must be down close to… zero?.

      Thanks so much for checking in on my post. It’s always lovely to hear from you.

      Alice

  3. Thanks again for another insightful article. When I was in Social Work grad school I worked as a residential assistant to a residential treatment center. The center used to be for unwed mothers and had many places across the States. Back then in the late 70’s and early 80’s is was for “troubled” teenage females. Read basically homeless due to abusive issues. There was no medication protocol. Treatment as in individual, group, and family therapy along with therapeutic milieu were used to fairly good effect. The worst behavioral activity was running away which was always quickly rectified.
    When I spent my time in the psych or prison units last year. The television was encased in a large metal box and locked.
    According to my hospital records there was one group held by OT’s on self esteem. I was considered a bad patient because I made the statement that OT’s should not be running groups on self esteem and that that was the provision of Master level Social Workers. I actually ran a group for inpatient psych patients back in the better days. They consider my claim to be a Social Worker as delusional and grandiose.I feel a group on self esteem in a prison setting psych unit to be cruel and unusual punishment.I distinctly remember staff members getting into a fight on the night shift and I located a non American very very rich female psychiatrist who was trained as a surgeon in her native country to ask for help. She knew my husband ( a burnt out Mental Health worker who is putting in time for retirement) through work and refused to do anything to help or diffuse the situation. I brought watercolors brushes, and paper and was the defacto true OT during my time there. The OT rooms were continually locked and filled with wonderful stuff that was never used.
    I blame my brainwashing for my need for hospitalization. I truly believe the psychotropic meds made me worse. I never witnessed any violence just bored to death patients with nothing to do but wait for discharge and freedom.
    We really need to have journalist go undercover and see what is happening. I think that will be the only way to stop Big Pharma.

    • mcoma,
      Thanks for reading and especially thanks for taking the time for such a great post of your own in response.

      Our cultural “brainwashing” (if I can use this word) is pervasive, contagious and starts at a very early age. I’m certain this cultural effect is a large part of the suffering that comes up in the mental health system.

      The cultural effects are overlooked and all blame is laid on the brain and family of the person suffering. I’ve been asked to treat unemployment, homelessness, divorce, community deterioration, effects of public education, drug addiction, school bullying, poor nutrition (and on and on) with drugs, drugs and more drugs.

      I guess if you only have a hammer everything starts to look like nails.

      And, no. I’m not going undercover.;-) What a terrifying thought. We all know where this would go. They’d be too drugged to report and discredited by their “mental” history.

      Alice

    • I had an experience similar to yours when I was in the state hospital. I was considered delusional and a liar because I’d told the staff during my intake that I was a former chaplain who’d been trained in psych hospitals so I knew something about what went on in the units! My friend, who just happened to end up being the social worker who was designated to take my social history (we’d not seen one another in almost fifteen years) heard the nurses calling me a liar while she was waiting for my session with the psychiatrist to end. When she realized what they were talking about she broke into their conversation and set things straight. They ran into the conference room to get away from her!

      I agree, we need people to do some undercover work.

      • Stephen,
        Wow. I appreciate your open reporting of your “undercover” experiences. This will not appear in the mainstream media but it needs to be talked about. You’ve already done the undercover work. A lot of folks have.

        People run away and slam doors when you crack through the walls of world views abruptly.

        Good to hear from you.
        Alice

        • You are so correct! When I recounted this particular experience in the department where I work, in this very same state hospital, one of the nurses who works in the department told everyone else (while I wasn’t there) that she didn’t appreciate me talking about how I was treated while I was there as a patient! We’re all supposed to hold hands and dance in a circle and sing Kum-ba-yah and pretend that bad things don’t happen at that hospital! Nurses seem to hold this opinion more than any other department in the hospital and I’m wondering why this is. Perhaps it’s because they’re the onese who give so much of the bad treatment to the patients more than anyone else on staff.

          • Stephen,

            This comment of yours would be funny… if it weren’t true:

            “We’re all supposed to hold hands and dance in a circle and sing Kum-ba-yah and pretend that bad things don’t happen at that hospital!”

            I think there is a tendency for people that work together to circle the wagons. This may be amplified in intense situations. I’ve certainly seen police and firefighters hang together even when wrong. Medical people and mental health providers, too.

            The view is certainly different from one side of the stethoscope (or locked door or injection syringe) to the other.

            Thanks for you input.
            Alice

  4. I’ve noticed this myself. Most people who say that they are skeptical of drugs or are not a “drug person” are quick to side with the drugs, believing somehow that their case is different. It was widespread after the 60 minutes special featuring Irvin Kirsch. Comments across the internet were filled with lines like “Of course anti-depressants don’t work for people who have real clinical depression, but for those who do they are a life saver!”

