Difference is Not Disease:
Scientific Integrity, Human Diversity, and the
Potentially Bleak Future of Psychiatry

Faith Rhyne
173
1587

Anyone who spends time around this site (Mad In America) knows that there has been a lot of talk lately about neuroscience and the future of the medical model of “mental illness.” However, many people who are affected by mental health practice and policy, for whatever reason, may not be aware of the current controversy and concern regarding the recent decision by the National Institute of Mental Health (NIMH) to steer funding away from research that is rooted in the definitions and delineations of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

In NIMH director Thomas Insel’s late-April statement, the DSM is characterized as having poor “validity.” This means, plainly, that there is no consistent evidence that the DSM classifications of experiences deemed “mental disorders” correlate to any specific or measurable process of disorder. The diagnostic categories of the DSM are based on subjective symptoms, for which there are often no identifiable causes.

The dominating reign of the DSM has been dealt what may well be a terminal blow. There may not be a DSM-VI.  Our entire “mental health” system may need to begin considering vast revisions of coding and service. Because the DSM has been publicly declared (by a presumed authority, the NIMH) to lack validity, anyone who uses the book in practice or policy will have to think hard about the integrity of the ethics that govern their professional practice. In some ways, the NIMH announcement was a great boon to the efforts to build support for alternatives.  In other ways it is an insult, given that advocates and activists have been criticizing the DSM as unreliable, inaccurate, distorting and ultimately useless for decades.

The DSM is on its way to being history. However, with the NIMH announcement came a new set of research domains that will affect the future of sciences pertaining to the human condition, with a specific focus on identifying neurobiological markers and processes that may be linked to manifest human difficulty that is currently seen as “mental illness.”

Yet, recent reports from the American Psychiatric Association clearly state that there is not a biological marker that can be identified using neuroimaging, indicating a vast abuse and squandering of funds that could have actually supported the research and development of additional evidence-based healing practices. Research that has purportedly identified variation in genetic or neural function or structure is minimally informative, as any phenomenon of the brain is:

A) dependent upon a great number of variables

B) likely to change, given the fact that we are in a constant state of growth and response

So, where does that leave us?

There is a fear that the research directions charted by the NIMH may lead to a hypermedicalized view of the human condition, and that many more billions of dollars will be spent developing invasive technologies designed to affect our neurobiological function, possibly in ways that may be toxic.  Given the exploitative collusion that regularly happens among researchers and industry, this is a legitimate concern.

“Scientific” research has, historically, been the driving impetus for vast and insidious human rights abuses and the formal literature has contributed mightily to distortions in our conceptualizations of normative function and expression. This is not, of course, to dismiss “science” or present an “anti-intellectual” view of the existing body of literature. However, a systematic review of said literature will reveal vast reams of flawed methodology, theoretical bias, and a dearth of the simple logic that informs us that our lives are complex, messy, and dynamic, with multiple variables acting upon one another in ways that make it difficult to generalize any conclusions across large portions of the human population.

Two people (or 7 billion people) can be genetically related and be, within their subjective experiences, very different. They can go through the same tragic events and experience them uniquely.  Even people who share tendencies of experience are not the same and what might be helpful for one person may prove to be unhelpful – or even harmful – to another.

However, in spite of the barriers to generalization, there are correlational trends among people who experience struggle between themselves and their life circumstances, with potential causal links between trauma, stress, and psychosocial dynamics as these factors relate to difficulty in experience. We are all affected differently by constructs of economy, opportunities for education, and the other factors which shape the landscapes of our lives, be they plush or war torn.

There are numerous psychosocial/emotional/existential/spiritual theories about what may cause difficulty in human experience. Entire fields of science and inquiry are based on hypotheses of the mind and musings on the heart. Obviously, we are more than our neural connections. Yet, we do have brains. We do have neurons and synapses, enzymes and chemicals, areas of tissue that mysteriously hold networks of memory, others that map our anticipations.

Do we need to know the specific neurological correlates of internal conflict?

How does the fear of being alone pass between our synapses?

Does hope light up our brains, or just our hearts?

Is it even possible to know? Is it important?

Perhaps it would be more useful for us to focus on what seems to help, rather than trying to identify some elusive shared trait among those who struggle for some reason or another with their human experience. By establishing evidence of the efficacy of alternatives, the “problem” may become less important than the possible (or obvious) solutions. It doesn’t take a Ph.D to know that when we are empowered, accepted and loved for who we are we tend to feel better and enjoy our lives more.

For the sake of fairness and acknowledgement of reality, there are some instances that neurological duress or wounding can be implicated in difficulty within our human experiences. The effects of chemicals and certain elements (such as illicit and pharmaceutical “drugs” and lead, for example) can wreak havoc on the functions of our brains, as can (actual and measurable) diseases like cancers of the brain. Even in the absence of drug effects, the neurological effects of an actual disease, or environmental toxins, some people do experience some significantly difficult recurring experiences. Sensory integration issues, distinct features of processing or thought tendency, and regulation of emotion and energy are genuine and very real struggles that many people often attribute to neurological differences.

First and foremost, difference is not disease. This cannot be said enough. Difference is not disease, by definition. Some differences are caused by diseases, but difference itself is not a disease. A disease requires an evident process, with indicators and predictable outcomes. Based on those exceedingly simple criteria, the bulk of challenging human experiences cannot be attributed to anything remotely resembling a disease.

Some people do have what they have found to be characteristics of experience that can be, in part, attributed to elements of our human function that are considered to be at least somewhat neurological, such as sensory integration. These differences – some of which can be experienced as disabling depending on the expectations that establish “normal ability,” contributing to severe sensitivities and learning differences, among other struggles – are often identified through neuropsychometric testing (e.g. IQ tests) of some sort. These measures are often problematic themselves. Yet, they do measure something, and those inventories of attribute do have the capacity to inform us of some aspect of our human experience, even if it is only whether or not we “test well.”

Acknowledging neurodiversity is in no way endorsing a biomedical disease model. There is an entire movement of people who identify with concepts relating to neurodiversity, which acknowledges that some people do fall well outside of the range of statistically normative neuropsychological features and that these variances from neurotypical function are a good thing, rather than a disease. The human species is diverse by nature, and rightfully so. We encompass artists, musicians, architects, astronomers, storytellers, engineers, farmers, cartographers and healers…and we all, as humans, struggle.

Yes, for some the struggle is tremendous.

Yet, just as we all struggle, we all also, as humans, have the capacity to live our lives well to the best of our abilities, which ought not be impeded or discouraged by circumstance or belief. We grow and change. We find out, through trial and error,  who we are, what we like and what we are scared of. We learn what works for us and un-learn the belief that we can’t learn.

It ultimately may not be important for us to know the specific rate and content of exchange across neural networks. Even if we figure out how something works in one person, or even in a supposed group of people, the variables that shape our lives and experience are complex. It is difficult to conclusively generalize any broad truth about why we are human in the ways that we are and what the future may hold for any of us.

If the NIMH spent as much funding on accessible, trauma-informed, integrated, choice-driven community wellness centers and lobbying for better quality of life opportunities as they do trying to find evidence of elusive brain diseases, we would not have the “mental health” crisis that we currently have.

We would, perhaps, have more of what we deserve, not as people identified as having a “mental health disorder” or as people that could “qualify for disability” but as human beings with universal human rights.

Do we really need research to tell us that kindness and compassion are healing, that options are good and that the more perspectives we have access to the better able we are to figure out a meaning and strategy that may best work for us?

Due to the resources afforded to the pharmaceutical industry, state institutions and the military, research funding has been unequally distributed. Therefore, the ideas and theories that have been formalized as “science” are largely representative of the interests and paradigms that research institutions and grantors may ultimately profit from.  In what directions will the NIMH fervor for a new nosology drive this science devoted to answering questions that don’t need answering, or which cannot be answered by a medical test? What good comes about from looking for a disease and what will they make of what they may find? Are so they so desperate to find something that they would be willing to create disease where there is none, simply so that they may find it?

So far, they have found, for all their sophisticated techniques, surprisingly little. There are no lesions, no consistent protuberances, no void grey areas of neurological scarring. Potential variations that have been identified could have been caused by anything, and may simply be the fact of human diversity in function and expression.

So, is there anything good or useful that could come out of new NIMH research directions?

Well, some innovative researchers may be able to secure some renewable research grants to conscientiously and strategically contribute to the body of literature on alternative non-invasive evidence-based practice, perhaps relating to the neurological benefits of naturally occurring micronutrients in delicious food or the measurable effects of mindfulness, stress reduction and life enjoyment programs. Perhaps someone could conduct research on the beneficial neurochemical effects of hanging out in fields with friends, laughing.

Researchers may gain insight into the effects of stress.

They may learn more about the specific ways that neuroleptics damage our brains.

All in all, we may not need research to tell us what we most need to know about human struggle and human healing, which is simply that both phenomena are intrinsically human and, by virtue of that, we are all different in what hurts and in what may help. It is, however, fair to conclude that for most people fear can be toxic and that love/acceptance/nurturance can be healing.

I do believe in the potential for bad ideas and dysfunctional systems to destroy themselves and I am hopeful for the development of an ethical science of the human condition. At the basis of this science would be a commitment to framing the human experience in a manner which is realistic and informed, with a resolution to not call things diseases which are not diseases. I am hopeful that young scientists paid attention in their philosophy of science classes, their ethics courses.

To me, it seems that it would be far more interesting and exciting to destroy a useless and harmful paradigm than it would be to try to prove evident mistruths. It would be a lot more fun to research the neurological characteristics of a life well lived than it would to be to spend life sitting in a laboratory looking at numbers about some poor little kid’s dopamine levels as they may be affected by neuroleptics.

*Laura Delano’s excellent recent post “Mental Illness,” the DSM-5, and Dreams for a Post-Psychiatry World explores the implications of recent shifts in the direction of formal understandings of human struggle as our realities relate to misinformation, oppression, and multisystemic trauma. In the comments is a really great discussion of the body, mind, heart, environment dynamic as it relates to potential hypermedicalization of our perspectives of human experience.

Here is a poem that I wrote about scientific paradigm shifts as such things may relate to brain research and a picture that I drew during a period of involuntary outpatient commitment, while I was thinking about how strange it sometimes is to be human.

relation

The Scientist’s Lobotomy

Did you look inside her brain

at that place

where you imagined

all those demons, that disease?

Was her skull split open

like a shell

for its soft fruit

to be examined

by the stainless tines

of your science?

What did you find, in that shimmering inside?

Was it not so dark as you thought it might be?

Did you see, there in the folds, the pits that you had pictured?

Did you find

the small empires

you expected

in a chemical rot and lesion?

Did you swim

in the swamps

tucked into the coasts between

this region and that region?

Were there valleys and layers, tangles like cities on a roadmap?

Or was it softer, smoother…perfect?

Did the gentle pink edge remind you of a shell

that you once picked up from the shallows of the ocean?

Did the salt on your lips taste like waves?

There were patterns in the sand and you traced them

as mountains.

You saw the pools, your eyes reflected against the sky reflected and…

…you knew the truth.

You found it in that shell that held the sunset.

That soft slick bruise

of grey and blue

that felt, to you,

soft like your scalpels

could never be.

For a moment, the whole world was there

and you felt

the sound inside

like music.

It’s so easy to forget

that you wanted to live

inside that place

where the ocean roared

against your ear

for you alone to hear.

When you looked at her brain did you see

the landscape of her memory?

Was it a castle

a library

a junk store

a field?

Was the universe in there?

Did it look like sand?

Or did it look like stardust?

Does stardust look like sand?

…or did you only see a small grey region, asleep

and of a certain weight

that you carved out

and placed on a scale?

Was it barely alive at all?

Did you find, in her crenellated warmth, the place

where voice is born?

You never heard it.

She never spoke.

You never listened?

It doesn’t matter now.

You’ve forgotten

what it was

that you were looking for

in that space behind her eyes.

Do you see that, even sleeping, her mouth looks like a bow?

You have no way of knowing that as a child

she sang the same song

over and over again

because it made her happy.

Tell me, when you pulled

the two halves apart

did they make

any noise at all?
Tell me, what did you see inside?
Did you find God?

Or did God find you?

173 COMMENTS

  1. I suspect all this Nuerodiversity malarky, and all this, “Brain Science,” is the latest way society in general, and psychiatry in perticular is trying to avoid the psycho-social causes of mental distress.

    Anything to avoid realising that some of us have messed up heads because we’ve had awful lives.

    On Radio 4 to day on some programme or other there was a feature about using imaging techniques to look at teenagers brains to try to find out why teenagers are so moody. The theory being that brains are, “rewired,” during the teenage years. Nothing about growing independence leading to conflict with families and society or being overwheled by the challenges of the teenage years then?

    The feature then said that a lot of mental health problems started in teenage years or early adulthood and studying brains might help understand what is going wrong with the brain. Nothing about the difficulties of making the transistion from a dependent child to an independant adult when you have had a difficult and tramatic childhood then?

    It’s like the psychosocial evidence is being ignored all over again, only it’s not genes and bio-chemical imbalances now, it’s brain architecture.

  2. A wonderful essay Faith, I really appreciate your openness to exploring the human condition and its functional nature, I particularly like;

    “Do we need to know the specific neurological correlates of internal conflict?

    How does the fear of being alone pass between our synapses?

    Does hope light up our brains, or just our hearts?

    Is it even possible to know? Is it important?”

    In my own journey to understand the nature of my psychotic experiences, “how to know” seems to lie at the very heart of understanding. Should I be able to think my way to understanding, or is a combination of thoughtful knowledge and “felt sense” required?

    Along the way to becoming totally medication free and independent, my self-interpretation (self-awareness & understanding) questions shifted from dependence on acceptance of the generalized brain disease medical model of a “treatment industry” approach based largely on ignorance, fear and historical accidents. Towards a more holistic sense of my profound nervous dis-ease, as involving my heart, lungs and gut, as much as my brain.

    Put simply, my experience of manic psychosis is a NEED of appropriate orientation towards reality, of organism know to the social environment as David Bates. What has allowed me to understand this growth process involved in psychosis, is reading the kind of neuroscience which seeks to explore the reality of the human condition rather than defensively judge it, as in fearful assumptions about pathology.

    Question! Can we really ‘assume’ that the experience we label “mind,” is all about what happens within the brain, alone?

    I personally believe that we are on the verge of a paradigm shift in the perception of ourselves, and what really means to be human, to be a sentient species.

    Please consider this important paper by the brilliant Stephen Porges, on the “Reciprocal Influences Between Body and Brain in the Perception and Expression of Affect”

    EMOTIONS, AFFECT REGULATION, and interpersonal social behavior are psychological processes that describe basic human experiences in response to events, environmental challenges, and people. These processes shape our sense of self, contribute to our abilities to form relationships, and determine whether we feel safe in various contexts or with specific people. Although these processes can be objectively observed and subjectively described, they represent a complex interplay between our psychological experience and our physiological regulation. These psychological–physiological interactions are dependent on the dynamic bidirectional communication between peripheral organs and the central nervous system connecting the brain with these organs.

    For example, the neural circuits, providing a bidirectional communication between the brain and heart, can trigger either a rapid increase in heart rate to support protective fight/flight behaviors, or a rapid decrease in heart rate to support social interactions. Peripheral physiological reactions can be initiated by the brain that detect features of danger in the environment, and alternatively, changes in our peripheral physiological state can feed back information to the brain and alter our perceptions of the world.

    Thus, affect and interpersonal social behavior are more accurately described as biobehavioral than psychological processes, since our physiological state can profoundly influence the quality of these psychological processes, and our feelings can, in turn, determine dynamic changes in our physiology. Our nervous system functions as a sentry by continuously evaluating risk in the environment. Through neural surveillance mechanisms (i.e., neuroception—see below), our brain identifies features of risk or safety. Many of the features of risk and safety are not learned, but rather are hardwired into our nervous system and reflect adaptive strategies associated with our phylogenetic history. For example, low-frequency sounds elicit in mammals a sense of danger associated with an approaching predator.

    Through exposure and associative learning, we can link these features with other events. Specific features in the environment recruit physiological states differentially associated with feelings of safety, danger, or ultimate demise (i.e., life threat). Each of these states is characterized by a specific set of capacities for affect regulation, social engagement, and communication (Porges, 2003). Current research in affective neuroscience focuses on brain structures and neural circuits related to specific motivational and emotional processes (e.g., Panksepp, 1998a).

