My name is Michael Rock. Until now I have been participating on MadinAmerica.com as a commenter named “Marcellas”. It is very nice to finally introduce myself to this community under my real name. Although I only occasionally commented, I have been a regular visitor and reader of MadInAmerica. I am especially grateful to Corinna West, Dr. Mark Foster, and Laura Delano. It was good to know I wasn’t alone.
I feel like I need to apologize for hiding behind Marcellas. Anonymity is not something I am proud of, nor was it a trivial matter to me. When I marched with Mindfreedom in Philadelphia last May, I was reluctant to introduce myself to some of you who were harmed by an industry I continue to work for. I am a group psychotherapist in a large hospital network in Eastern Pennsylvania. I have been working with people in groups for twenty five years. I love my job, and believe I am helpful. I felt that “Marcellas” allowed me to continue to work quietly for change within the system.
When I read Anatomy of an Epidemic, it seemed obvious (from my admittedly limited vantage point) that the national trends in treatment outcomes closely reflect our local outcomes. By this time I was already on record as a critic of medications and the chemical imbalance theory, and a skeptic of diagnosis.
I wrote To Mr. Whitaker in 2010 after reading Anatomy of an Epidemic to tell him that I was introducing his book to our team library and intended to discuss it. He was kind enough to write back and wish me luck.
I spent the next three years being more stubborn then loud, and I like to think I made some progress. I developed a model of behavior chain analysis using CBT, DBT, and Positive Psychology. I call it “Habits”. It can be presented in a very brief series of sessions (our average length of stay of 7 days). A central theme of the technique is to assume that anyone can learn to control their thoughts, feelings, and actions. Everyone can learn to explore what they are capable of, rather then limited to.
The model is very popular with our patients. I use a lot of humor and try to make it entertaining as well as helpful. I consistently receive the highest number of compliments from patients at discharge than any other team member, and I am very proud of this. More importantly, I’ve yet to find evidence that the model doesn’t work.
However, my message indirectly challenges the assumption that “accepting illness” along with “medication compliance” is the best path to recovery. This has made me unpopular with those invested in preserving the status quo. Obviously there are financial incentives involved.
In January I received my “final written warning” from the hospital, and have been working under threat of immediate termination since then. I’ve been to several meetings in which it was stressed to me how serious they are about firing me, and I believe them.
I am not sure what effect leaving Marcellas will have on my career. I don’t think there is anything I can do to prevent being fired at this point. Not only am I am small fish in a big pond (I only hold a BS degree in Psychology and work for the largest employer in the area), but I also live in a “right to work state” which translates from Orwellian into “the right to fire anyone at any moment for any reason, or no reason at all”.
Since January I have driven to work every day wondering if the ride home would include boxes of photos from my office. Sympathetic coworkers tell me that when they fire me I’ll be escorted by security in a public walk of shame. It’s assumed they will want to make an example out of me. So I have this to look forward to.
I want the reader to understand that the people who are firing me are not bad people. They are trapped in the same system as everyone else. I believe they respect me and like me personally, and it’s very clear to me that firing me is painful for them. I believe also that the practices at my hospital are not unusual in the current paradigm of care. From all I can see, my hospital is state of the art in contemporary industrial psychiatry.
I am not bitter about being fired. I am aware that speaking publicly in this way could blacklist me, and I may never work in mainstream mental health again. I have always been very proud of my work and my reputation, and it is difficult for me to throw these away. Naturally I am nervous about losing my income (although not as nervous as my girlfriend, who is convinced she will soon be supporting me).
I intend to use the extra time I’ll soon have to write about the narratives of disability, the people I met in the system, and to suggest an alternative to it.
I know there are more out there like myself, working under the same pressures, trying to help people. I expect you are also haunted by the people who come to us for help; trust us, do everything we suggest, and get worse. Please know that you are not alone.
I know now that I am not alone. I am Michael Rock.
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.