    And of course, whenever and wherever people talk about drugging kids, people who are not totally for or against it are like “Well they are definitely over-prescribed, and a lot of them don’t really have [insert diagnosis] (I like to say: How do you know? You’re not a doctor) but some kids really need those meds, blah blah blah (Again, how do you know?)”

    It seems most people in the U.S. are of the opinion that psych drugs are bad, except for when they are not, which is whenever they feel assured that some case is different. It’s irrational thinking considering the fact that the legitimacy of their use hasn’t even been proven for a single disorder, not even schizophrenia. How can there be even a single case where they are absolutely necessary, when they do not in fact fix brain malfunctions and no human being — especially a child — has ever dropped dead in the history of the human species because they didn’t have a psychiatric drug in their blood stream.

    • JeffryC,

      Thanks for reading and commenting. I think you sum this issue up very well. You’re right. I haven’t often met a person who said “Hey. I’m a pill person.”

      Some of the most wild west (shoot pills at anything that moves) “prescribers” I’ve known make good sounding mouth noises. They say all the right things. One has only to follow behind on their work to see the truth.

      I think what you say here is very astute:

      “It seems most people in the U.S. are of the opinion that psych drugs are bad, except for when they are not, which is whenever they feel assured that some case is different.”

      This adds considerable clarity to what people really mean when they say they’re not a pill person. It means they know what to say.

      I second your “sigh”.

      All the best.

      Alice

  5. The idea of changing the system has been done in the past. The UK was active in changing and ultimately her visit there led Dorthea Dix to investigate and challenge the abusive American Mental Health system.I really think we need Michael Moore of some one of his ilk to do a documentary. I think there were some investigative journalists in the 1960’s who did go in undercover. Writing as you do is enough for you!
    These days documenting the truth would be much more difficult than in earlier decades.
    Saul Alinsky who wrote “Rules for Radicals” was a wonderful community organizer who was able to pinpoint the weak spots of the opposition.
    I think there needs to be a two prong approach one delineating the
    current poly pharmacy and one bringing to light the whittling down of psych units to mere holding pens.
    The problem with the “Bring Change to Mind” campaign has been highlighted here on MIA.What they could do if they were aware!!!
    My only thoughts are having volunteers come and monitor the hospitals akin to the UN monitors for elections in despot countries.
    There is a very good but scary book called “Feed”. In my less optimistic moments I fear the book( written as a literary satire for young adults) will become reality. I hope thought a surge is coming that will change the course for everyone involved in Mental Health.

    • mcoma,
      Good comment. I appreciate all the work that went into it.

      I like your idea of having outside observers overseeing care. This should extend into our rapidly expanding prison and jail systems where many people are being held and drugged. Human rights oversight is in order.

      I’ve heard rumblings from UK about “privatization” of the NHS. Do you know anything about this? This word has been used to disguise corporate takeover of medical care (and many other things) here. It causes a precipitous decline in quality and rapidly escalating costs. It means “for profit” for shareholders. This has no place in medical care.

      Thanks for your reading, thinking and writing. Keep it up.
      Alice

      • Privitisation of the NHS is happening right now as I type. The laws came live this month. We now have clinical commissioning groups of GP’s who decide who gets the contracts for services. The copetition laws that apply to business have to be taken into acount now, they didn’t before. We all wait to see how this mess unfolds.

        Over the last decade the NHS was softened up with internal markets and privitisation of cleaning and food and other anciliary services but now commissioning groups can commission a private sector service to replace an NHS unit. The fear is that the private sector will undercut the NHS service to get the contract. They can do that by using profit from another enterprise. The good NHS unit then closes and all the expertise and machinery goes. The local population is then at the mercy of the private provider.

        It all costs more because of the costs of the regulators who are supposed to maintain standards, the cost of negotiating oontracts, the profit the private company wants, the extra interest on capital investment private compaines have to pay on loans (the state is charged less) and the greater differential between the wages at the top and bottom in private companies compared to state ones. As there is less money to actually spend on the service the wages at the bottom go down and sometimes the number of staff employed. So cleaing suffers and infection rates go up (I generalise, but you get the picture). And finally, the governance and oversight which looked at healthcare need according to geographical area and other concerns is being degraded as the market has a greater say in how healthcare is delivered.

        It will be an interesting few years as this unfolds. If a more left leaning government gets in at the next election we will then see how they deal with this and to what degree they reverse them. I’m not holding my breath, they put in the internal market and encouraged the privitisation of ancillary services to the detriment of the NHS as a whole.