    These important discoveries emphasize cortical and sub-cortical structures in the emergence of the complex affective repertoire of humans and their contribution to social relationships (e.g., Schore, 1994, 2003a; Siegel, 2007). However, underlying these contributions are details of an important and often overlooked neurobiological substrate: the neural circuits mediating the reciprocal communication between body states and brainstem structures, which have an impact on the availability of these affective circuits. These underlying circuits not only promote feelings (e.g., Damasio, 1999), but also form a bidirectional circuit (e.g., Darwin, 1872/1965) that enables mental and psychological processes to influence body state, and to color and, at times, to distort our perception of the world.

    Thus, the study of affective processes, especially in their prosocial and healing roles, requires an understanding of the neural circuits both between higher brain structures and the brainstem and between the brainstem and the visceral organs (e.g., the heart) mediated through the autonomic nervous system. All affective or emotional states are dependent upon lower brain regulation of the visceral state and the important visceral, tactile, and nocioceptive cues that travel to the brain from the periphery. Moreover, there are distinct visceral regulatory states that foster different domains of behavior. These states do not preclude the important bidirectional information from higher brain structures.

    Emotion, Motion, and Visceral State: Features of Mental Health

    Regardless of the operational, and often arbitrary, distinction between emotion and affect or between emotional expressions and feelings, the measurement of physiological states (e.g., autonomic, endocrine, and muscle activity) needs to be embraced in affective neuroscience, particularly if there is to be a functional dialogue with experiential clinicians. In most cases, physiological state has been conceptualized as a correlate or a consequence of higher brain structures (e.g., cortex) presumed to be driving emotion and affect.

    However, it would be naïve not to explore the connections and potential bidirectional influences between peripheral physiological states and the brain circuits related to affective processes. Physiological state is an implicit component of the subjective experiences associated with specific psychological constructs such as anxiety, fear, panic, and pain. The convergence between physiological state and emotional experience is neurophysiologically determined, since the metabolic requirements necessary to modulate the muscles of the face and body require supporting changes in autonomic state.

    All emotional and affective states require specific physiological shifts to facilitate their expression and to reach their implicit goals (e.g., fight, flight, freeze, proximity). Through the study of phylogenetic shifts in the vertebrate autonomic nervous system, it is possible to link the different expressive features of emotion in humans with the phylogenetic transitions in visceral regulation observed in vertebrates. Physiological monitoring provides an important portal to monitor these reactions, since some affective responses are often not observable in overt behavior.

    There is a rich history of research linking the neural regulation of face and viscera (e.g., heart) with brain circuits. Gellhorn (1964) elaborated on how proprioceptive discharges from facial muscles influence brain function and promote changes in visceral state, thus providing an example of the bidirectionality between peripheral and central structures as well as a neurophysiological basis for the assumed relation between facial expression and body feelings. Even earlier, Darwin (1872/1965) acknowledged the important and often neglected bidirectional relation between the brain and the heart in The Expression of Emotions in Man and Animals: “When the heart is affected it reacts on the brain; and the state of the brain again reacts through the pneumo-gastric [vagus] nerve on the heart; so that under any excitement there will be much mutual action and reaction between these, the two most important organs of the body” (p. 69).”

    In this paper Porges points out the historical assumptions which gave rise to our current paradigm of ineffective treatment for those suffering a presumed “mental illness,” underlining just how much the human heart has been left out of the equation, when comes to understanding mental health. Please consider;

    “Within the field of mental health, there is a similar acceptance of a disease model without a focus on the intervening feedback circuits that mediate the features of the disorder. Within psychiatry, anxiety and depression are defined by clinical features and not by a measurable physiological substrate. The prevalent strategies in mental health research that use neurophysiological variables (e.g., imaging, autonomic measures) are not directed at defining anxiety or depression, but use neurophysiological variables as correlates of a clinical diagnosis.

    The value of taking a different perspective can be illustrated with the construct of anxiety. If anxiety were viewed as dependent on a shift in autonomic state in which an individual’s physiological state is dominated by the sympathetic nervous system, new clinical research strategies might emerge that focus on characterizing how states of anxiety and a vulnerability to being anxious would be potentiated or dampened by different autonomic states. Treatments would then be developed either to (1) dampen sympathetic tone or (2) enable the individual to move to environments or shift contexts that are less likely to trigger the increased reactivity associated with higher sympathetic excitation.

    Unfortunately, most researchers in psychiatry and psychology express little interest in the mapping autonomic regulation as a “vulnerability” dimension for various psychiatric disorders and behavioral problems, even though visceral features are often symptoms of the disorders they are treating. Clinical disciplines rarely acknowledge the proximal functions of the visceral state. Likewise, clinicians seldom monitor the expression of vagal withdrawal or sympathetic excitation in their patients.

    Such a shift in autonomic state would be manifested in several physical and psychiatric symptoms, including flat affect, difficulties in auditory processing, hyperacusis (i.e., auditory hypersensivities), tachycardia, and constipation. In addition, conventional models of mental disorders neglect the contribution of neurophysiological mechanisms in dynamic interaction with contextual cues in the environment. In contrast, these disciplines have embraced distal constructs related to the functions of receptors within the brain that lead almost reflexively to drug treatment, while generally failing to recognize the important role of visceral state and visceral afferent feedback on the global functioning of the brain.

    This strategy is far from parsimonious and does not take into account either the phylogeny of the mammalian nervous system or the intervening neurophysiological and biobehavioral systems along a continuum from genes to behavior. Rather these disciplines have assumed that clusters of observable behaviors or subjective experiences are linked parsimoniously and directly to neurochemical levels in specific brain circuits. Thus, they overlook the important potential of psychological and behavioral interventions (including changes in environment) that would be therapeutic by virtue of their direct influence on physiological state, without necessitating pharmacological treatments.”

    http://austininconnection.org/documents/Reciprocalinfluencesbetweenbodyandbrain-inpress-1.pdf

    Porges “Polyvagal Theory,” gives a solid science perspective on the “how” and “why” person centered approaches like eCPR work.

    From my own reading of neuroscience outside the “treatment industry” I’ve come to know by way of a more balanced thought/felt sense, just how much I function with an ‘autonomic’ expectation about the external environment, and how this unconscious process leads me into “assumptions” that I tend to take for granted. Especially when I NEED to embrace my attachment processes and trust the “group think.”

    Please keep up the great work of “open hearted” exploration that you do, Faith.

    Best wishes

    David Bates.

  3. Faith, “Keep the Faith” http://www.youtube.com/watch?v=eZQyVUTcpM4 :D.

    It is true that many misgivings have been committed in the past “in the name of science”. The most obvious that comes to mind is eugenics. The problem is that science is agnostic to those misgivings; it’s only those who twist science to push for despicable agendas that are to blame.

    What science gives us that is not available to confront misgivings perpetrated in the name of other areas of knowledge (such as theology) is the ability to falsify them. You cannot falsify “everybody has to believe in Allah”, but you certainly can falsify “bio marker X is the cause of disease Y”.

    We should become fans of the NIMH approach, not because it is going to be successful (in fact, studies of genetically identical twins in which one of them has been labelled as “mentally ill” while the other didn’t already predict its utmost failure). It’s precisely because it is doomed to fail that we must embrace it. That is not to say that the powers that be will not try to invent something else to do social control, however, psychiatry is finished.

    • What about studies of identical twins separated at birth who end up having exactly the same rate of a mental illness despite having been raised in completely different environments?

      I say mental illness, but you can call it what you want. I think it is reasonable to call it this way because whatever it is causes serious problems in the lives of people with the difficulty. Difference is fine, but disorder only connotes that the difference leads to function that is less healthy. When people’s kidneys don’t function within the range of normal we say that they have kidney disease we don’t say that it is a manifestation of renal diversity.

      I can understand not wanting to uniformly label all these states as diseases so I’ll call them whatever you want. I’m not meaning to be disrespectful. It seems you all still call it the same thing, you usually just up quote marks around it. So it seems you are having the same difficulty. I just don’t understand why when we talk about the mind a completely different terminology should apply.

      When I see someone with severe psychosis, disheveled, unable to speak, unable to take care of their basic human needs I do think they are sick. They certainly seem more sick than someone with a mild kidney disease. Why is it so wrong to say they are sick? When in that state the person could easily look indistinguishable from other “real illness” states. Alternative explanations would include delirium or a brain tumor for example.

      I’d also point out that these “mental illnesses” can also have physical findings similar to other “real diseases”. For example, schizophrenic catatonia which has motor findings like rigidity (similar to Parkinson’s disease), sometimes can have fever and can even be fatal in the absence of intervention. How can that not be a disease? I understand these are relatively extreme examples, but I think the movement here does damage to itself by not recognizing that things are not so black and white. Maybe some people that hear voices are neurodiverse or having a response to severe struggles in life that should be considered within the range of normal human experience. I can see the viewpoint that labeling that as a disease is misleading or does a disservice to the person. But surely there is a range of severity and on one end some of this is organic disease. The question in my mind is where to draw the line and I agree that it is not clear. But then again maybe everyone here disagrees that there is a line at all.

        • Please clarify Morias. You dispute that such studies exist? Or you think that they are fatally flawed and do not bear on the question?

          I’m not so dull as to think there is not a pre-packaged answer as to why twins reared apart data do not demonstrate anything useful. I’m just curious what flaw is supposed to be.

          The real problem here is that I don’t think equal skepticism is being applied on both sides of the problem. Where are the studies that prove that there is no heritability for psychiatric disorders?

          • Here is your problem Scott, to disprove the statement “so called mental illness is caused by genetics”, I only need one counter example of a couple of identical twins in which one has been labelled while the other has been spared from the label. Those studies abound in the literature (see Suzanne below). That is how science works. In the pseudo scientific world of psychiatry, anecdotal cases of identical twins that have been both labelled might account so something, but in science that is irrelevant to the proposition.

        • Thanks for saving me time :-). Psychiatry, given its unscientific nature, lives by mantras. They need to keep repeating them, as Scott did, to convince themselves of their own lies. It’s like the mantra that SSRIs save lives. How is that they keep repeating it in spite of a) evidence that they are no better than placebos, b) they are known to increase violent behavior and c) the CDC data on suicide correlates high usage of antidepressants with a 28% increase in the suicide rate is BEYOND me. Yet, they keep repeating the mantra.

          • To clarify,

            My comment was directed at psychiatry and the mantra of “antidepressants saving lives” and *not* toward Scott.

            Scott, I think that genetics is never 100% of the reason a person ends up with a real disease, and you seem to be saying the same thing. I’m fascinated with *epigenetics* and the way genes end up *expressing* themselves.

            These things appear to have a lot to do with how we think, what we eat, the way we choose to live, which is good news, IMO.

            Also, I’m not implying that “mental” illnesses are the same as others. At the risk of being tarred and feathered, I’m saying that in some cases there may be underlying physical conditions, such as poor thyroid function, absorption difficulties, etc that end up being falsely diagnosed as “severe mental illness.”

            And, IMO these conditions might involve genetics. However, I refuse to believe a person is ever a *victim* of genetics, because any of us can change the ways our genes are *expressed*.

            I hope this makes some sense, as I’m often misunderstood on this subject.

            Duane

        • Perhaps I was unclear… I guess I have to spell everything out carefully.

          I do not think nor was I saying that genetics causes schizophrenia or any other mental illness. If I was trying to say that I would have said that identical twins are always concordant for schizophrenia. What I’m suggesting is that if one identical twin has schizophrenia then the other one is more likely to have schizophrenia than would be expected based on the rate of schizophrenia in the general population. If this is true it suggests the presence of a heritable factor. NOT that it is caused by genetics or that it is 100% inheritable. In fact that it is something like if one twin has schizophrenia then 50% of the time the other twin also has schizophrenia. Doesn’t really matter what the actual number is as long as it is higher than the rate of schizophrenia in the general population. If this is true for identical twins separated at birth it largely eliminates the potential confounder of a shared schizophrenia inducing environment.

          I do not discount the influence of social or environmental causes on the development of schizophrenia or any other mental illness. These are obviously huge influences on the development of mental illness. The presence of heritable factors does not mean anything about being pre-determined or there not being an influence of environment.

          The article you reference is a brief review from 1982 which is not particularly well written for one thing. The article also finds 50% concordance in referencing a very few small comparisons of twins reared apart, similar to the number I mention above and suggesting heritable factors. They appear to find a way to discount from the data set most of the concordant twin pairs for methodological reasons. It seems like they think they weren’t separated from each other early enough to be valid. I still think these data strongly suggest heritable factors. Regardless, it is a minority opinion in the field to say the least. There are much larger studies which address similar questions of heritability in mental illness and other traits which I think overall strongly implicate heritable factors. The reference definitely comes nowhere close to proving that heritable factors play no role in mental illness whatsoever. I will wait anxiously for a study that provides evidence in that regard and not just an opinion that the idea is false or an explanation of why other people’s work is invalid.

          For most ideas it is not hard to dig something like this up (see global warming). It is the weight of the evidence taken as a whole which must be interpreted. That is how science works “cannot say 2013”. If I were saying something as ridiculous as schizophrenia is a 100% genetically determined and 100% penetrant condition, then all it would take is one counter example to prove me wrong. That is not what I’m saying and it is not that simple.

          • Problem is that the defenders of psychiatry make it sound as if their invented diseases are like truly genetic diseases, such as Down syndrome. The latter passes the identical twin test. None of the invented diseases does. This “probability” /”predisposition” argument is very dangerous. By genes alone, children of violent parents are more likely to be violent. Should all the children of convicted killers be preemptively locked in, just in case? Since so called “mental illnesses” are not real ones, not Down syndrome type of real, we should get rid of coercive psychiatry period :-).

          • Final thought, that is not how science works, what you describe is how “fake” science works, such as economics or catastrophic global warming. If what you are trying to say is that psychiatry is fake science, then yes, I agree with that. In some quarters the type of science you are describing is also known as “dismal science” or “pseudo science” :-).

          • ScottW began his comments here by making a reference to studies of identical twins separated at birth who end up having EXACTLY the same rate of a mental illness despite having been raised in completely different environments. Then when I provide a link to a study which refutes that preposterous claim, he dismisses it by virtue of his own subjective judgment of it being “poorly written.” LOL!

            Can ScottW provide ONE SINGLE link or citation which supports the ludicrous statemt about twins separated at birth who end up having EXACTLY the same rate of mental illness? No? I didn’t think so.

      • ScottW,

        The so called gene studies supposedly proving bogus DSM stigmas have been totally debunked by many experts for a long time like most if not all so called research to give psychiatry the illusion of something medical and scientific to cover up the fact that they serve as a mere funnel for BIG PHARMA to push the latest lethal poisons on patent.

        Anyway, I suggest you read Dr. Jay Joseph’s THE GENE ILLUSION and THE MISSING GENE along with many of his articles including ones he posted on this web site. He does a great job debunking the bogus twin studies you cite as well as the great heritability and other bogus eugenics claims psychiatry has been pushing since they used them to gas to death those they stigmatized as “mentally ill” before and after Hitler came to power. Then, they transferred this gassing apparatus to the concentration camps to get rid of other so called “inferior” people.

        Dr. Joseph also does a great job exposing that just like Rockefeller funding the evil eugenics research to justify robber barons like himself stealing far more of the world’s resources for their malignant, greedy selves due to their supposed superior genes while preying on and devaluing/stigmatizing those they exploited and destroyed due to their supposed inferior genes, today right wing neoconservatives are doing the same thing to justify their own psychopathic global hijacking agenda as explained in the book and web site POLITICAL PONEROLOGY and by Dr. Robert Hare, world authority on psychopaths.

        So, no surprise that most of us have little tolerance or patience with the ongoing bogus claims of the supposed latest “neuro” findings by the mental death profession for its junk science VOTE IN stigmas just like those dealing with the boy who cried wolf eventually got fed up with his constant lies to the point this liar became a victim of his own deceit and selfishness.

          • Joanna,

            Thanks for the great link, which coincides with what I said and other resources I read, but I haven’t seen this excellent source.

            I agree that the U.S. is probably the chief KOL of hidden or not so hidden murder with the mental death profession being one of the top psychopathic intraspecies predators stigmatizing, demonizing, dehumanizing and poisoning those they and others target for earlier and earlier death now that they are targeting even babies in the womb and toddlers for their bogus stigmas and poison drugs.