        • John,
          I’m so sorry to hear this. “For profit” means “for profit”.

          Our “private” for-profit medical system is a cash cow for a few at the top of large corporations and to corporate shareholders. It puts straws into tax coffers through medicare and medicaid.

          Infant mortality is increasing.The numbers with no access to health care is increasing. The price tag is increasing.

          “The fear is that the private sector will undercut the NHS service to get the contract. They can do that by using profit from another enterprise. The good NHS unit then closes and all the expertise and machinery goes. The local population is then at the mercy of the private provider.”

          This is exactly what’s happened with the “privatization” of prisons here. They low bid. The government infra-structure dissolves. Then the price goes through the roof and the services vanish.

          It’s not possible to provide social services with a for-profit model. You can only provide profits. This is well known.

          You’ve been sold down the river.

          I’m so sorry.

          Alice

          • They’ve sold off a lot of the social care sector already. Things like home care where people get home visits. The social workers job is now to do an assessment and then put the job out to tender to varios “Care” agencies. The workers get paid badly and by the job, so they cut the time with the clients to the minimum and give very little peronal attention, especially if the client is at all, “Difficult,” as people with mental health diagnosis are likely to be (I have a gardening client who is an agroraphobic hoarder who also has physical dissabilities who has carers who do his shopping and offer help with cleaning etc and he is always having battles with them, it’s a wierd thing to witness.).

    • I think that the alternative, as always, is to think about what is going on and to change what can be changed. In schools the issues that drive difficult and disruptive behaviour are many. But the very fact that the number of children on these drugs keeps growing points to ADHD/ADD being a not very valid diagnosis.

      In the UK there was a programme in London where the good teachers from the good schools had time to go to the not very good shcools to help the not so good teacher bring up thier standards. That might well reduce the number of children put forward for diagnosis as I believe it is often the young and inexperienced teachers who have poorly developed class room control techniques that are likely to put children who they find disruptive forward for assessment. The more experienced teachers often don’t have a problem with the child, so passing on their skills would redue the impulse to medicalise the child

      • John,
        Thanks for the UK view on education and ADHD.

        I did a quick Wikipedia for rates of illiteracy. US and UK run neck and neck with 20% illiteracy and 40% “functional” illiteracy (lack literacy skills to manage every day life).

        There is something basic about our education structure that’s not fulfilling its prime directive. It makes me wonder if teaching reading (and other basic skills) is the prime directive of the education system we’ve built.

        Thanks for keeping us thinking.
        Alice

        • You’re better at the basic research than me Alice. I admire you for that. It’s also a skill I need to learn.

          This is one of the oddities of education in the UK (and maybe the USA too). Under the last government literacy and numeracy were pushed in schools with Literacy Hour and Numeracy Hour in primary schools yet if you are right the effect has been very little. There has been huge increases in box ticking for teachers but I’m not sure if the outcomes have improved much.

          We now have a creeping privitisation of education with the Acadamy programme where private business sets up organisations to run state funded schools. They have more independence in terms of curriculum than state run schools. But the evidence is that programmes such as the one I outlined above, where teachers scare skills, resulted in as much, or more lifting of outcomes.

          • Home schooling is getting harder in the UK too. There are financial advantages to schools to have children with diagnosis. Tehy get money to pay for teaching assistants. Whether they make any differnece has been contested. I was one for about 5 weeks. My question is are they there to enforce the school rules or to help the child get their emotional and social needs met?

          • John,
            I hope that privatization of school works better than privatization of utilities, prisons, medical education, medical care in this country. I have developed a “cringe” reflex when I hear that word. It may not be fair to assume the result will be the same in UK as in the US. But then again, why wouldn’t it?

            I’ll cross my fingers for UK’s school privatization.

            Alice

    • Alex42,

      Thanks for being willing to take another look at one of the most sacred of sacred cows in our country, the mandatory “free” public education system. It is in no way “free”.

      I agree that changing the way the education system works would be better than drugging kids. Amen to that.

      But it’s not likely. In Oregon, the IEP (individual education plan) brings in more revenue for each individual school. They’re paid by the head. An “IEP” head brings in more money than a regular head. There is a financial conflict of interest here. More IEPs equals more revenue for a school. AN IEP the ticket to drugging.

      Any masters level educator can make a psychiatric diagnosis and demand you drug your child. The kindergarten teacher or basketball coach can saddle your child with a lifelong psychiatric label and a lifetime of drugs.

      I think any person incarcerated and made to sit still and be quiet inside a crowded room every day for years could develop “symptoms”. Those who become hopeless and withdrawn could be labeled with ADD. Those who rebel, jump around and act loud could be labeled with ADHD.