          • Donna, yes it’s a great piece isn’t it.
            Psychiatry is up there at the top of the list but it doesn’t exist in a vacuum it’s readily facilitated by Capitalism.
            It’s a dog eat dog system which hurts the vulnerable, and inequality causes and maintains mental distress. Wealth creation doesn’t cascade down, the very rich and powerful happily feed off and even make money out of those very inequalities which can drive us mad.

  4. I’m jumping onto this thread and want to preface my comments by saying thank you to Faith, ScottW, and David, Duane, Susan, Cannotsay, and everyone for generating ideas, emotion, and dialogue. I’v been away from the reply section for a while but have enjoyed reading your contributions….My comments to ScottW (below) are my own. If you do read them, ScottW, keep in mind that I don’t and could never speak for Faith, at whom you’re comments were directed.

    Here goes: you wrote, “In reality I would say almost all medications only correct problems symptomatically. Often the underlying cause of the disease is unknown or it cannot be corrected. Surgery is one of the few fields in medicine where causes of disease are actually fixed.”

    Yes! Ninety-nine percent of all drugs on the market do not treat a disease process. Of course, this includes all psychiatric medications. Thank you for raising this point. It’s important and is often missed completely. Unfortunately, it seems that pharma’s marketing techniques greatly exaggerate the benefits and downplay the risks, while intentionally making the mechanism of action and inserts confusing for potential consumers/users/people seeking help. However, you say drugs “correct problems symptomatically”, which is not true. They can mask a particular symptom, often for a finite period of time, and often while creating a new problem (there’s no such thing as a selective drugs) or taxing the body in some other way. So, a simple “correction of symptoms” is impossible.

    But more importantly, it’s seems you’re missing the most fundamental message with has nothing to do with studies or semantics. Faith, who wrote this absolutely beautiful and thoughtful piece, and I, and rest of the people in this movement are saying that being called sick or ill by the medical establishment for being neurodivergent or experiencing altered or extreme states of consciousness feels hurtful, insulting, and is actually harmful. And, if the medical establishment is working with people in such a way that feels hurtful and is harmful, while claiming to know something about a mysterious disease process at the root of the person’s suffering when they don’t, why operate in this way? Why not listen to the people they aspire to serve, and take note? Why not call it ‘distress’. Why not say, loudly and without shame, “We don’t know why you are suffering in this way. But we can work with you, if you’d like, to identify ways to work through this, or to make meaning out of it, or to change what can be changed, or to explore the use of a drug which might help (and/or hurt) you….” Why not use language which reflects honestly, respect, and a little humility about what we don’t know?

    • “I, and rest of the people in this movement are saying that being called sick or ill by the medical establishment for being neurodivergent or experiencing altered or extreme states of consciousness feels hurtful, insulting, and is actually harmful. ”

      This is cannotsay2013 and I approve this message :D!

    • Thanks Vanessa. I don’t think I missed that point or at least I’d like to make it clear that I’m not missing that point. I have a different view intellectually about whether it is accurate to call these phenomena illnesses or not. But, I acknowledge what you and Faith are saying about feeling hurt by those labels.

  5. Dear Suzanne,

    I think you’re being unfair. I admitted that I may have been unclear in my original statement. Then I clarified what I meant. You seem to be ignoring that.

    I didn’t dismiss the article because it was poorly written. I summarized my interpretation of what they were saying and explained why I don’t agree that this disproves my point. I thought it was pretty clear and reasonable.

    The reason I said it was poorly written is because I noticed in the abstract it says something like, “people with schizophrenic.” I just thought it was kind of a blatant typo for a published article. I guess I should have said it was poorly edited. Anyway I guess I set myself up for that.

    Your study actually supports my clarified point which is that the rate of concordance is 50% in identical twins reared apart. They interpret that data a little differently than I would, but now I’m repeating myself again. It’s unfortunate I wasn’t more clear in my original statement – I’ve read it over again several times and I think I meant to say something like ‘RISK’ instead of ‘RATE’. Anyway, I think I’ve clarified what I really meant.

    I’m not getting the sense that you really want to reasonably debate the idea. My final point is that what you referenced is not “a study” it is a review which does not present new data, but provides an interpretation of previous data.

  6. ScottW,

    You started out your comments here with a blatant lie, and I called you on it. How is that “unfair?” Then you try to backpedal and excuse the blatant lie by reframing it as being “unclear.” Whatever.

    You are correct that I don’t want to “debate” you. You seem to be way more attracted to obfuscation than truth. I just want the lies about so-called mental illness to stop. As anyone can see from the many personal accounts on this site, from the data shared by Robert Whitaker, from the fact that “mental disorders” are THE leading cause of disability in North America, and as I know from my own personal experience – the lies are killing people and destroying lives.

    Regarding your “final point,” who cares if what I referenced is called a “study,” a “review,” a “meta study,” a “meta analysis,” or “evidenced-based-ultimate-last-word-on-the-actual-truth?” Your side-stepping into the realm of semantics was a nice attempt at dragging a red herring into the mix, though. Nice try.

    Be well. And please stop lying. It’s not nice.

  7. Hi ScottW,

    As I’m sure you realize now my first reply to your first comment referred to “exactly the SAME rate of…” Anyway, I don’t think I need to comment on that anymore…

    Regarding twin-adoption studies, I think their two greatest flaws are a) the absolutely ridiculously tiny sample size (nobody’s fault, there just aren’t that many identical twins separated at birth into different adoptive families who go on to develop “schizophrenia”), and b) the fact that, given the problems associated with such small samples, the studies do not control for the possibility that higher rate of schizophrenia in the twin group is simply due to chance – I know this might sound ridiculous to you if you are used to studies with much larger samples where this kind of thing simply does not happen, but when you are dealing with sample sizes so small the possibility of simple chance cannot be ignored; a seemingly impressive higher rate of concordance might come down to two or three extra twin pairs. Perhaps I remember this incorrectly, but I think that in some Finnish study where a database exists which allows to look at the adoptive family environments of the study’s subjects (which had not been looked at when the studies where published) this chance difference in family environments could account for a lot of the difference between twins and non-twins: by chance more twins than non-twins had ended up in “dysfunctional” families.
    The point is that these studies should look at the adoptive family environments as part of the study, and they do not.

    But all that aside, let’s say that in the end you do find a higher rate of concordance in twins than in non-twins (adopted non-twins, you cannot compare with rates in general population since the adoption itself could play a part in schizophrenia). I get your point that this seems to point to a “genetic component” and to some extent I agree, but only to some extent, since to me that genetic component is of no importance whatsoever from a therapeutic perspective and cannot be said to form part of the “disease”. I know this all sounds a bit convoluted; perhaps a good way to explain it is this:

    Let’s say for the sake of argument that you do find that 50% of adopted monozygotic twins develop “schizophrenia” and only 10% of adopted non-twins develop it. I say you can still interpret that as evidence of a 100% environmental disorder. But what could this possibly mean other than I’m a sore loser? It means that the 40% non-twins who are not developing schizophrenia but who, for the disease to be environmental should develop it, are in fact developing something else – another “disorder” which goes under the radar of the study because it does not fall within the conceptual framework of a “medical disease”. And it is not one single disorder either, but many, and just as “bad” if not worse that schizophrenia. The pathogen is in the environment, and it causes damage to all who are exposed to it (to 50% of both twins and non-twins) but depending on very complex genetic differences (what in the good old days of common-sense used to be called “temperament”) this damage expresses itself as “schizophrenia” in some cases and as other “non-medical disorders” in other cases.

    What could these “non-medical disorders” be? Let’s use an example: imagine a person “S” with temperament “s” (coded by many genes spread throughout their chromosomes) suffers repeated sexual abuse as a child and as a consequence develops “schizophrenia”. A different person “P” with temperament “p” suffers the same sexual abuse and does not develop “schizophrenia” Aha! “S” has a vulnerability for schizophrenia! No, not quite; here is the catch: “P” becomes a paedophile and a violent sexual predator. Furthermore, “P” is quite clever and escapes detection so his disorder is never noticed. This is a very crude example but I think you’ll get the idea of what I mean. One environmental “pathogen”, 2 genetically-determined temperaments and two different disorders, one “medical” the other not quite (a lot of debate about that). One, schizophrenia, will be very visible whereas the other can go unnoticed for a long time and continue “infecting” other people. Which one would you say is “worse”? Is there any point other than academic curiosity in finding out what the genetic variations which code for temperament “s” (or “p”) are? Particularly if it turns out that temperament “s”, in the absence of abuse, results in particularly intelligent well-adjusted people? Are you going to “correct” their genes in case they are sexually abused later on in life? Your target, obviously, should not be “s” or “p”, but sexual abuse.

    But does this hypothesis obtain in the real world? The great difficulty is to know what these “non-medical disorders” are, and also what “abuse” or “trauma” is, because of course it is not always going to be something as obvious as paedophilia and sexual abuse. I’ll just say this: take a look at the world. Do you see poverty, crime, random violence, war, pettiness, anxiety, insecurity, substance addiction, human trafficking, selfishness of all kinds and shapes? I walk past the same homeless man everyday and sometimes he catches my eye and smiles, and you know what I do? I look somewhere else. Is that the response of a “healthy” human being?

    I know, this is not the nice, clean and simple science where “diseases” are simple discrete entities; it sounds too much like philosophy and too much like politics and almost like religion, but I’m afraid reality is not nice, clean and simple but very, very complex (and in its complexity very beautiful too). The “mind” sciences are not going to go anywhere if they continue to think within the little boxes of XIX century scientific disciplines… whatever happened to the interdisciplinary revolution?

    Oh! And next time you “see someone with severe psychosis, disheveled, unable to speak, unable to take care of their basic human needs” please try to find out what medications he or she is on and for how long he or she has been on it; that might have something to do with it… (did you get around to reading “Anatomy of an Epidemic” yet?)

    • Hey Morias – Always a pleasure… Thank you so much for your very reasonable and substantive reply. I was thinking about going underground and observing from afar again. I realize I have to be meticulously careful about what I say here as it isn’t my intention to anger people or hurt feelings.

      I follow what you are saying and it is quite clever. I would still say if the twins with temperament “s” are ending up with “S”, schizophrenia at a higher rate than the rest of the adoptees then it indicates heritable factors influence the development of schizophrenia. In other words, heritable factors influences the form of the dysfunction in the setting of the environmental stressor. In your model the causality is 100% environmental regardless of this and it is internally consistent. I guess my main thought is that it strikes me as quite a bit of mental gymnastics to put the causality 100% in the environment. I’ve been trying to avoid the word “cause” because, as you know, I don’t think the causality is 100% genetic or 100% environmental. So, my personal opinion is that the model you propose isn’t likely, but it’s definitely possible and I appreciate that it is at least in theory falsifiable.

      As you know there isn’t going to be a study in the past or future that is perfect and indisputable. My interpretation of the data would just be that if the if the separated twins are 50% concordant and only 10% of the adopted non-twins develop the disorder it really seems a striking result to me. Sounds like maybe you agree, but just put the causality regardless entirely in the environment and the genetic background just influences the form the dysfunction will take. I will have to look more into the size of some of the more recent twin studies. I know there are some really large and detailed data sets from Sweden which people have been looking at recently. It might be that schizophrenia isn’t the best set of phenotypes to look at in addressing the question. There is one recent large study of twins (hundreds of twin pairs) reared apart that looked at the heritability of regular tobacco use which is interesting (Arch Gen Psychiatry. 2000 Sep;57(9):886-92). http://www.ncbi.nlm.nih.gov/pubmed/10986552.

      I do think the issue is of more than simply academic interest, but I think we will have to save that discussion for another thread. Good discussion.

      Also: I think that psychosis of the severe form I described has been around a lot longer than antipsychotics. So I understand that you have a concern that medication in the long run could worsen psychosis, but psychosis is also still a real thing that can be profoundly disabling. Anyway, I brought the example to bear on a point I was trying to make about whether the person could be considered sick or not.

      Haven’t read AoE yet… Don’t tar and feather me, I still plan to read the bible. 😉

      • All that elaboration so that we can agree to,

        – Psychiatry’s invented diseases ARE NOT genetic diseases such as Down Syndrome is.

        – People’s behavior is a combination of their genes (“predisposition” of their biology if you will), their environment and I would add (from a Christian perspective), their soul/free will.

        If we agree on this, then we should all agree that all coercive psychiatry should be abolished. Why do we punish DSM-5 behaviors but not others like homosexuality that have exactly the same origin (the same type of studies with self described homosexuals have been performed on identical twins with similar results as those who performed on so called “schizophrenia”). What makes behavior described as “schizophrenic” pathological but, in this day and age, “homosexuality” non pathological?

        We already have the criminal justice system to deal with those who misbehaved in ways agreed upon by society via the democratic process. Note that I say ALL, not “all except case a, b, c, d, etc”. ALL.

        This is perfectly consistent with dealing appropriately with disabilities due to “real” diseases such as Down Syndrome, Alzheimer’s, etc.

        Psychiatry is not a scientific endeavor, is a pseudo scientific scam that is used for the purposes of social control by governments worldwide with the coordination of psychiatrists and Big Pharma companies are are too willing to comply with the scam while they enrich themselves in the process.

        • I worry about all misbehaviour being dealt with by the criminal justice system, I’m thinking of women I’ve met in High Secure psych services convicted of crimes where no one was hurt but property was damaged i.e. arson. Psych forensic services are vile, really bad, really scary terrible places, but equally prison wouldn’t be appropriate neither. What I learnt from listening to those women was that there was typically never any intention to hurt anyone, but it was sadly the only way they could ask for help, and they’d had the most awful lives, filled with abuse, trauma and neglect. I know it’s an offense to start a fire but I just wouldn’t want to see those women in prison for years as much as I would not want to see them in high secure psychiatric forensic services.

          • Have people ever considered short term holding/containment WITHOUT forced treatment?
            I ask because of knowledge of a couple of rare psych’s who would do that with people at risk of serious harm to put a ‘pause’ into things.
            I’d like to know what you think of that.

          • You must have misunderstood me.

            When I say “the criminal system” what I mean is to have the same rights as criminal defendants.

            Right now in the US we have the double standard that if you are labeled with one those DSM fictitious “diseases” you can be locked in under the “dangerousness” standard providing so called “clear and convincing evidence”, which is a standard in legal procedure that is weaker than “beyond reasonable doubt”, the standard used in criminal proceedings. Also, most judges refer to the opinion of the psychiatrists, so in practice if a psychiatrist says you are dangerous, you are locked in. In criminal proceedings, to be locked in you must be proved dangerous “beyond reasonable doubt” and you have the right to “trial by jury” who has to agree anonymously to locking you in.

            What I mean is that if society finds some behavior objectionable, it should object to it via the criminal proceedings, not by giving the DSM shrinks the right to decide, as they did with homosexuality, who deserves to be locked in without those safeguards.

            This homosexuality example is very relevant, because it illustrates very well that “reliability” (there is no doubt that homosexuality exists) is not the same as “validity” (the decision as to whether homosexuality was a “mental illness” was a political one because psychiatric diagnosis is scientifically invalid).

          • cannotsay2013,

            You’ll have to forgive my lack of knowledge about your criminal justice system, I am keen to learn.

            So is it the case in the US that a person deemed to be mentally ill can be locked up in prison as opposed to a psych hospital without having been convicted of a crime ‘in case’ they do?

            What I worry about are distressed people who have committed a crime being imprisoned when that would be the worst place for them like the women in our high secure psych services I referred to. Hospital isn’t right but neither is prison.
            Like you, I don’t want people locked up [anywhere] on the say so of a DSM diagnosis..I don’t have the answers, but there is some psych/criminal justice overlap which isn’t clear cut.

  8. Hi Faith, I wanted to respond to the catatonia thing briefly and no room above.

    You are exactly right, what I’m describing is exactly like neuroleptic malignant syndrome except that it was described long before neuroleptics existed. There is also neuroleptic malignant syndrome a rare but severe side effect of antipsychotics. Fascinating that the disorder and the a medication can both lead to such similar phenomena. You are also right that at least in this extreme form called ‘lethal catatonia’ or ‘malignant catatonia’ it is rare. I was just, as an exercise, trying to think of an example of a psychiatric condition which would be difficult to say was not an illness. I thought this might qualify because of it’s physical findings and potential lethality.

    I’m not sure I agree with you that because the reference is from the late 80s it is going to be invalid. I mean it is a reported phenomena, it’s not a reference which posits a mechanism or something that might be out of date. The reports could be false I guess, but we aren’t talking about one report and it seems pretty widely accepted that this is an extreme presentation of schizophrenia.

    Anyway, thanks for your civil responses, I’m enjoying the conversation.

    • What ScottW is describing as “catatonic schizophrenia” is probably not a psychiatric condition at all (whatever THAT is), but rather a physiological problem or illness, like perhaps encephalitis lethargica.
      http://news.bbc.co.uk/2/hi/health/3930727.stm

      Robert Whitaker writes that neuroleptics (a.k.a. antipsychotics) can induce “deficits similar to those seen in patients ill with encephalitis lethargica.” Hence the similarity in symptoms between patients suffering with “neuroleptic malignant syndrome” and Scott’s version of “catatonic schizophrenia.”

      Susannah Cahalan recently wrote a book, Brain on Fire, about her “month of madness.” Even though she was at one of the best hospitals in the world and had access to some of the best doctors on earth, she was misdiagnosed with mental “illness,” as she had symptoms which looked exactly like “schizophrenia.” What was actually afflicting her was a rare disease, anti NMDA receptor autoimmune encephalitis. Fortunately for Susannah, a neurologist caught it at the catatonic stage that “precedes breathing failure, coma and sometimes death.”
      http://www.guardian.co.uk/books/2013/jan/13/susannah-cahalan-brain-fire-interview

      There is a network of British psychiatrists (the Critial Psychiatry Network) who favor the abolition of the “schizophrenia” diagnosis because it has no basis in science, it is harmful, and it promotes stigma. I think I’ve seen somebody comment on this site that a diagnosis of “psychosis” is about as useful as a diagnosis of “rash.”

      • Here is a link to a really interesting article on catatonia, http://archpsyc.jamanetwork.com/article.aspx?articleid=210437

        I don’t think the phenomena of catatonia can be dismissed, at least not entirely, like that given that it is quite common in “psychiatric illness”. The variant I described is called malignant or lethal catatonia. I think you could be right though! and maybe it is something like encephalitis lethargica. I think it’s a good thought.

        I’m also glad you brought up NMDA receptor encephalitis as I was just thinking about that. It is a very interesting condition which was only “discovered” about 6 years ago. It was around before that of course, but probably often got labeled as schizophrenia or brief psychotic disorder or catatonia or whatever. Was it a mental illness and now it is not? I think it is still a “mental illness”, just the same as it was before, now we just know something about the physiology.

        The thing is that I think you’re really making my point for me. Here we are shaving away at the impenetrable block of “the so called mental illnesses” which are not illnesses and supposedly do not have a physiologic basis. Maybe some catatonia is encephalitis lethargica and maybe some schizophrenia is NMDAR encephalitis. I still say it is a “mental illness” or whatever I’m allowed to call the things that we’re talking about. How much of “mental illness” have we accounted for with these two things? I don’t really know, not a lot obviously.

        Then again NMDAR encephalitis has opened the doors to a whole new class of mechanisms that could explain some mental illness. Since that time there have been discoveries of a number of other autoantibodies that cause neurological or psychiatric disease. How much of “so called mental illness” will ultimately be accounted for by this type of mechanism? who knows… maybe it could be 2%, 5%, 10%. We will really won’t know for a while.

        Here is my point though: If these things were psychiatric illnesses and now we know something about how they work, how can you be so sure that a physiologic basis won’t eventually be discovered for 25% or 50% or even more of what we are calling “so called mental illness”. Will they no longer be psychiatric illnesses? I say they still are, but if people are uncomfortable with that, fine maybe they can be neurological illnesses now or we can invent a new category of medicine to treat the illnesses that psychiatry treats now because psychiatry is too contentious of a name. It’s a little like doing away with the term schizophrenia which is fine too since we all know that schizophrenia is actually many different disorders (one of which is perhaps NMDAR encephalitis). This is what Tom Insel meant when he said DSM categories lack validity – schizophrenia is not a term that really does much to distinguish meaningful categories of disorders. It just lumps everything together and obscures the fact that there are many versions with different underlying mechanisms.

        Anyway, I’m just going to say this again. I just don’t understand how anyone can be so certain that other psychiatric phenomena won’t eventually have a physiological cause identified. I’m not saying they will all be autoimmune encephalitis type disorders, but something, anything. Something you don’t even know about yet. And that doesn’t mean the social environment isn’t going to matter we already know that social influences and trauma are critical, but that could interact with whatever the “disease” mechanism ends up being. Or induce the mechanism directly for that matter.

        So I’m not wedded to any of the names really. If, theoretically, I could prove that 50% of psychiatric illnesses had a physiological cause then I could rename them all and take some doctors and train them up in the new treatments for these new disorders and then call them “Mental Neurologists” or something. Sorry, I’m getting a little silly. Time to get some sleep.

        Peace 🙂

        • Biology and brain probably is involved with almost everything that goes in our normal mind. I don’t know how the brain/body creates the conscious experience, but every time we even think a mundane thing such as “should I get a coffee”, neurons are certainly part of that process.

          I don’t know about mental illness, that seems like a pretty general term and it’s part semantics, etc, if it should be used or not.

          However, the thing that psychiatrists currently often say it that, for instance, schizophrenia is currently considered a cell level brain disease which causes atrophy in brain (I took that definition straight from an “official” schizophrenia guide site for patients funded by a pharma company). This is not true. As you said, schizophrenia is an umbrella term and there are many different kinds of patients with that label. Maybe some have some kind of an encephalitis or virus or whatever which causes them visions despite psychological, social, etc, stuff. Maybe this is a brain disease.

          However, at the same time there probably is a huge number of people with the same label whose symptoms are caused by social issues, trauma, poverty, lack of sleep, prolonged stress, exploitation, etc. All of these things can change the way brain and body operates and the operation of the brain and body can cause psychotic symptoms. I still wouldn’t call it a brain disease. For instance, if you stay up for four days without sleeping, your brain will probably operate in an abnormal manner, maybe it’s flooding with stress hormones an so on. If you have a trauma, your mind or body may go to a stressed up state regularly from different cues and prolonged stress without rest can “wear out” healthy bodily functions. Etc, etc.

          I think there’s a difference here, one is caused by a cellular level pathology and you can’t much help it psychological means, other is a natural response of body/brain/mind to certain conditions. In this sense, often for instance neuroleptics resemble a brain disease much better than schizophrenia. 😉

          • Hermes, what a brilliant summary of a very complex topic. I agree with everything you’ve just said here. Especially the bit about neuroleptic “treatment” of a natural response to extraordinarily stressful conditions. Neuroleptic “treatment” can be truly sickening – in both the literal and figurative sense of the word.

        • Encephalitis is not a “mental illness.” A psychiatrist is not qualified to treat encephalitis (or stroke or aneurysm, end-stage syphilis, rabies or any other medical condition which may present as a “mental illness”). If a supposed “mental illness” has an actual physiological cause, then it is not a “mental illness” or a “psychiatric illness.” Illnesses with physiological causes should be treated by real doctors or medical specialists, not psychiatrists.

          To quote E. Fuller Torrey about the term “mental illness,” he says, “The very term itself is nonsensical, a semantic mistake. The two words cannot go together except metaphorically; you can no more have a mental ‘disease’ than you can have a purple idea or a wise space.” (from Torrey’s seminal work, “The Death of Psychiatry”)

      • The Japanese renamed it:
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472254/
        You’re right in your observation of the British alternative of ‘psychosis’, this is in common usage not only within psychiatry but also outside of it, and within HV activism, this is why descriptive plain English words work better like ‘voice hearer’.
        The DX summit is really interesting, I’ll be keen to learn what descriptions people want to use

  9. The clinical description:

    Catatonia F20.2 ICD-10

    Catatonic Schizophrenia is dominated by extreme loss of movement of the body parts.
    The Catatonic Stupor is a motionless apathetic state in which the patient does not react to external stimuli.
    Individuals may be mute, rigid, show “waxy flexibility” in which they maintain positions after being placed in them by someone else for hours. Or, they resist movement in proportion to the force applied by the examiner.The catatonic phenomena may be combined with a dream-like state with vivid hallucinations.

    When I was diagnosed as having Schizophrenia in my youth I also had the diagnosis at one point of Catatonia. This is my description from my experience:

    Imagine fear and distress so great that your mind and body completely shut down. This is where I went when my voices attacked me.

    Imagine a retreat to the core of yourself where you are untouchable. Where you remain till it feels safer to be in the world.

    Look at how gracefully a bird glides across a lake, it’s head and upper body almost motionless, yet underneath the stillness, it’s feet vigorously paddle, unseen.

    This is Catatonia from the inside. You can see and hear but you can’t cry out or break free. You are encased in an extreme concentration of fear.

    I don’t view that experience as illness, I just wanted to share my personal description to contrast the clinical

  10. I have a problem with this Nuerodiversity malarky.

    We all have different brains. For one thing they change as we accumulate new expereinces. I remember a radio programme that said that people who learn a new language produce more brain tissue in the part of the brain responsible for language. When we learn something new nueral connections are made – or that is how I understand it.

    So gay people have different brains from straight people, people from the USA have different brains from people in the UK, people who love Mozart have subtle different brains from those that like Queer Core. Not because of anything innate but because brains change as experience accumulates. But I’m not sure how that relates to mental distress or anything else on this website. I’m not aware of any other explanations of, “nuerodiversity.”

    What people who talk about nuerodiversity seem to be talking about are the different ways people think and communicate. I can see how people who think and communicate in ways that are not popular or mainstream can find themselves feeling on the outside of society and how this can be distressing. I can also see how being with people who are accepting of minority ways of thinking and communicating can be helpful and reasuring. I can also see how discussing how ones styles of thinking and commuincating that are considered unusual so as to better negotiate a social world that is intolerant would be extremely useful. However I see no reason other than fashion to couch such ideas in terms of nuerodiversity unless there are reputable studies of brain scans to show that they actually exist and have some signficance other than they reflect the way the person has come to make sense of thier world.

    I know people who think and communicate in ways than many would consider unusual. Sometimes I put the time in to try to understand them, sometiems I don’t. I also know people who have different political believes than me. Sometimes I try to undersatand them, sometimes I don’t. I even know people who have different musical tastes from me and sometimes I put the time in to try to understand thier tastes and sometimes I just quietly despise them for being tasteless philistiens, because that’s me, a bit of a shallow bitch at times but at others incredibly caring and compassionate.

    My position may seem a tad extreme and to some insensitive but I wonder if I am merely exhibiting an insentive and rough interpretation of Sami Timimi’s opinions?
    http://us.macmillan.com/themythofautism/SamiTimimi

  11. I feel a tad uneasy about the term neurodiversity, whilst respecting anyone’s right to choose that description for themselves it’s not one I would use for myself as it sounds too biological. I would feel I’d need a brain scan with rainbow colours or something like that to demonstrably show my difference was neuro. Within the HV movement voice hearing has been referred to as a difference, like being left handed, I accept that description although for myself it doesn’t quite sit right because at times my voices feel quite removed from being left handed and more like no hands or hundreds of hands.

  12. ScottW. Thanks for reading and responding. You say you understand the point that labels are hurtful (and probably contribute to chronicity of the distress which psychiatry ostensibly seeks to alleviate) but that you, “…have a different view intellectually about whether it is accurate to call these phenomena illnesses or not”.

    Your self-proclaimed “intellectual understanding” of someone’s own experience (!!) is called a moral judgment, which has nothing to do with intellect.

  13. Hi Faith, Vanessa and Cannotsay,

    I just wanted to say that I’m not proposing to label anyone here or everyone with diverse experiences or extreme mental states as having an illness. I wouldn’t say that about anyone unless they were someone I knew well. I really don’t know where to draw the line on what is a mental illness and what isn’t. It just seemed like I was hearing that no matter what the experience or how disabling it might be it could never be considered as the person being sick.

    I don’t agree with that because I think people can have illnesses that affect their mind. Some of them are things like Huntington’s disease which I think most people would agree is a real illness. A person with Huntington’s disease can develop psychosis and really no one understands the mechanism. On the other hand someone can develop psychosis and become catatonic and we know even less about that than we do about Huntington’s disease. Then again some people hear voices and maybe they kind of keep to themselves but are otherwise OK or maybe someone just lives their life in a completely different way than I can understand. I’m perfectly comfortable with saying some of that isn’t illness.

    When it comes down to what is and what isn’t it shouldn’t have to do with “normal” it should have to do with suffering and not functioning well. In my opinion somewhere along that continuum there is profound suffering and dysfunction and it is reasonable to say the person is sick. If the person doesn’t want to say they are sick then I guess that’s OK, but in the severe cases they probably still need help (in whatever form) and I think they should get it. I really don’t see that as a moral judgement either, I see it as a compassionate perspective. In my mind if you are sick you need help to get better, it doesn’t mean you are bad or defective. And that goes for me too if I am sick.

    I can understand that some people think the label is unproductive because it connotes that something is defective and you’re stuck that way. That isn’t how I think of it, but I get it. I don’t like the idea that there is something defective about me either. That’s a personal thing, how you view the circumstance if you find yourself in it. For a lot of people it probably does help recovery to have an alternative perspective. But many are suffering and their mind is clearly not functioning well. Many are at risk of hurting themselves or other people or dying because they’re not drinking water even. If that person says I’m not sick I’m just fine this way, leave me alone – how can I in good conscience go along with that? I have to say I disagree.

    *** I want to propose one final scenario – at the risk of people here calling for my beheading. And it’s a serious question and I really want to know what people think. Let’s say a someone walks into a crowded mall, they are swinging around a large sword and they are dirty, covered in their own feces. People are freaked out and the police are called. The person isn’t aggressive, but they are confused, talking nonsense. They seem frightened and unpredictable. The police believe that people can have illnesses of the mind and so they don’t arrest the person, they take him to the local emergency room which seems like the right thing to do to them. A doctor sees the person and determines that they aren’t on drugs and there is no evidence of “medical” illness except dehydration and malnutrition. The person is trying to leave. What should we as a society do in this situation? ***

    I’m curious about two types of answers, 1) practically given the reality of our world as it is and 2) in an ideal world with limitless resources. It’s a fairly extreme case and I know it doesn’t match everyone’s experiences. Still, this type of stuff happens a lot at public hospitals in urban areas and I think it is a reasonable question. It ignores all the distraction about illness, and DSM and mental death industry and biological causes and neurodiversity. It is just a practical question.

    It’s a tough call. You can let them go, but they might hurt someone or get beat up or die from exposure. Who knows. You could keep them, but not give them any medication as someone suggested. What if they don’t get better? What’s the humanitarian thing to do? I’m not posing it as an impossible question, I know people have ideas and I’m really curious to hear them.

    • Scot, I posed the question about the validity of short term containment without forced treatment as I have known a couple of psychiatrists who have done that with people at grave risk to put a ‘pause’ into what’s happening for them.
      This is incredibly rare because 99.9% of psychiatrists would compel physical treatments. I would like to know what people think about this.
      The example you offer – I remember going to a friends house after being alarmed by his answerphone message which clearly indicated him to be at risk, so I raced around and found him in a completely disheveled incoherent state. I put water to his lips and progressed to feeding him. He went from being unable to speak a sentence to conversing with me no problem. This was a man who had been dosed up at maximum “therapeutic dosages” of a depot injection AND oral ‘antipsychotics’ for 12 years who went cold turkey and got off the lot which was hellishly difficult but he did it and never looked back.
      He told me that he realised that most of the times he had been sectioned [committed] he had been in that state. So he been subjected to all of that for want of food and drink. I could see how he would have appeared “sectionable” to others.
      Now in terms of ‘getting better’ beyond hydration/nutrition he would in no way fit any psychiatric definition of ‘better’. He lives with enduring difficulties, he isn’t ‘recovered’, he wouldn’t view things in terms of ‘recovery’ anyhow, but he chooses to live with his differences unmedicated and I fully support that.

      • This reminds me of a situation I witnessed as a chaplain in a medical hospital. A middle aged woman who’d been married for 30 years was admitted to one of my units. I was called to see her because she was causing numerous problems for the staff and had to be constantly watched. She’d set fire to the contents of her trash can, run up and down the hall screaming, cursing like a sailor with language that curled your toenails, jumped over the wall into the nurses’ station, you name it and she’d done it. She took one look at her husband of 30 years and claimed that she’d never seen the man in her entire life and that he looked like a pervert to her. The nurses called the admitting doctor, suggesting that she be transferred to the psych unit. The doctor came to the unit, spoke with the woman for two minutes, and stated that she was not going anywhere, especially not to the psych unit. He then asked for a large hypodermic full of glucose. He predicted that the woman would be perfectly fine in a matter of five minustes after receiving the shot. The nurses were extremely dubious but had to eat crow when things turned out exactly as the doctor predicted. She was having terrible problems with her blood glucose levels, which had sent her into behavior that looked like “mental illness.” It proved to me then and there that we are much too quick to jump to unfounded conclusions and assumptions concerning peoples’ behavior, especially when it makes us uncomfortable or upset.