      If one thinks of school children as young PEOPLE, my theory makes sense.

      I’ve read estimates of illiteracy rates as high as 40% in this country coming out of schools (depending on how you measure and who you count) and have been steadily declining. So school isn’t there to teach people to read.

      Yes. What we are doing to our children with this thing we call education needs to change. A lot.

      Thanks for the space for another rant.

      All the best.

      Alice

      • What about homeschooling? It’s something that we have available in the US as an option that is not available in other countries.

        I know people who homeschool their kids for other reasons. While I understand that the option might not be realistic for all people, it’s clear to me that I would seriously consider it if the threat is to have one of my kids (I don’t have any yet) drugged as a condition to go to school.

        • cannotsay2013,

          Thanks for bringing up home education.I have two boys. I’ve always home schooled them. They love it. I love it.

          Even though it’s been years since parent have been arrested for homeschooling their kids it still took an incredible amount of courage for me to educate my kids at home.

          It kept me awake at night for years thinking I was doing it all wrong. Then I read the story of an illiterate mom who learned to read along with her homeschooling child.

          Educating my kids at home has helped clear out some of my own cultural training. It’s allowed me to see that many things I “knew to be true” were simply incorrect teachings from someone else’s agenda.

          Home education can be hard to pull off by single parents and in homes that require both incomes to pay the rent. There may not be anyone home to supervise the kids. They may depend on school as day care. I’ve seen people work opposite shifts to pull it off, though.

          Homeschool laws very considerably from state to state. Transitioning a child who has many years of public education can take a while.

          If you are a product of public education this may influence your approach to home education. I thought at first that I had to replicate the classroom experience at my kitchen table. Nothing could be further from the truth.

          I’m a strong proponent of home education. There are as many variations on things that work as their are families.

          Thanks again for raising this important topic. Yes. Home education is a great way to make a truly individualized education.

          All the best.
          Alice

          • I don’t have children yet although I hope someday I will but I agree with what you say here. I am also the product of “mass education” (public and private) and I had always the concern that the only education possible was that that I knew. That until I began to read about how the current system of mass education came into being, historically speaking, and how individual education was pretty much the norm before mass education was put in place. In addition to the topic discussed here, there are all kinds of reasons why sparing little children from the experience of a mass education is a good idea: bullying, exposure to illegal drugs at an early age, etc.

            Agreed though that not all families can afford it but for those who can it’s a great alternative to mass education.

      • I may have shared this with you already. My mother never went past the third grade. She wrote a better letter, with correct grammar and punctuation, than my twelth grade students. I was so aggravated with them that one day I brought one of her letters to class and read it to them. I then asked them about what grade level they thought the letter writer had attained in her/his education. They were speechless when they realized that they couldn’t write as well as my third grade educated mother could and did!

        I found that many teachers were willing to pass students on to the next level even when the students were not proficient for the grade they were leaving. The teachers were not willing to put up with all the flack that paretns would give them for flunking their children. Also, coaches and parents put tremedous pressure on teachers to pass students who are on the school’s sports teams. It’s all a very rotten situation and few are doing anything to correct it.

        Teachers who maintain stiff standards are often made fun of by other teachers and parents give them lots of trouble. I saw all of this take place while teaching in private schools, which are supposedly better than the public schools.

      • Hi Alice,

        I was at a lecture last year at Harvard Medical School (the name of the lecturer slips my mind at present) and he was explaining that a lot of what we are diagnosing as ADD/ADHD in young children is really just different rates of maturation of certain frontal lobe controls. By around age 8-10, he was saying that these tend to normalize across the group. So really, the problem of education is it is expecting all children who are the same age to have the same level of brain development and able to handle the same environments, which is not accurate. Unfortuantely the ones that mature at a slower rate get pulled aside for being problematic and are often set on a lifelong path of drugging, underachievement, and other social problems.

        I realize now I was very fortnuate that I went to an alternative school (except for the very gifted, which also as a group have social challenges) where we could progress through at our own pace (so in a graduating class the age range was 14-18).

        Maybe once the rate of childhood psychiatric diagnoses reaches truly unmanagable levels (when they are the majority?) we will start to change our systems to better fit the needs of our diverse minds.

        Alexa

        • Alexa,
          Yes. You were very fortunate to go to an alternative school.

          Even before ADD/ADHD and drug marketing, children were squished together and homogenized.

          We left the era of the one room school where all ages were taught together then traded it for the factory model of learning.

          It’s time to get honest about education. People are not sprockets or interchangeable cogs. treating them as such is abuse.

          Let’s move onward (or back) to a model that does more of what we want and less of what we don’t want.