    • Scott, I stand by General’s Patton quote “God deliver us from our friends, we can handle the enemy” :-). The idea that somebody should be forcibly “helped” because some shrink says so illustrates the type of totalitarian attitude that pervades psychiatry. 40 years ago, gays were forcibly “helped”. We already have the criminal system to “help” to go to jail those who misbehave in ways determined by the democratic process with the “beyond reasonable doubt” and trial by jury of peers safeguards. Everything else is social control no matter how you spin, twist and try to “nuance” your arguments.

        • This is not a very hard question. Either the person was committing a crime -and that would depend on the jurisdiction where that person was doing that- (thus, there was probable cause for his/her arrest, and then that person is protected by the laws that protect criminal defendants) or the person was not committing any crime whatsoever and should be let go. Period, end of the story.

          What you propose is, under the excuse of “helping”, that some shrink locks in that person indefinitely, regardless of whether that person had committed any crime whatsoever, forcibly drugs that person with poisonous drugs and labels that person “crazy” for the rest of his/her life.

          Having been at the receiving end of involuntary commitment/drugging, I take the “treat me as criminal defendant” approach anytime. Since I had not committed any crime, I would have been spared of the most humiliating and stigmatizing experience of my life.

          So, I repeat, I stand by General’s Patton quote “God deliver us from our friends, we can handle the enemy”. I can handle being treated as criminal defendant; it is very hard to handle one of these “helping zealots” :D.

          • I wouldn’t want to see anyone indefinitely locked up and drugged, but the memory of those women simply doesn’t fit the committed a crime or not scenario.
            Yes technically they have committed a crime, but it’s almost like the difference between premeditated murder and self-defence.
            For them starting a fire in a building where no one was inside was their ‘self-defence’ against a world where sometimes many people had committed violent crimes against them. Crimes such as arson can carry heavy sentences and distressed people don’t have a good time in jail.
            They do need help, not psychiatric, and not in the name of a DSM diagnosis but as hurt traumatised people. I don’t have the answers but it’s one of many questions which don’t easily fit into a post psychiatric world where everyone is totally ‘responsible’ all of the time. Our prisons are filled with people who shouldn’t be there because they are distressed and our high secure hospitals have contained some women who have never committed any offence [they are supposed to be for people who represent a serious risk to others]. I don’t even think they should be in a high secure hospital, prison yes. What shocked me more than anything, seeing a few women in high secure hospitals for no other reason than local services couldn’t cope with their self-harm. Forensic psych services and prisons are a shade of grey when it comes to those who have committed crimes but are clearly very distressed. Do they need special pleading – yes. Do you need some help – yes. So what help do we offer which is isn’t being drugged up in hospital or drugged up in prison?
            A post psychiatric world would have to consider these issues.
            None of us know with certainty if we *might* be in a position of being distressed and end up committing a crime – I remember my voices telling me certain things about the pet shop [containing animals which distress me], that they were going to escape and hurt me, I was close to going into that shop with petrol and a match, if I had I wouldn’t be here now. I had friends to talk to who helped stop me, but what if I hadn’t? Would you want to see me in prison anymore than drugged up in hospital?

            Young people with ‘anorexia’ is another tricky area. Imagine you’ve got a 4 stone 15 yr old daughter who is at deaths door, do you let her die or if there’s no amount of persuading, do you allow an IV or NG to be put in against her wishes for the shortest possible time?
            Now I detest the EDU regimes with a vengeance, I’ve seen what long term iatrogenic damage they do, there is no justification for years of relentless forced feeding using behavioural techniques [reward & punishment], I’ve seen some young women self-harm in response to that because when in an environment where you cannot express dissent it can sometimes be the sanest act. But could I watch a young person die in the name of their personal freedom, no I couldn’t, but I wouldn’t go beyond literally saving life and wouldn’t push anyone through those refeeding regimes over and over again.
            We’ve had a couple of high profile cases of older women taking their cases to the high court to stop forced feeding because they’ve had enough of ‘re-feeding’ and enough of their eating distress and want palliative care – I support them in doing so, as I support assisted dying for those who are terminally ill or suffering from a degenerative condition, I believe in the work of Dignitas – but they won’t see anyone on ‘psychiatric’ grounds.

            As for Scotts example, I’d offer some time to get physically well and have some support – non-medical sanctuary [like Soteria] but if he wanted to leave still experiencing differences in perception I wouldn’t stop him.

            Self-harm and suicide, really muddies the waters because if you’re admitted to Emergency after an OD you will be treated whether you want it or not but this isn’t fixed. There was case here of a women who drank antifreeze and went to hospital with an advance directive and her wishes were respected and she died.
            Why didn’t they forcibly treat her is a question many asked – others argued because of her diagnosis – ‘PD’. There are indications that people assigned that diagnosis are less likely to be saved than someone with a diagnosis of ‘psychosis’, because of their difference in perceived value.
            Self-harm without stated suicidal intent no matter how serious is readily ignored here, you can attend hospital repeatedly and go through a cursory psych assessment [5-10 mins] and that’s it you can go. A friend self-harmed over many months each week until she died, staff have given up on her.

            Taking away legislation to detain people and forcibly treat them doesn’t remove all the uncomfortable questions, they would still be there.
            We could take the position that anyone is free to kill themselves or others and take the consequences of that, but what if any were preventable with some assistance?
            I’ve known someone who was sectioned [committed] for a short period by a rare and deeply committed psychiatrist with no forced treatment. He did that to put a ‘pause’ into what was happening for her. I know he’s not common, but if he hadn’t done that I doubt she’d be here, I feel certain she would have died by suicide. He forced no treatment but she was away from her home for a short period where accessibility would have been easier.

            Now the another side of this is when enlightened practitioners have worked with people self-harming [without suicidal intent] as voluntary patients or in their homes where self-harm hasn’t been prevented but harm-minimisation approaches have been used [even with dangerous methods]. A psychologist had to teach support workers how to cut down a young woman’s ligatures and persuaded her to use a less dangerous ligature [stretchy socks]. Harm-minimisations has even been used with children as young as 8. HM is highly controversial for some survivors and staff alike but it is something I support and have taught to peers and health workers.

            I don’t have the answers, but I don’t believe in forced treatment other than in very time limited specific scenarios like a young person dying of starvation, but I think there may be a case for time limited containment without forced treatment to prevent serious risk [death]. My views may be contradictory and may not make sense, but they’re not fixed, I’m open to anything..I’m open to evolving and changing.

          • So we as a society could do it the way you suggest. Despite a reasonable concern that the person may harm someone else, die because of not taking care of themselves or at least continue to lead a miserable existence of suffering – We can say just let them be until they break the law.

            I really disagree that it is “not a very hard question” though. I think it is an incredibly challenging question. For one thing that guy in the mall with the sword is going to get arrested. If there is no other option, law enforcement will act and they will take him to jail. The jail has their own psychiatric evaluation system, but let’s say that doesn’t exist. He hasn’t committed a crime yet (though I’m sure the police can come up with a crime – weapon in public, resisting arrest, threatening in public). Anyway, it’s not a “real crime” and he would eventually be released from jail.

            But, I would also argue that there is a good chance he ends up back in the mall with the sword or somewhere else. Then the whole thing starts over again which sucks. He also then might eventually commit an actual crime. Hopefully he doesn’t chop someone with the sword, but he could. Probably more likely he trespasses or assaults someone or breaks something and then he really is going to be in trouble…

            Now, he could spontaneously get better or maybe he has a friend who nurses him and he recovers somewhat. But I don’t think it is the most likely scenario. He may stay that way chronically or he could get attacked because he is so vulnerable. Maybe he lives a miserable life for the next 5 years and one day gets hit by a bus and dies.

            You can most definitely argue that if he doesn’t want help, leave him alone. You can say that there is no higher principle than human autonomy. But, you really have to be OK with the possibilities I described. If you are, then that’s fine I understand where you’re coming from. I just don’t think that’s an easy or obvious choice at all.

            Now, you say that I “propose” that:

            “some shrink locks in that person indefinitely, regardless of whether that person had committed any crime whatsoever, forcibly drugs that person with poisonous drugs and labels that person “crazy” for the rest of his/her life.”

            But I didn’t really propose that. I understand you might have been assuming that is what I propose or you’re just saying that is what people propose on the extreme opposite end of the spectrum from you. I’m not trying to be snarky, I’m asking please not to typecast me to everyone unfairly.

            I also understand what I’m hearing from most people, which is what they don’t want. They don’t want the person ending up in the hands of evil psychiatrists. They don’t want them forcibly drugged with poison. They don’t want them labeled or locked away for the rest of their lives. Of course I get that.

            There are a lot of other options and I have heard a few ideas. I’m just trying to figure out from a practical perspective what people think should happen. I do think there has to be some intervention though. I understand that forcing anything is a really concerning concept and humiliating and stigmatizing people is horrible. But, I don’t think a compassionate society allows people to suffer like that. I don’t want to force anyone to do anything, but at some point, for people’s safety and out of human compassion I think you do have to do something. And I think most people outside of this site think so too. A lot of people with “so called mental illnesses” already end up in prison. If there isn’t an alternative, then how is that any different than criminalizing “mental illness”?

          • PLEASE NOTE: The reply I just left which starts, “So we as a society could do it the way you suggest.” IS NOT a direct reply to Joanna, it was meant as a direct reply to Cannotsay, though it appears in a confusing spot.

      • But it’s not clear cut all of the time – I don’t want to see severely traumatised women go to high secure hospitals or prisons for low level arson where no one was hurt, whether the distress they experienced which led them to that place is described by DSM or Formulation

      • I see identifying the so called mentally ill as either covered with feces per Scott or slinging feces per Sally Satel both a personal and global attack on those given bogus DSM stigmas to degrade and dehumanize them so much that society will be more than happy to have such subhumans forcefully drugged, committed and robbed of all human, civil, democratic rights in the guise of mental health.

        • Here is a great MIA article on Fuller Torrey & Sally Satel, forced drugging/commitment advocate twins. You can watch the video and see how Sally Satel like Scott here defends what she euphemistically calls “benign paternalism” or forced drugging, commitment and loss of all human rights in the guise of mental health.

          Not only do we have to put up with the out and out lies about bogus DSM stigmas being genetic or brain chemical imbalances and the supposed efficacy and safety of useless, lethal forced “treatments,” but we have to hear the lies that those falsely accused of being “mentally ill” are inclined to be either covered with feces or slinging feces in public!!!???

          I have been around for quite some time and I have NEVER EVER seen anyone covered with or slinging feces in public or elsewhere no matter how weird they looked or acted!!

          But, anything goes in the world of the psychiatry/neurology/BIG PHARMA cartel to keep forcing those bogus stigmas, lethal drugs and other torture treatments on those they make appear subhuman to incite the public to think these dangerous crazies need to be locked up and forcibly drugged and controlled! Ironically, the most crazy behavior done by many people was because they were on psychiatric drugs per Dr. Peter Breggin, Dr. David Healy and many others.

          See video for Sally Satel’s throwing feces statement when describing the so called “mentally ill” while pushing her fascist “benign paternalism.”

          https://www.madinamerica.com/2012/07/conquering-benign-paternalism/

    • This is a trick question. No “mentally ill” person will be seen covered with feces or wielding a sword in a public place, etc.

      Trick answer: Even if such an outrageous event could occur, the police would not be inclined to let the person go free.

      I believe there are laws against certain lewd or gross behavior that have nothing to do with “mental illness,” but let’s make it as gross, vile and disgusting as possible to make sure everyone gets it that those stigmatized as “mentally ill” are subhuman, disgusting, vile, vermin and all the other types of language used to incite people to allow or advocate for such people to be robbed of all human, civil rights and forcibly committed and tortured with lethal drugs, abuse and false accusations. This has been typical of all ethnic cleansings, the Holocaust, racism, sexism and other ism’s to promote and justify treating others as inferiors and less than human.

      • Hi Donna. I believe a careful reading of what I have already said will answer most of the questions that you raise in regards to my opinion. You’re mischaracterizing me though because I’ve said that I do not think of anyone in this state is vile or subhuman. I’ve also I think over and over pointed out that I did not advocate to “rob people of all human rights” or “torture with lethal drugs”.

        I said that the example I gave is relatively extreme, but I don’t agree that it is impossible. I’ve personally seen people in that state many times and not just because of “mental illness” but also because of deliirium or traumatic brain injury or dementia, etc. These types of things do happen with some regularity and there have to be practical solutions. I definitely understand that the vast majority of people labeled with mental illness don’t look like this, but it does happen. When it does I do see it as evidence that the person may be gravely disabled and potentially viewed as needing help. Just because I say that does not mean that I advocate to rob them of all human dignity, forcibly poison them or lock them up forever. I’m not going to get into another debate about this, so let’s just agree to disagree about what I mean or advocate for.

        • Scott,

          I will never agree with you on this topic or many others including to agree to disagree.

          Whether you are a neurologist or psychiatrist or in another profession is pretty meaningless now. Dr. Fred Baughman, Neurologist, author of ADHD FRAUD and many excellent articles on the web has lamented that his own field has sold out to the biopsychiatry/BIG PHARMA cartel. He exposes bogus DSM stigmas including ADHD and bipolar as 100% fraud and the worst medical crimes ever perpetrated against humanity.

          Yes, you did use the most extreme, imaginary example to deliberately violate the so called mentally ill as do many like Sally Satel and Fuller Torrey who admit they even advise forced treatment advocates to turn over furniture when calling the police to falsely accuse their victims of violence, another ploy to rob people in emotional distress of all human rights by vilifying them as insane dangerous villains deserving the human rights abuses they advocate to pander to BIG PHARMA and the power elite they really serve.

          I have seen many people with Alzheimer’s and similar mindless states and NEVER EVER saw them covered in feces since they are in diapers. Further, most decent, modest people do not wish to discuss publicly the less than noble aspects of all of humanity. But, anything goes when it comes to making the so called “mentally ill” appear as deranged and disgusting as possible, which you did quite well. You are well trained because the feces slinging and covering appear as the ultimate in human depravity to accomplish this goal whether you claim to intend that or not.

          Anyway, based on my many years of research about bogus psychiatry, I believe that most if not all of your posts push the current biomedical DSM model with all of its BIG PHARMA ad ploys to maintain the status quo even though Dr. Thomas Insel of the NIMH has admitted the DSM is junk science with no validity whatsoever. Of course, anyone who has had the misfortune to encounter biopsychiatry when seeking help for typical life problems learned about this dangerous fraud the hard way as warned by Dr. Peter Breggin in his great books, TOXIC PSYCHIATRY and YOUR DRUG MAY BE YOUR PROBLEM with Robert Whitaker finding the same evidence and more in MAD IN AMERICA and ANATOMY OF AN EPIDEMIC.

          You claim there must be some biomedical cause underneath these bogus stigmas, but fail to admit or realize that many suffering typical human distress and/or trauma from many forms of abuse were subjected to deliberate updiagnosing of the bipolar fraud fad to exploit the victims’ health insurance and make them permanent disabled patients on a cocktail of lethal drugs while totally refusing to acknowledge the abuse/bullying or real problem as dictated by the DSM only focusing on outer symptoms while ignoring all social/environmental stressors to blame and stigmatize the victims to push the latest lethal drugs on patent. See Dr. David Healy’s great book on the bipolar fraud fad, MANIA.

          Finally, I don’t think there is ever any excuse whatsoever to portray ANY of the so called mentally ill as covered with or slinging feces when the bulk of people so stigmatized and vilified are perfectly normal people victimized by the latest bipolar, ADHD and other fad frauds when suffering trauma or extreme stress from domestic, school, work, community and other violence, bullying, mobbing and abuse per Dr. Carol Warshaw, Dr. Judith Herman, Dr. Frank Ochberg, Dr. Peter Breggin and countless others.

          Psychiatry/neurology/medicine basically serve the power elite to exert illegal social control on anyone challenging these powerful people who wish to maintain the status quo of their stealing a grossly huge unfair share of the world’s resources while exploiting and enslaving the majority in the guise of medicine and mental health. Dr. Joanna Montcrieff and many of her colleagues expose this travesty in the books, De-medicalizing Misery and articles like Psychiatric Imperialism you can find online.