          At the very least, we can attribute harms done to the door it comes out of.

          Thanks for checking in and giving me more opportunities to rant about this. 😉
          Alice

  8. I copied this to have room to comment:

    cannotsay2013 on April 8, 2013 at 9:12 pm said:

    Yes, I would do exactly the same if faced with the choice. Sometimes people forget that we, Americans, have a lot of tools at our disposal to fight the psychiatric oppression.

    cannotsay2013,
    Exactly. I think that each of us can support one another to make creative moves to take care of ourselves and our families.

    Thanks,
    Alice

    • cannotsay2013,

      Yes. The history of our education system is a real eye-opener. John Taylor Gatto (an award winning New York School Teacher) did a good job writing about this in “The Underground History of Public Education”. I think it’s available to read for free on line now.It’s a big work. Some of his shorter books about education may be more accessible like “Dumbing Us Down”.

      He reviewed minutes from the meetings where our education system was designed.Chilling and enlightening reading. The militia had to be called out to march the kids to those first public schools in Boston. People did not want the system we have today. Literacy rates were much higher before public education.

      This many generations into our great experiment with public education and it’s hard for anyone to question it.

      Thanks,
      Alice

      Thanks,
      Alice

      • Hm, do you have an opinion on what the function of public education is? Lucy Johnstone wrote on this site that some see the function of psychiatry is to stop society being aware of the way many people are harmed in this socity. Contentious, but interesting.

        So what could be the function of public education? To free up adults for wor? To get them used to being bored and complicit with authorities so they are suitable for boring service sector jobs?

        Do you have any ideas Alice?

        • John,

          What is my opinion about the function of public education?

          What a great question. Of course I have thoughts and opinions about this.

          Although we may seem to have wandered off topic for MIA, I think this question is squarely on topic.

          How have we ended up with such widespread and unquestioning obedience to the pharmaceutical companies’ (and all advertiser’s) directives?

          This obedience to drugs (and other things that are bad for us and bad for the planet) is pervasive throughout all levels of society. Even mothers who know their kids are miserable being drugged seem helpless to stop it. The few that have the courage to stop the drugging often feel compelled to lie and pretend compliance.

          You would think that a country which is as highly educated as we would be less easy to fool and manipulate.

          In my opinion, our most holy of cows, our education system, is the cause of our obedience.

          According to John Taylor Gatto, an educator and historian who looked into the roots of public education in the U.S., our Prussian model of mass education was designed and adapted here specifically to provide control of a large population over a large geographic area.

          It was not designed to make good readers. The population of the colonies (outside of slaves) was already highly literate.

          One of the key features of our Prussian model of mass education is to produce a majority of people who have an unquestioning obedience to leadership.

          Whether that leadership comes from the front of the classroom, the front of the platoon or the front of a television doesn’t matter. We are conditioned to obedience through 13 long years of childhood classroom control.

          There may be some talkers and grumblers but people go to work and do as they’re told. Even the miners who are are paid by corporate coal mining companies to blast the tops off their own mountain homes in West Virginia and poison their own groundwater still show up to work. They may feel bad and grumble about it, but they still do it.

          Sorry. This is sounding like another essay. Very good question indeed. Google Gatto. Read his books.

          All the best.
          Alice

          • Thanks, this is hugely challenging. I googled Gatto and watched some video’s of his work. I foudn his criticism interesting but he didn’t have many answers.

            There are writers like Gatto in the UK, though not many who are prominant at the moment. I think the 70’s was when I last saw an upsurge of interest in such opions.

            Dorothy Rowe, the UK based Australian psychologist, wrote that there are two types of edcuation:

            1 education by molding
            2 education by enlightenment

            According to Rowe in Russian there are seperate words for both concepts.

            The word education itself, according to Rowe, comes from a latin word meaning to lead out of darkness.

            The restrictive nature of school, and the move towards a factory/office atmosphere instead of one of learning and democracy was one reason why I found working there so hard.

            To lead out of darkness would be the function of any good psychosocial programme for people who are mentally distressed. Would it not?

          • I began to wonder about it all when I got involved with Catholic schools, where they put each and every student in a uniform so that each and every one of them would look alike. They said that it was for economic reasons because uniforms were cheaper than civis and kept the kids from making fun of the less rich students. I never bought that at all.

            One of the ways that you gain compliance from people is to take their individuality away from them and make them one of the masses. Often, the boys were put in uniforms that looked exactly like military kacki(sp)with military belts and military style shoes. In earlier years everyone had to say good morning to the teacher all in unison, as one voice and body. All of this started me thinking about why it was done. I didn’t like the conclusions that I came to, but of course I’m one of those people that has to question everything and accepts nothing as gospel truth until you prove it to me to suit me.