          So, despite your claims to the contrary, you used the vile feces defense to justify your forcing your unwanted treatment on one and all. “Power corrupts and absolute power corrupts absolutely.

          • Donna,

            Who put the diapers on the people with Alzheimer’s you’ve seen NOT covered in feces? I’d be willing to bet they didn’t diaper themselves. If they were wandering the streets or left alone, you can bet they would have trouble caring for their basic human needs.

            Those individuals because of their illness were unable to care for themselves and thus society or their families were forced to take away some of their autonomy out of compassion. You are providing an example of the same approach I would advocate for anyone who for ANY reason reached this degree of inability to care for themselves. I DO NOT suggest that anyone in that state is disgusting, depraved or deranged as you rigidly insist, I do not think that and it is not the point. I do think that it suggests a profound disability, easily recognized by anyone. I do think that by even the loosest standards of human decency and compassion one is obligated to do something to help that person.

            As to whether this happens or not? Ask a social worker if you don’t trust anyone in medicine. It is convenient to ignore the fact that people suffering from extreme mental experiences can SOMETIMES reach an extreme inability to care for themselves. You suggest I should not bring this up out of decency, but how does one decently or compassionately ignore it? Most people with psychiatry related problems won’t have this issue, thank god. Those that do are likely unable to voice their opinions on this blog. However, they do deserve to be incorporated into any model of “so called mental illness” and what to do about it. Whatever you think about psychiatry, this issue must be addressed by any alternative model. It may feel good to focus ONLY on denouncing psychiatry, but it is not particularly constructive.

          • Scott,

            You may be making the false assumption that a psychiatric hospital is a safe place. They are not.

            You asked for alternative options. If you go to the ‘Resources’ tab at the top of this site, you’ll find some.

            Obviously, there are not enough facilities, such as peer-run respites, Soterias, etc. But a person would be much better off staying in a safe place of some kind – out on a farm or ranch; in the home of a friend or relative with some support on place until the psychosis passes.

            If psychiatric hospitals addressed underlying medical conditions, root causes of psychosis; if they offered safety – physically and emotionally, you might have an argument, but they do nothing of the sort.

            Jim Gottstein, Attorney makes some good arguments against the use of forced treatments. –

            http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=1059&context=alr

            Duane

          • From Gottstein’s article:

            The United States Supreme Court has unequivocally declared involuntary commitment a “massive curtailment of liberty” requiring due process protection.94 While the government does not have to prove its case beyond a reasonable doubt, it does have to prove it with more than a preponderance of the evidence.95 Further, involuntary commitments are constitutional only when: “(1) ‘the confinement takes place pursuant to proper procedures and evidentiary standards;’ (2) there is a finding of ‘dangerousness either to one’s self or to others;’ and (3) proof of
            dangerousness is ‘coupled . . . with the proof of some additional factor,
            such as a “mental illness” or “mental abnormality.’’”96

            The Court has suggested that the inability to take care of oneself cannot
            be considered a sufficient finding of dangerousness, unless survival is at
            stake: “a State cannot constitutionally confine without more a nondangerous individual who is capable of surviving safely in freedom by himself or with the help of willing and responsible family members or friends.”97 In addition, “although never specifically endorsed by the [United States] Supreme Court in a case involving persons with mental
            disabilities,” it also seems people may not constitutionally be involuntarily
            committed if there is a less restrictive alternative.

            And from C.S. Lewis:

            “Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience.”

            Be well,

            Duane

          • Hi Duane,

            I agree that there should be a high threshold for sure. dangerousness to others, dangerousness to self or inability to care for oneself to the point where life and limb are at risk seem reasonable to me. I also of course believe that due process, evidentiary standards and legal rights should be very carefully respected and followed without exception.

            I’m not really making the argument for specific places to put people or interventions here. Just trying to make the point that I think at some point it becomes reasonable to intervene. People keep trying to say that I’m therefore advocating for all sorts of horrible evils (I’m not saying that you are). I’m not saying that the current state of matters is ideal or correct at all – I’m not advocating for that here. Though some will still say that I am no matter what I say.

            I just think it is an important point that we are not just talking about people who are depressed or manic or have psychosis and are acting unusually. These sometimes are not benign states and people can hurt others or themselves. I’m not trying to say there is no alternative either and I’m learning about those alternatives here.

  14. Hi Faith, Hi ScottW,

    First of all, Faith, to clarify, I agree with you, not with ScottW (no offence, Scott). I don’t know if my arguments sometimes sound like I’m rooting for “the other camp”, but unless I misunderstand myself (and I don’t think I do) I am definitely not.

    What I am saying is that if you are going to call “schizophrenia” (and I don’t think that word means anything, but it’s shorter than discussing separate symptoms which is what we should really be doing), if you are going to call “schizophrenia” a “mental illness” then everybody in the world without exception is “mentally ill”. There is no essential difference between a schizophrenic and a non-schizophrenic – the difference is one of quantity, not of quality, and nobody gets a completely free ride. Do I believe in “mental illness”? No, not unless you are happy calling something that is present in every single person’s personal make-up an “illness”.

    Perhaps another analogy might be helpful to explain what I mean:

    If you mix yellow and blue you get green, if you mix yellow and red you get orange, right? If you have a gradation from red to blue (a long row of boxes with different mixes of red and blue, with pure red at one end and pure blue at the other) and you mix yellow into that gradation you’ll get a different gradation from orange to green. A given amount of yellow will change the whole red-blue gradation. It won’t change one box more than another; the change throughout all the boxes will be uniform. If you add more yellow the whole gradation will change more, if you add less yellow it will change less.
    Now, say yellow is “trauma” and the red-blue gradation represents all possible human phenotypes (expressed genomes). If you apply the same amount of trauma you’ll get the same amount of change in all different phenotypes, but of course this change will look different for each phenotype; even though the yellow is the same, each box has a different colour to begin with, so obviously each resultant colour will also be different. But the rate of change will be the same. Given the same amount of trauma, the magnitude of effect on each phenotype will be the same. Since the amount of trauma (yellow) depends on the environment and each individual’s environment is in some respects different from any other individual’s, no two individuals actually receive the exact same amount of trauma (of yellow) so their actual rates of change are different, but this is because the input of trauma is different, not because they respond differently to the same input.
    Now imagine an observer -“society”- labels the shades that are more obviously green as “mental illnesses”; a particular cluster of shades of green is labelled “schizophrenia”. There is however no reason to say that the original shades of blue had a “propensity” or “vulnerability” for “mental illness”. For this to be true, blue would have to change more than red when it is mixed with the same amount of yellow; the rate of change would have to be different, and it isn’t (or that’s what I think and how I interpret adoption studies).

    I know Scott will be thinking, OK, maybe, but green would still be a “disease” because it makes the “green people” less able to cope with their environment; it decreases their capacity to adapt and “survive” whereas orange people do fine, so “oranges” are not ill. But what I’m saying is that orange people don’t do fine either, and here is where we have to question a bit what a disease actually is.

    A disease is something which lowers survival, yes, but when it comes to “mental illnesses” we have to take into account that the human mind is in constant interaction with the environment and very particularly with the social group, with “society”. In this context survival cannot just mean survival of the individual, but must also mean survival of the group as a group. What I am suggesting is that the disease of the “oranges” who seem to be doing fine is a “social disease”; a disease which affects the survival of their social group rather than their own individual biological survival.
    So for example: an “orange” might be a very successful executive of a pharmaceutical company, and the lack of empathy and obsession with personal success which are the result of the “trauma” he’s received in his upbringing does not have a negative impact on his life as far as anyone can see. But this lack of empathy and obsession with personal success makes him cover up the fact that one drug his company manufactures has very bad unreported side-effects and 0 effect on the condition it’s supposed to treat (let’s call this hypothetical drug “Proxac”). What he is doing might no even be illegal and it has no negative effect in his life: his employers love him, he makes more money; life’s good. But in the meantime “Proxac” is causing havoc in his social group, his country, culture, by disabling an increasingly large number of people, putting stress on resources, damaging the economy, etc. His actions are having a detrimental effect on the survival of his group: they are a “social disease”. Like the body is made up of cells, the social body is made up of individuals, and you can (you must) apply the concept of disease to both bodies to get the full picture.

    That’s more or less it in a nutshell, although obviously this is a gross oversimplification and there are other fundamental aspects to this I’m not touching on, such as Free Will (yes, it exists). The only other thing I’d mention is that I think we are all exposed to certain amount of trauma, so everyone has a certain amount of “yellow” in them. As you can see, this hypothesis crosses over from science into philosophy and so I’m not sure to what extent it is falsifiable in a strict sense, although certainly parts of it are.

    Also, Scott, although I don’t want to go into it in detail I’ll just mention because I think it might interest you that in other comments I have written about psychosis being a defence mechanism, not a symptom of the disease but part of the healing process; much like fever which is part of the body’s immune response to a pathogen and not just a symptom of a “disease”. Of course, just like fever can in extreme cases be harmful in itself and an intervention is needed to stabilize the patient, the same is true of psychosis, but the emphasis is on the fact that this is only justified in extreme cases and, crucially, the intervention must actually stabilize the patient and not just appear to do so while in fact adding wood to the fire, so to speak. In this I’d say that current psychiatric interventions are catastrophic; the only good thing you can say about them is that they are better than a bullet to the head, which is not really something to be proud of. To follow the fever analogy, they are like trying to lower a fever by blood-letting (actually, blood-letting for fever has a sounder scientific rationale).

    By the way, in case I cause confusion: the 50%-10% figure in my previous comment was completely made up as a hypothetical example; it does not come from an actual study.

    And Faith, I never got around congratulating you for your article, I thought it was very good. But your responses to ScottW are even better; I think it’s good of ScottW to pop up from the underground from time to time.

    Thank you ScottW for being the “devil’s advocate” here (and please do read AoE; it’s not the bible, but it condenses a lot of information in a clear format – and don’t forget “The Emperor’s New Drugs” either).

    Now I really have to get back to work; might not be able to comment/answer for a while (collective sigh of relief?)

    • I break my self-imposed silence to briefly clarify something from my comment above:

      In my analogy of colours, just like yellow (trauma) goes in, it can also go out – it is not a one-way process. If you end up of a colour that is a “disease” (very bright green, or very bright orange) in the sense that it impairs your functioning in the world or in the sense that you are a nasty piece of work knowingly or unknowingly destroying the world, it does not mean that you cannot change and get rid of enough yellow (probably not all, true) to be a much better shade. Depending on the amount of yellow presents some will be able to do it on their own, some will need help (that is, real help and not abuse masquerading as help), but I am sure it is always possible.

      Just wanted to clarify this because if you imagine the analogy with paints it might read like I’m describing an irreversible process. Imagine it with light rays and the analogy works better…

      • I’m not even really sure we disagree all that much Morias. I mean, I’m not sure I entirely follow the whole colors thing, but it seems like you’re willing to accept that a person’s genetics sets up their brain or ‘temperament’ in a way that can predispose them to developing “so called mental illness” under the right circumstances. I understand that you’re saying that everyone is set up for success and only when exposed to the “environmental pathogen” do they get manifest whatever variation on dysfunction they are inclined to. I don’t really disagree with that, I just think that some brains are more resilient. If you expose 100 people to a moderate trauma some are going get severely dysfunctional like “schizophrenia”, some are going to get anxious or turn into a jerk and some will probably be fine. Maybe we part company there, not sure.

        Where I’m pretty sure we part company is that I think some brains are really set up for something like schizophrenia. Or autism for that matter which is maybe cleaner because it happens so early that often there might not be time for anything that could possibly be construed as trauma. My basic point being that at least in some cases you don’t even need trauma or the trauma could be so subtle or minor as to almost defy the characterization of being traumatic.

        Hmmm… Autism. Now I’m curious, how do you think about autism Morias?

        • I’d say we disagree 100%, but at least we’re getting closer to understanding how we disagree. The colours thing is an attempt to explain in a simple way how a phenotype variant can be associated with a particular type of “disease” without this implying in any way that that phenotype predisposes for that disease. It answers, if you like, the “mystery” of adoption studies (a mystery that is not resolved by saying “there must be something genetic in schizophrenia, we just haven’t found what yet”). I know it all sounds a bit convoluted but it is extremely important in practical terms, particularly in connection with ‘preventive psychiatric interventions’ and the combined use of neuroimaging and genetics. If these “finer points” are not clearly understood we might be heading towards a very bad place (I’ll avoid mentioning the nazis).

          Precisely my point is that I do not think some brains are more resilient than others, or rather: yes, brains as organs can (like the rest of the body) be more or less resilient to “material” pathogens (virus, etc), but MINDS are not. All minds are equally resilient or vulnerable to trauma. We are dealing with “mental” disorders, not brain disorders (that is the whole basic debate, isn’t it?) and the mind, the active brain, is not a brain-in-a-jar, but a system of interactions. Trauma or abuse is not a material pathogen but a relational -“immaterial”- pathogen, and psychosis is not a “disease” of the brain, but one of the ways in which the mind defends itself from this relational pathogen. If you are looking for a disease, a mental disease, you are looking for a relational disease -a disease of the system- and so you must look at the whole system of complex interactions around the ‘schizophrenic’ individual. To put it another way: one ‘schizophrenic’ individual is not a diseased individual but a symptom of a disease affecting the social group of that individual.

          All minds (in your terms, all brains) are equally resilient and given the same trauma they all experience the same harm, but this harm is expressed in different ways – some more damaging for the group than others. And I’d say that “schizophrenia” is actually at the lower end in terms of harm to the group: “schizophrenia” is -for society- one of the least harmful responses to trauma. ‘Schizophrenics’, so to speak, ‘trap’ the harm done to them inside themselves and only pass on small amounts of it; they suffer so conspicuously because they don’t pass on the harm, they wrestle with it in their minds. Other responses to harm involve passing it on, such as in the extreme case of the sexually-abused who becomes a sexual abuser (just one example of many); these responses are far more harmful to the group. I don’t think anybody can be exposed to trauma and be “fine”, it is just that some ways of not being fine are less obvious or more socially accepted than others. And by the way, although this is too large a subject: the more socially accepted a way of not being fine is, the more harm it causes to a society; societies which accept too many ways of not being fine as ways of being fine collapse and “die”.

          Of course all this is in many ways a very uncomfortable hypothesis; for one thing it implies that if ‘schizophrenics’ do not develop ‘schizophrenia’ because they have an innate vulnerability which makes them unable to deal with ordinary levels of stress, but on the contrary only abuse of one type or another can bring about ‘schizophrenia’ (as a defence mechanism against abuse), then for every ‘schizophrenic’ there must be one or more abusers. This hypothesis shifts the responsibility from the ‘schizophrenic’ to the surrounding group, and of course the group does not particularly like that.

          About autism: the greatest problem with autism is that if ‘schizophrenia’ is a near meaningless term because it is just an umbrella term for some vaguely defined traits, ‘autism’ is ten times worse in that respect. If fact there’s no doubt that the term ‘autism’ applies to several disorders (and some non-disorders) with completely different etiologies, which is why it’s really called ‘autism spectrum disorder’, the ‘spectrum’ meaning: this is not just one thing but many. So it is impossible to discuss autism in general.

          Some forms of ‘autism’ are in fact genetic disorders (or rather, behaviours associated with genetic disorders) but here is the catch: in these cases we have already identified the genes responsible for the disorder – there are no complicated mysteries, no elusive genetic ‘vulnerabilities’. A very different story from ‘disorders’ such a schizophrenia where the genes have not been found and the only evidence that there is a genetic component comes from those ridiculously limited and flawed twin and adoption studies. Studies which even if they were not flawed yield results which can be interpreted in different ways (I showed you one, there’s probably others I haven’t thought of). The situation could not be more absurd (and tragic).

          But since you bring autism up, check this out:

          http://www.casinapioiv.va/content/dam/accademia/pdf/sv117/sv117-bear.pdf

          It isn’t a research paper but a presentation given at the Pontifical Academy of Sciences (which has a lot of very interesting material available for free – a little-known treasure-trove of references).

          You’ll like this paper, it describes research into a drug to reduce cognitive dysfunction (‘autism’) in people with fragile X syndrome. It is 100% biological psychiatry – this is in fact how it starts:

          “We have entered the era of ‘molecular medicine’ in which it is anticipated that the knowledge of the human genome will reveal causes and treatments for mental illnesses. This process begins with careful clinical identification of patients who can be distinguished by a common set of phenotypic traits, thus defining a syndrome. Molecular genetic studies are then undertaken to test the hypothesis that the syndrome has a shared genetic cause.”

          Needless to say I think the author is working within the wrong conceptual framework but he is nonetheless an honest scientist going about things the right way; the paper shows good science at work. If drugs currently in use in psychiatry had been developed like this I can assure you not a single one of them would have ever reached the market or be in use.

          I don’t think you are being quite honest with yourself, Scott… a good starting point would be reading AoE.

          One last thing, this paper I link ends with this paragraph:

          “It is important to add, however, that while drug therapies might correct disruptions in synaptic biochemistry, they will never substitute for quality sensory experience and education. We imagine the drug treatment will unlock the potential for substantial gains in cognitive and social behaviors. But this potential will only be realized when pharmacotherapy is combined with appropriate cognitive and behavioral therapies that exploit life-long neuroplasticity.”

          ‘Life-long neuroplasticity’, now that’s something worth talking about and of immense importance for all “mental illnesses” whatever their etiology; but we don’t hear a lot about it, in fact almost nothing, I wonder why?

          • “..This hypothesis shifts the responsibility from the ‘schizophrenic’ to the surrounding group, and of course the group does not particularly like that”

            Agree Morias, that’s one reason why Laing was so despised by family organisations wedded to the medical model.

            “A very different story from ‘disorders’ such a schizophrenia where the genes have not been found and the only evidence that there is a genetic component comes from those ridiculously limited and flawed twin and adoption studies”

            Absolutely agreed.

            The debate here regarding autism seems to be around whether it’s a “brain processing” issue or “developmental”, I’m not finding either useful..

          • Hi Joanna (I hope this comment ends in the right place)

            I’m afraid I cannot say anything of help when it comes to specific therapies for autism, but I just wanted to thank you for posting your experience of catatonia which I think is incredibly valuable – I hope I’m not trivializing it by saying this.

            I really just cannot understand how psychiatrists can ignore accounts such as yours and refuse to take them as their starting point. How can their minds be so closed? At one level I understand why, but I still find it hard to believe; it is so profoundly irrational, this inability to see what’s right in front of their faces. To me this irrationality of psychiatrists is something that rightly deserves the name “mental illness”.

            Anyway, I’m sure you don’t need another rant; I’m sorry I cannot be of help and thanks again

          • Hey Morias.

            Fine we disagree 100%.

            So schizophrenia cannot arise in the absence of trauma? It would be nice if you could provide data that substantiates this.

            I’m glad you refer to your conceptual understanding as a hypothesis because I think that is exactly what it is. Not that mine isn’t a hypothesis too… I’ve tried to provide you some of the evidence that I see as supporting my hypothesis. It is not all twin studies and I’ll get back to that in a second. You’ve explained why you think the evidence is invalid and you’ve offered a set of philosophical analogies that describe alternative scenarios. In the end you’ve also got to provide evidence that what you are proposing is true. Not just that what I’m proposing is wrong.

            For example what is the evidence that all minds are equally resilient? That nothing genetic predisposes to schizophrenia? That no one can experience even mild trauma and still be OK? I mean data, give me data. I get that you’ve got ideas and that you are very smart and thoughtful. You say that I’m being dishonest with myself, I don’t know what you mean, but to me it seems like your view is self-evident to you and I’m trying the one trying to provide data. Give me the data.

            Yeah, we know autism is a bunch of things. I know schizophrenia is a bunch of things and it is a made up category which comprises a check list of behaviors that encompasses a Venn diagram of many overlapping syndromes or whatever. I’m so sick of this part of the discussion. Give me some credit – you know that I know that. There is no way to have a discussion using words in human language without using labels and saying autism is the only one I have that I know means something to you. You want to propose a different word or set of words then fine I’ll use those. I’m sick of having to delete words I’m writing so I can go back and put parentheses around them.

            You say some forms of autism are genetic disorders where we have found the genes. Yeah, I guess. Fragile X has phenotypic overlap with autism spectrum disorders, just like Huntington’s disease has phenotypic overlap with schizophrenia spectrum disorders. How is it any different? They each account for a miniscule percentage of all disorders that fall within those categories. DiGeorge Syndrome is a genetic disorder with phenotypic overlap with schizophrenia. I can go on… Genes can cause symptoms indistinguishable from schizophrenia, genes can cause symptoms indistinguishable from autism. The vast majority of autism and schizophrenia we don’t know the genes or environmental factors responsible, but they both have high concordance amongst relatives based on the degree with which they share genetic material. There is so much more evidence about this than just twin studies.

            The quotes you offer from this paper are EXACTLY what I’m advocating for… That type of scientific process rationally offers the greatest amount of hope for treatments that impact the underlying biology of the disease while limiting side effects or toxicities as much as possible. Problem is that thus far that process has yielded spectacularly few drugs that are in use in any area of modern medicine. Most medicines that we have in any area of medicine were not rationally designed… Doesn’t mean we shouldn’t try, I want us to try. That’s why the process they describe is EXACTLY what I’m advocating for.

            Finally, of course I advocate also for life long neuroplasticity, education, therapy and social interventions which will also alter the substrate that gives rise to psychiatric disorders (regardless of whether their cause is 100% environmental). And, further create an environment in which the organism can thrive given these new tools and the acute stabilization potentially offered by newly discovered medications.

            Sheesh Morias, you know I like you, but we are like ships passing silently in the night sometimes. At least that’s what I think. Note that I did not edit or re-read this rant, please don’t hold me responsible for minor points lacking clarity.

        • Scott,

          Thinking doesn’t make it so. See Dr. Mary Boyle on Schizophrenia? A Scientific Delusion? and Dr. Colin Ross’ Pseudoscience in Biological Psychiatry among tons of others debunking the bogus genetic and other biological causes of so called schizophrenia, a hodgepodge of many different symptoms upon which nobody could agree.

          As Dr. Thomas Szasz exposed, so called schizophrenia became the “sacred symbol” of psychiatry because without it they couldn’t justify their existence. Yet, psychiatry is infamous for using such bogus stigmas and junk science theories to stigmatize, disempower, humiliate, silence and remove/destroy those deemed a threat or even a nuisance to those in power just like Soviet Russia.

          A perfect example is the book, THE PROTEST PSYCHOSIS, whereby the bogus schizophrenia stigma was redesigned to fit angry black men justly fighting for their human, civil and equal, rights, so they could be targeted, stigmatized, poisoned, discredited and removed from society also based on bogus eugenics theories that they had inferior intelligence as in the horrible book, THE BELL CURVE. This same evil has been perpetrated against women, gays and other minorities.

          Of course, every time people/victims/society catch on to the latest psychiatry/BIG PHARMA fraud, they admit to its fallacy while pretending the best intentions while perpetrating new lies for the same purpose as Dr. Insel, the APA, BIG PHARMA and others are colluding with their latest bogus neuroscience to waste more billions and seduce BIG PHARMA back to the fold of their ongoing crimes against humanity.

          This is the problem with this great neuro research in that eugenics from the Nazi era is alive and well under different names and guises, so I think any of this so called brain research proposed by the likes of Dr. Insel of the NIMH with like minded people in the APA, academia and BIG PHARMA poses a huge danger to a free, democratic society given the huge human rights abuses it continues to advocate with obvious junk science. Dr. Insel and his cohorts have made no secret of the fact they want BIG PHARMA to come back to the fold to invent new drugs to keep the gravy train going. As long as the latest pseudoscience keeps ahead of those exposing it, they will continue to profit very handsomely while continuing to destroy countless lives.

          Those of us challenging your unproven neuroscience theories get quite upset because we bear in mind George Santayanna’s warning,

          “Those who fail to remember the past are doomed to repeat it.”

          NEVER FORGET!!

  15. Joanna Care,

    I respond here because of lack of space above.

    To me, the discussion about “involuntary commitment” and “forced drugging” is personal. I am not talking hearsay, I am talking about what happened to me and how having been at the receiving end of both has basically harmed me in ways that I was only able to appreciate over time. The question about “have you ever been interned in a psychiatric hospital” shows in all kinds of applications for jobs, security clearances, etc. Not to mention that it makes all potential social relationships toxic. It caused my divorce and it caused me to sever my relationship with my parents, who used the whole ordeal to exercise control over me. Needless to say, I haven’t had any more commutations with them, despite their repeated attempts to contact me via email/phone. I have just ignored them. And overtime, those attempts stopped for good.

    It has also impacted my ability to date other women. I am not going to lie about what happened to a potential life partner, but the question is always about, “when should I tell her”? Not in the first date, but what if I wait 2 months, she learns, becomes ballistic (feeling “lied to”) and then worse, tells everybody else via Facebook and suddenly my life is ruined. So sorry, I am an absolutist on this matter, freedom should only be taken away if the person commits a crime, end of the story.

    “We could take the position that anyone is free to kill themselves”

    That is EXACTLY my position.

    “or others and take the consequences of that,”

    Actually, the crime of making “credible threats” already exists, at least in the US. If somebody has made “credible” (“credible” as in “beyond reasonable doubt” and determined as such by a jury of his/her “peers”) threats to another person, that somebody will go to jail but only after those threats have been determined to be credible. If you are labelled, those threats do not need to be “so credible” and the incarceration lasts for as long as a shrink determines to be necessary. That is the injustice I am talking about.

    “but what if any were preventable with some assistance”

    People should be free to kill themselves if the chose to. It is really that simple. The “right to kill oneself” is implicit to the “right to live”.

      • There are many ways to help a person thinking about suicide. I don’t think that detaining that person against his/her will, and forcibly drug that person will improve matters. Had I had suicidal thoughts when I was committed, the whole experience would had made matters worse, not better.

        The notion that a person is “helped” by being detained and forcibly drugged is deeply, deeply misguided.

        • I was referring to the question of limited short term holding without forced drugging, I have repeated that several times to make it clear, so I cannot be clearer. Having attempted to die and lost several friends by suicide it’s very personal to me too. With my friends I’d say that for two of them it was the right decision for them, but the other three it’s not clear cut.
          I’ve made it clear I respect people’s right to choose and support physician assisted dying, and I’d go even further and say that Dignitas should consider requests for unbearable long term mental distress as well terminal physical conditions because overdosing every week for months until all your organs pack it is a really shitty way to die, and one of my friends for whom is was the right decision for her should have had an easier way out than the hell she went through. On the other hand I first attempted when I was a teenager I don’t think I was in a position then by virtue of my age to see everything clearly – and yes the admission didn’t help me, although ironically sometimes you start fighting to live just to escape them! Suicide and people committing crimes whilst very distressed are not black and white, if I had torched the pet shop because of the reptiles within them which my voices told me were going to attack me, I would have gone to prison for a long time.
          I think there would need to be lawyers who did plead for mental distress and somewhere to go, not hospital, not prison, not drugging where there was help to make sense of things.

      • I agree with Joanna. I’m imagining if it were my choice to let a person leave and go to commit suicide. Let’s say it’s a 19 year old girl who has been traumatized and she says “I’ve got a gun in my car, I want to leave so I can end it all.”

        If it was within my power, how could I let her go? How could I look her parents in the face and justify that if she went through with it. Would I say “well it’s her choice”?

        I understand where you’re coming from Cannotsay with people having a right to end their lives if they want to. But isn’t there room to account for when people aren’t thinking clearly? I just disagree that this is black and white. I disagree that it is simple.

        • A lot of people with “so called mental illnesses” already end up in prison. If there isn’t an alternative, then how is that any different than criminalizing “mental illness”?

          I have to agree with that Scott, and I also agree that these questions are not remotely easy, they are challenging and so they should be. At this moment in time I’d like to see some alternative framework which doesn’t involve long term drugging/forced treatment of any kind but makes some provision for limited short term holding for specific circumstances such as the starving young or suicidal, and special pleading for those who have committed non-violent offences who were clearly distressed at the time, and alternative provision for them to go for a while to look at what’s happening [without forced drugging].

          We’ll have to agree to differ cannotsay, I can respect that.

        • Believe me Scott, you don’t have the slightest clue of what it is like to have been treated as a criminal without being one. You can keep your “false empathy” for yourself.

          “But isn’t there room to account for when people aren’t thinking clearly? I just disagree that this is black and white. I disagree that it is simple.”

          I am sorry, but this “life is not black and white” thing is the excuse psychiatry uses to abuse its power. If that 19 year old girl wants to end her life too bad for her and her family/friends.

          Shrinks will not be able to prevent all bad things that happen in life even if they were to be given the totalitarian powers they dream of. “If only”, “if only”… If only shrinks minded their own business… For every so called “19 year old girl” that you claim to have been “helped” by psychiatry I can give you 10 whose lives have been ruined by psychiatry (many of them MIA readers), including people who have taken their own lives pushed by SSRIs and neuroleptics. On average psychiatry does more harm than good, that’s the fact: psychiatry’s treatment of choice (SSRIs) are no better than placebos and make people taking them violent. Only an evil mind could think that the solution to a suicidal person is to force that person into antidepressants. This explosive cocktail is confirmed by the CDC data that shows that from 1999 to 2009, the suicide rate increase 28%, a time during which more Americans were on antidepressants than ever. Giving shrinks more power will only make the amount of misery existing in society increase.

          Life might not be “black and white” but science certainly is. Science is a totalitarian endeavor governed by the laws of nature and the laws of logic. If you want to preemptively lock in that 19 year old girl, do not use the excuse of “science” to do it (because there is no science behind psychiatry). Just openly say so. Say that psychiatrists want to have totalitarian powers because “they say so”.

          I have nothing but contempt for people like you who bring these false analogies and false choices to justify your ever increasing demands for totalitarian social control powers.

          • “If that 19 year old girl wants to end her life too bad for her and her family/friends”.

            cannotsay, I can respectfully agree to differ but that’s quite a brittle statement, have you ever lost anyone close to you by suicide? [and I will stress again that I make no calls for forced detainment with forced drugging forevermore]. Would you take same view of the 15 yr old dying of starvation through eating distress?

            “I have nothing but contempt for people like you who bring these false analogies and false choices to justify your ever increasing demands for totalitarian social control powers”.

            I don’t know Scott, I’ve only just ‘met’ him/her these last few days [are you a psychiatrist Scott?]but whether you like or loathe Scott, views are being expressed which you would have to engage with if this were an open global debate with all our governments asking ok what shall we do? Let’s have the entire electorate decide. You would have to engage with these questions.

            So Scott can I ask you, what do you think of the idea of people being detained for short periods for only a limited range of reasons with NO forced treatment?
            And how about if psychiatrists didn’t make those decisions?

            cannotsay – I would also point out that some people have advance directives which state what they do and don’t want in a crisis, so if some people did want things you wouldn’t want for yourself are we going to respect them or only respect what we approve of?

          • I can see that you’re really angry at me, but I don’t feel like you’re being fair. Most of your anger seems to be directed at what some of the ideas I’m expressing represent to you. I don’t think it’s a fair characterization of what I’ve said. You don’t know me or what I’ve been through, but I can accept that the issue is a very emotional one for you. I’ve said that I can accept that your position is different than mine, but it doesn’t seem like you can accept that mine is different than yours. Perhaps it is time that our dialogue on this comes to an end.

            I’ve been enjoying learning about how people think differently than me. I find it stimulating and my philosophy is plastic. The least you can give me is I’m here listening to what people have to say. I thought this was supposed to be an open place where people with different views could exchange ideas. I hadn’t gotten the idea that most here want me to leave, but if I do then I will.

          • As a person who came extremely close to killing himself in his suicide attempt, I am very glad that someone intervened so that I am sitting here this morning typing this comment. My attempt happened during the most trying time in my life and I was out of balance and spinning into the void. I was rational. But I am glad that someone saved me so that I could go on to fight the good fight another day.

    • I would never get anyone hospitalised unless they asked me to, I personally cannot act against a person’s wishes and wouldn’t want to be in a position where I was expected to.
      I’ve written about this elsewhere,for me being pro-choice in my life means doing what a person wants irrespective of whether I agree or would want it for myself, that is the essence of advocacy.
      I wasn’t sure if Scott was a psychologist or psychiatrist [sometimes it can be hard to tell in the UK I wanted to check] and there are many many people who can sell themselves as good, and that’s not the exclusive preserve of psychiatrists. Szasz is your guru not mine, we have some ‘good’ psychiatrists too, some of them have written here.
      I enquired about the shades of grey not suggesting we leave unlimited powers to psychiatrists forevermore, I stressed this repeatedly so stop misrepresenting me, you devalue your own arguments by insisting I am saying something I’m not.