  9. Hello Alice. I have an opinion I’d like to share about this post. Why do you think the woman at the beach is the winner of the American Dream any more than you are? I mean, there you are, walking to the beach, writing in between, renting only until you can figure out what to do next, as in buying a home? It sounds like you each have the American Dream, just two different versions. Indeed, you were both at the same beach.

    I do believe your writing is worth something, but what about offering your medical expertise to people who can’t afford holistic alternative care? I understand you like writing, and perhaps that is your calling, but its too bad that a person with your education and experience can’t offer alternative help to people who need mental healthcare. And, you could go undercover, as a writer.

    Personally, I don’t see your having quit being a psychiatrist as a justice to our mental healthcare system or the people in it. Obviously, you were smart enough to get through medical school, so you could learn acupuncture or another type of holistic care.

    I hope you are writing in other places than this blog. I like this blog, but I really don’t think many psychiatrists who are still writing prescriptions every ten minutes are reading it, which is too bad. I wish they were!

    • MichelleB,
      Thanks for reading and commenting. I like to hear your thoughts. You ask some very good questions.

      Ah yes. We have both “won”. I’m unemployed in a rental with my family with no house or job in my future. I’m not under a bridge. My kids are not being drugged.

      She has a job, a house and a kid that will soon be drugged.

      It is a shame that a person with my education, experience, training and smarts is unable to find a way to get paid to use any of it. I suppose I could work for free without the expensive liability insurance. Or I could retrain in tropical medicine and move to Africa. As you point out, there are endless opportunities for someone like me.

      Yes. I do write other places. Check alicekeysmd.wordpress.com

      Thanks for asking. All the best.

      Alice

      • Hi Alice and thanks for your reply. I must add that my comment, obviously, is a rather negative take on your post. I started my day off (the day I commented) with my son in the office of a psychiatrist. I guess you could say it was uphill from that point, but it was a very hard day. I have so many emotions about the way they talk to him, view him, and ‘treat’ him, that I feel I am going to explode.

        I wish so much that there were more psychiatrist who were like you, and able to serve the people who can’t afford hundreds of dollars per visit. My sincere apologies if my comment was a personal attack.

        Maybe one day you will meet more people like yourself, and you could start some type of service to help patients, and if not, then I hope your words reach many people. I hope the conversations you have, like with the woman on the beach, might enlighten a few people. The woman you describe does reflect the views of most people I meet too, and that’s pretty hard to deal with too.

        I will check out your writing, and thank you again for your kind response.

        Most sincerely,
        Michelle B.

        • Michelle,
          I apologize. I re-read my reply to you just now. I didn’t mean to sound short in any way. An extra apology if I came across badly. I can’t always tell how things sound in writing. I’m so much better in person (I hope).

          I’m so sorry about your difficult times with psychiatry. What’s going on within patient care is a shameful contortion and degradation of the practice of medicine.

          We’ve left “first do no harm” far behind in our efforts to stay on the economic bus. If I could stop this out-of-control bus, I would. I tried to stop the bus (a small local one) by throwing myself under it in 2011. It kept going.

          The best I’ve been able to do so far is get off the bus and speak the truth over and over. And this is the best advise I’ve been able to come up with so far:

          Get off the bus and speak the truth.

          I do hope that some private conversation or writing I have makes a meaningful ripple in the pond. I have private conversations with doctors whenever the opportunity arises. This has turned out to be the positive outcome of my recent job search. No jobs but a chance to talk about my thoughts to working doctors.

          All the best to you and yours.
          Alice

  10. That mother on the beach could have been my mother, or one of my sisters. In fact, she could have been my psychotherapist, or my lawyer, accountant or child’s principal. I have heard the same from the masses. There are far too many people that claim they are not pill people, but willingly accept the “professional’s” opinion. Finding a good psychiatrist is more difficult than finding a good mechanic. People look for professional advice and rely on the system to provide it. I understand why you would not want to be a psychiatrist anymore. You are intelligent enough to understand what is wrong with the system, and now you are trying to find out how to fix it.

    Your simple observations are great… we all relate to that woman on the beach. How does change occur… real change. I think of the AIDS epidemic and how it consumed us for years. We did not cure AIDS or eliminate HIV infections, but we did educate. The power of the media and celebrities helped, public service ads… How can we create such an outcry? That is the real question. There seem to be lots of movements… you yourself said you were starting to sound like a conspiracy theorist. It is not a theory… there is proof. Whitaker’s book… countless ex pharmaceutical reps… but how do we get the message to the masses? That’s what I’m trying to figure out.

    • Jeff,

      Thanks for reading and for your thoughtful and gracious comments. I appreciate your support of my writing efforts. There is more than one way for a doctor to help people.

      This woman I wrote could be anyone we know. I hear a variation of this story every time I have a personal conversation about psychiatry. She is a compilation of many who I’ve talked to.

      You’re right. I HAD to stop work once I read RW’s book. I tried for a while to work in a new way within the old system. This went nowhere useful.

      When I talk about truths that are not widely known, people do see me as being a conspiracy theorist, having a “bad attitude” or in being “too down” about things. I’ve been accused of these (and worse) by strangers, acquaintances and people who I’d once considered friends and trusted co-workers.

      We must each do what we can to get the message out.

      Thanks for reading, thinking and writing.
      All the best.
      Alice

  11. I’ve copied and pasted this comment unchanged from the above thread to have room to respond:

    John Hoggett on April 9, 2013 at 3:13 pm said:

    Home schooling is getting harder in the UK too. There are financial advantages to schools to have children with diagnosis. Tehy get money to pay for teaching assistants. Whether they make any differnece has been contested. I was one for about 5 weeks. My question is are they there to enforce the school rules or to help the child get their emotional and social needs met?

    John,

    Thanks for your conversation. I like to hear how things are going across the pond. Personal reports are enlightening to me.

    In Oregon (homeschool laws vary by the state you’re in) the school offers a free computer, internet connection and on-line curriculum. I never heard how this works out in practice.

    The teaching assistants? Not sure. Not much experience with them. Behavioral control, perhaps?

    All the best.
    Alice

  12. I have copied and pasted this comment unchanged so I have room to respond:

    John Hoggett on April 9, 2013 at 4:41 pm said:

    They’ve sold off a lot of the social care sector already. Things like home care where people get home visits. The social workers job is now to do an assessment and then put the job out to tender to varios “Care” agencies. The workers get paid badly and by the job, so they cut the time with the clients to the minimum and give very little peronal attention, especially if the client is at all, “Difficult,” as people with mental health diagnosis are likely to be (I have a gardening client who is an agroraphobic hoarder who also has physical dissabilities who has carers who do his shopping and offer help with cleaning etc and he is always having battles with them, it’s a wierd thing to witness.).

    John,

    In Oregon in the late 80’s county (public) mental health services were “spun off”. What this amounted to was privatization to “not for profit” corporations. “Not for Profit” corporations behave just like other corporations except they don’t have stocks and shareholders to pay dividends to.

    These public mental health services have been sliced and diced and sold off and moved around year after year to the lowest bidders for 24 years.

    Add layers of increasingly powerful for-profit insurance companies, medical service provider organizations and politicians beholden to campaign finance contributions.

    We have a mess there. A cash sink hole called mental health services and not much in the way of care happening. Tax dollars vanish through this web into corporate pockets.

    It is not possible to provide public services through private venues. No one will take care of your poor, elderly, sick and needy like you would.

    Welcome to our world. You’re just a bit behind us in the process.

    All the best.
    Alice

    • OH, I’ll just go and put my head in the sand…..

      Magaret Thatcher, the UK prime minister in the 80’s just died. She was old so her death was expected sometime around now. She was the figure head for this ideology as I believe Reagon was in the USA. As I’ve pointed out before Biopsychiatry really took off as neo-liberal ideology did in the Thatcher/Reagon years. No one really seems to have turned the tap off since.

      We mourn and perhaps organise.

  13. Hi Alice, just to say I loved your post. A tad dystopian, but true enough.

    As a former psychiatrist, your in a unique position to tell it how it is, and possibly be believed. Whereas as a former patient, if I ever speak my mind on psychiatry, it merely confirms an obvious need for meds. So keep up the writing…

    • Hi,
      Thanks for reading and commenting. I can live with “a tad dystopian”. Perhaps I can even feel proud to have gotten this rating.;-)

      Maybe I’ll be believed because of my psychiatry background. One would think. One would hope. But mostly not. I get some pretty cranky looks from some docs when I trot out my opinions. I talk to brick walls. I talk to the “yes pills are bad BUT…” folks. Every once in a while I run across a member of the choir. What a relief.

      I did meet one lovely doc recently who spoke on a similar wavelength. We talked a while, shared thoughts. He’d just started to read “Anatomy of an Epidemic”. I wept afterwards. What a profound relief to be validated by another psychiatrist.

      Thanks for your support of my writing. This seems to be what I’m supposed to do right now. And that’s okay with me.

      Alice

  14. I’ve copied and pasted this post from above unchanged so I have room to reply:

    John Hoggett on April 10, 2013 at 8:06 am said:

    Thanks, this is hugely challenging. I googled Gatto and watched some video’s of his work. I foudn his criticism interesting but he didn’t have many answers.

    There are writers like Gatto in the UK, though not many who are prominant at the moment. I think the 70′s was when I last saw an upsurge of interest in such opions.

    Dorothy Rowe, the UK based Australian psychologist, wrote that there are two types of edcuation:

    1 education by molding
    2 education by enlightenment

    According to Rowe in Russian there are seperate words for both concepts.

    The word education itself, according to Rowe, comes from a latin word meaning to lead out of darkness.

    The restrictive nature of school, and the move towards a factory/office atmosphere instead of one of learning and democracy was one reason why I found working there so hard.

    To lead out of darkness would be the function of any good psychosocial programme for people who are mentally distressed. Would it not?

    MY REPLY:

    John,
    I was more impressed with his early written work (“Dumbing Us Down” comes to mind. A small book to read.) than his later recorded work. I haven’t the patience to listen through the long recordings. The messages get lost for me. But I’m oriented to the written word on paper by default.

    In his earlier writings he reviewed the things that he did as a NY public school teacher over a couple of decades, what worked and what didn’t, and how people responded to what he did.

    If only our education system would lead people from the darkness. So often it seems to do the opposite. This makes me wonder if we’re using the wrong words for what we do in schools.

    When I tell people how to evaluate the meaning of the words being used (ex. mission statements), I tell them to evaluate the outcomes. Maybe the first couple of times or rare events can be called accidents in spite of good intentions. When one continues to do the same things that cause consistent bad results, at some point you have to ignore mission statements.

    Watch what’s happening to discern the truth.

    The “education” we do is more what you described as a “molding”.

    I would love to see a psychosocial program that enlightened the mentally distressed. As long as it also helped with the basic needs of life: Food, water, shelter, safety,relationships.

    All the best.
    Alice

  15. I’m copying and pasting this comment from above in the thread so I’ll have room to reply:

    Stephen Gilbert on April 10, 2013 at 8:29 am said:

    I began to wonder about it all when I got involved with Catholic schools, where they put each and every student in a uniform so that each and every one of them would look alike. They said that it was for economic reasons because uniforms were cheaper than civis and kept the kids from making fun of the less rich students. I never bought that at all.

    One of the ways that you gain compliance from people is to take their individuality away from them and make them one of the masses. Often, the boys were put in uniforms that looked exactly like military kacki(sp)with military belts and military style shoes. In earlier years everyone had to say good morning to the teacher all in unison, as one voice and body. All of this started me thinking about why it was done. I didn’t like the conclusions that I came to, but of course I’m one of those people that has to question everything and accepts nothing as gospel truth until you prove it to me to suit me.

    MY REPLY:

    Stephen,

    My older came home from his first half-day of kindergarten (in a yuppie high-end high-rated school) with this story:

    His teacher had a box of cookies. She said that everybody would get a cookie if everybody clapped. Then she told them that nobody would get a cookie if even one person didn’t clap.

    That was his last exposure to “education”.

    I went into this believing that public school was the great gift to the masses and that anyone that home schooled was depriving their kids. Our school was the “good” one. We had the “good” teachers.

    Dog treat behavioral training from day one. Of course, he saw nothing wrong with this. He thought it was great. He was very hungry. We’d been told absolutely no snacks would be served.

    Sigh.

    Alice

    • One of the many things that I appreciate about you is that you actually answer peoples’ responses to what you write. It provides the opportunity to carry on a dialogue, which is how I believe education actually happens. The sharing of ideas is an important part of learning. I’m really glad that you’ve found a home here on MIA. Although this doesn’t provide any money to support your family, and it’s probably not as uplifting as “walking” with people experiencing difficulties in life I feel it contributes in an important way to the ongoing Journey. Thanks.

      • Oh Stephen,
        It’s my joy and pleasure to engage in ongoing dialogs here. I’m learning a lot and getting to know great people (like you).

        Writing essays is one way I work out how I think and feel about things that trouble me. Here on MIA it’s like supercharged essay writing in the comment zone. I write more off-the-cuff. I find the views expressed here both very thoughtful and thought provoking.

        I do miss the personal long-term relationships I once had when I worked with people in my office. I miss the problem solving of crisis work. I miss teaching student doctors and supervising trainees. I miss collegial discussions.

        No money in this. True. But I’m not alone in this world either. I’m fortunate. And we’re not a high-needs family.

        So overall, I feel lucky to be here doing just what I’m doing. Until the next thing changes.;-)

        All the best.
        Alice

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