      You’re wrong about advance directives, they are not always followed in general medicine just as they are not always disrespected in psychiatry, agreed it’s a much tougher battle with less success but some people’s directives on their choices within services are followed. Where we would agree is that directives on no admission/no treatment are not followed and are overridden, but overrall you make everything very black & white.

  16. “When it comes down to what is and what isn’t it shouldn’t have to do with “normal” it should have to do with suffering and not functioning well… In my mind if you are sick you need help to get better, it doesn’t mean you are bad or defective. And that goes for me too if I am sick.”

    Thank you, Scott. Seems that we all share an interest in seeing that a person in severe distress gets help (assuming they want some kind of help), but that’s where it gets tricky. What does it mean to help someone? And this isn’t an impractical, philosophical question either. Usually “help” assumes a set of shared values, which in America is about, “how can we change or stop this as soon as possible?”, as opposed to staying curious and supportive by listening (to the person and/or body) for meaning. What is this “symptom” trying to communicate? In this way, a fever or ‘delusional’ beliefs, for example, are not a problem, but an important messenger. And often the mental health patient’s symptom not only carries an important message for him or herself, but also for the family and community. If we remain open, what we call mental illness is a profound opportunity for transformation and can a great gift the community.

    About autism… I have lots of thoughts. For now I’ll say that I live with a close friend who carries a diagnosis of autism. He is mostly non-verbal, and cannot work or cook or use the bathroom himself. He has many ‘tantrums’, and in moments of acute frustration is aggressive. But he doesn’t consider himself diseased or sick. He’s keenly sensitive and funny and doesn’t care what anyone thinks of him. His differences have connected, challenged and grown hundreds of people over the course of his lifetime. And yes, he struggles very, very much. But he thinks ‘normal’ people do too. He’s written at length about we are hysterically (and tragically) self-obsessed and vain, and take ourselves and our ideas way too seriously.

    On that note, I’m going outside to play!

    • Vanessa I appreciate you speaking of your friend diagnosed as autistic, my relative is very verbal but struggles with the nuances of social interaction, i.e. give and take, takes things literally, and can have very explosive rages. I know she would not consider herself diseased or sick [neither do I], I do however worry greatly about what will happen to her when her parents are no longer here as she doesn’t have independent living skills and would need social security support and possibly a support worker of her choosing to assist her with cooking a meal etc, and our current welfare system is vicious and punishing.
      Your friend is right about the rest of us taking ourselves too seriously so may I for one moment offer some light tongue-in-cheek humour ridiculing psychiatry’s approach to suicidal feelings.

      The Ferguson Safety Smock for suicidal inmates and patients

      Feast your eyes on this product:

      http://www.preventsuicide.com/index.htm

      That’s me on the right, first thing in the morning before a hairbrush, I’ve no idea who the hairy geezer beside me is [actually I’m told he’s the CEO of the company].

      http://www.preventsuicide.com/faq.htm

      Now I can’t take this smock off when wearing it [looks very fetching] because it’s made from incredibly strong fabric and apparently it’s “not designed to prevent exhibitionism. It’s for people who wish to be clothed, which is the majority of suicidal inmates”.

      Nah not me, personally I prefer to be naked when I’m suicidal.

      Now please look at this additional product – the sani-belt for suicidal and self-destructive females:

      http://www.preventsuicide.com/products.htm

      This does suggest that there are an extraordinary number of suicides as a result of using sanitary products as the method. I want to reassure readers that I have put this to the test under scientific conditions [I wore a white coat].
      I placed two tampons up each nostril, and smothered my mouth with an Always Ultra [with wings]. I even had a medic on standby just in case of respiratory failure. The results of my scientific experiments were that suffocation by sanitary products is quite difficult achieve.

      “The use of Ferguson products has enhanced our safety standards. It has reduced malingering by 100%.”
      – Russ Ford,Senior Nursing Officer, Bermuda Dept. of Corrections

      Ah yes he’s absolutely right of course wearing these smocks ensures there’s no ‘dramatic’ self-harm, no fake suicidal behaviour. These products really do make the jobs of Samaritan’s and psych services that much easier.

      I am available for smock modelling please contact my agent for details of my fees.

      • I have a vague sense that it’s wrong to laugh at this but I can’t help it, I’m laughing.

        …I just re-read the last phrase and it cracked me up again.

        Oh God, it happened again, it’s like a reflex.

        my wife just came in to ask me what is wrong with me, I have to go now.

  17. Wow, a lot of action. I’m going to start a new post.

    I am not a psychiatrist. I am a neurologist. So you’re all wrong 😉

    I have suffered myself with psychiatric forms of distress and so have those in my family. I’m probably not going to say too much more at this point because I’ll be honest in saying I don’t feel very safe in this space. I’m feeling some hatred for what I’ve said and I do feel uncomfortable.

    Cannotsay: I’ll take the $100 in unmarked 5’s and 10’s, you can leave them at an address I will post as a comment on the next article published on MIA. Just kidding. I doubt it will make much difference to you that I’m not a psychiatrist. For the record though I have not boasted any academic credentials to you and I have never asked you to accept what I’m saying as the “word of god”. Nor have I said anything about “unlimited power”. Along the lines of what Joanna said, please stop continually mischaracterizing what I’ve said. I know that you didn’t ask me to leave, but you’ve used hurtful and severe language and tone. I am here engaging and listening, I think some people welcome that and I stand by what I said, if I think that most people don’t want me here then I will leave. I know you didn’t ask me to leave and I won’t leave just because you wish I wasn’t here. OK?

    Joanna – I think the idea you propose is a good one and it might work well for some people. Probably it doesn’t happen enough. The truth is I really don’t know what to do in these situations which is part of the reason I’m here. I’m curious about these issues legally, experientially, scientificially, medically and philosophically. I do have some ideas, but I definitely don’t claim to know what the answers are.

    As far as psychiatrists not making the decision, they often don’t. In many parts of the country law enforcement officers, paramedics, firefighters and emergency room doctors can also place people on temporary holds. Psychiatrists don’t go out looking for people to hold against their will, someone brings them in, often already legally held against their will. When it comes to forced medication, a lot of doctors will medicate someone against their will if they are thought to be acutely dangerous to themselves or others at that moment. Yeah it’s a judgement call and I’ve made it as a doctor. For example when delirious patients or those with brain injuries are flailing around and trying to leave the hospital. It is hard, and I’ve only done it when I thought someone was going to hurt other people or hurt themselves. I don’t feel good about it and if there is one reason I’m glad I’m not a psychiatrist it is because I’m thankful that is a rare situation in my specialty.

    However, no doctor can just decide to force medications on someone regularly in non-acute situations, at least where I’m from. There are legal proceedings for determining if someone can have a medical procedure or medication given against their will. That is true no matter if we are talking about psych meds, surgery or antibiotics. So ultimately a judge decides. Maybe the judge just goes along with what the doctor says some will say and maybe there is some truth to that. However, the person is entitled to legal counsel and to appear in front of a judge. If we decide that this is wrong, we should decide to change the process from a legal perspective. As Joanna eludes to it is ultimately a political and legislative position change.

    Vanessa – In my mind whether someone wants help or not is almost always the most important question. Sometimes in rare or extreme situations though, I do think people need help and cannot say or are unable to recognize it. Not everyone will agree with that and I can accept that. When I told cannotsay I accepted his/her position I meant it, I think it is extreme, I disagree, but I understand and respect it. I do think society needs to intervene at a certain point and I am NOT SURE what form that help should take. That’s why I asked the question I asked. Not because I thought I knew the answer, but because I don’t know the answer.

      • Quit putting things in quotes as though I’ve said them, like “European benign paternalism”, I’m not sure if you got that I’m from the US or not.

        I didn’t ruin anyone’s life, I’ve saved lives and prevented morbidity. I’ve had people on my service delirious having suffered serious traumatic brain injury. Swinging at nurses, trying to pull their IVs out and tearing at bandages that cover scalp flaps overlying missing pieces of skull. What would you do? Let that person in a blind unthinking daze hurt other people, maim themselves and walk out onto the street to die? Get real. I’ve given emergency medication to sedate that person and they and their families have thanked me. How dare you with your contempt.

          • What is with the smiley faces is this just fun for you?

            You can be damn sure I didn’t use an SSRI as that would be ridiculous. Yeah I asked the person or rather they have volunteered their thanks to me. Again I ask you what you would do?

            I don’t know your situation at all and I’m not presuming the situation I’ve been put in as a doctor is anything like the situation you were in. In fact I think I’ve given you enough details to demonstrate that it wasn’t. I’m not the European psychiatrist that gave you an injection against your will. I’m sorry that happened and I don’t defend it. I’m just saying come on… be a little reasonable. I did what I would want someone to do to me if I was in that same situation. For what it is worth, I’m talking about a patient who had been hit by a car while riding his bike. He was out of his mind because he had a massive brain bleed.

            Jesus Christ.

          • And I’m quite certain that US shrinks are every bit as as bad European ones.

            This sometimes looks like blood sport cannotsay, which has it’s limits in how effective it is

          • “And I’m quite certain that US shrinks are every bit as as bad European ones.”

            Sure, only in the US they are more under check. We have the legal protections against detention that I spelled out earlier plus a great system of medical malpractice -which can literally bankrupt them- that combined have them under control, much more under control than in Europe. Morally speaking though, I agree they are not better.

    • Something else Scott, following up on,

      “I’ll be honest in saying I don’t feel very safe in this space. I’m feeling some hatred for what I’ve said and I do feel uncomfortable. ”

      Let me elaborate on how different my perspective is from yours. After I decided to stop the drugs, I sent a very strongly worded message to the psychiatrists that committed me (message that of course went unanswered).

      I then spoke spoke to the US citizens division of the US embassy of the country where this thing happened and their advise was that I should never go back to that country.
      That if I were to be committed again, there is little they could do because the laws in that country are what they are (as I said, the same is true in all of Western Europe). They had had cases of natural born Americans who had been committed while on was supposed to be a short stay there (business/tourism), and that there was nothing that could be done to free them until the psychiatrist who ordered their commitment decided to free them.

      I insisted with a question like “but is it relevant that in the US I could not have been committed under that standard?”, their answer was blunt: NO, IT ISN’T. So bottom line, I followed their advise and I have never been back there.

      This is how different I see the issue of “feeling threatened” from you :D.

  18. Scott thanks for confirming who you are, I wasn’t certain and that’s why it’s always worth asking who a person is, I hope you didn’t actually place that bet cannotsay.

    Sometimes I don’t feel comfortable here either because; I don’t worship Szasz, do see Capitalism as contributing to mental distress, that it’s assumed I’m hating anyone who votes Conservative/Republican [which I don’t], that I’m telling lies about how government policies in the UK are impacting on people in my country purely to discredit a conservative government [which I’m not], that being ‘left’ leaning automatically means I want massive state intrusion in private life and no freedom [I don't], that unless I sign up to all suicide/murder is fine in the name of freedom then I must be supporting lifelong drugging and detainment by psychiatrists in hospitals [which I don’t].

    I accept that US psychiatry services are not the same as the UK, they are harder to get out of.

    Equally,[and much more importantly] I’ve found many people here offering; enlightenment, willingness to engage and debate even when it’s painful and from very different positions,willingness to listen, great breadth of knowledge and experience which I’m learning from,willingness to consider my experiences and views, some shared thinking, humour, warmth, genuine curiosity [of the best kind],and inspiration.

    It’s more than psychiatry which needs to change, it’s all our systems and structures, the social fabric of our societies, otherwise how will we get people on board who have never experienced psychiatry if we’re not willing to debate the difficult questions other than in a linear fashion.
    Man on the street isn’t going to grasp any suicide tough shit, any crime go to jail, and I could bet £100 on that

    • I sure wish the JW’s would stop knocking on my door asking me if I’d like to ‘let God into my life’..so tempted to go to the door with 666 on my forehead holding a chicken and bread knife saying ‘mmm, we needed a human for the next ceremony’ rolling my eyes

  19. 2- The whole thing is fun in the sense that I know I could not have this dialogue with a shrink in the UK, or anywhere else in Western Europe for that matter.

    I can think of critical thinking UK shrinks and ex shrinks who would happily debate with you, some of them have blogged here.
    For the hard line medical model types, if you were at an event they would shut off from you relentlessly telling them they want everyone drugged and incarcerated – that’s not the best tactical strategy for gaining allies. There’s only a point to keep hammering it home if the other person is denying that reality

  20. Sure, only in the US they are more under check. We have the legal protections against detention that I spelled out earlier plus a great system of medical malpractice -which can literally bankrupt them- that combined have them under control, much more under control than in Europe. Morally speaking though, I agree they are not better.

    that’s a fair point I accept that

  21. Hi Meremortal. On the balance I totally agree with you. In fact my overall experience at MIA has been one of really being impressed by the depth and thoughtfulness I’ve encountered. That’s the reason I’m still here, because I really think there are important things to learn here. At least from my perspective, people like Morias, Faith and Joanna have made important points that really have influenced the way that I think, I hope that they would say the same. That would be my goal, but I don’t know if they feel that way and it’s OK if they don’t.

    It has been fixated on a bit that I said I felt unsafe, but no one has threatened me and I did not mean to imply that. There are obviously many ways to think about feeling safe and I didn’t say it to indicate I was afraid of bodily harm. I did not call MIA “toxic”, so again I hope that you didn’t mean the quotes as though you were quoting me. I’m fine with people disagreeing with me and I hope that this is clear from my comments. Truthfully, I’m here because I enjoy the feeling of expressing my ideas in an uncomfortable environment. However, that doesn’t extend to being asked for my address or feeling like I’m being attacked with abusive language or being repeatedly ascribed motivations that aren’t accurate. Mostly that has not been the case and again if I felt like that was the majority of what I experienced I wouldn’t be here.

    It is awesome that MIA exists and it definitely counts as one of the most fascinating and intriguing communities I have ever encountered on the internet.

  22. “It is awesome that MIA exists and it definitely counts as one of the most fascinating and intriguing communities I have ever encountered on the internet”.

    agreed!

    Faith, it is sometimes hard for some things to ‘translate’ on the net, in terms of communication, we can’t see each others faces, hear tone of voice, communication isn’t only about the content of what we say. The net is a wonderful thing but it also has it’s limitations [like anything] because it can get very heated in a way it might be different face to face.

  23. Hi Scott,

    I never thought you were a psychiatrist because you are too interested in psychiatry, and on the whole I find psychiatrists just don’t give a **** about their own subject.

    Do you sound a bit angry in your last reply to me? That might be a good thing… believe me, I share your frustration re. ships in the night.

    I myself am not an empirical scientist and I don’t work with data; the last data I handled was my income tax return. I’m more of an abstract theory type of person; that’s the kind of thing I do and what I can offer, for whatever’s worth. There is some of this data you ask for in AoE and Emperor’s New Drugs, (and I’m sure many other books I haven’t read), which is why I keep recommending them to you; I honestly think you will appreciate them. Of course their case is not 100%; they don’t offer proof in a strict sense, but they do present a lot of evidence in a fairly rigorous way – more evidence than the other side, I’d say. They’re worth the money.

    But you do have to give them some time, you have to allow yourself to think for a moment, could this possibly be right? Can we interpret the available evidence in this way? This is what I meant when I said I don’t think you are being honest with yourself. You have to play devil’s advocate with yourself, not just with MIA. Isn’t this one of those basic rules of philosophy of science (which much to the world’s regret no research scientist actually follows)? Never set out to prove your hypothesis right, set out to prove it wrong; and if you can’t maybe it is right, but you must always be on the outlook for new ways to prove it wrong.

    I do believe all minds are equally resilient to “immaterial” pathogens such as trauma. Do I have proof ? No, I have arguments and I think it fits better the available data (that I know of). In any case, to really talk about this kind of thing in detail we would have to first get into the relationship brain-mind, the organ and the mental processes, and I’m not going to go there here (I have to save something for the book I want to write when I retire, don’t I?)

    I’ll sort of leave it here… I’m a bit washed out after my analogy of colours; I was so pleased with myself when I was writing it and I don’t think anybody got it…

    I’m interested to hear that you do agree with the idea of life-long neuroplasticity. Where does that leave all these brain-imaging studies that look for differences in brain morphology in adults in order to stablish a “genetic component”? Isn’t it a bit too obviously absurd?

    Me, I’m waiting for the longitudinal study on a random sample of 100.000 people who are given a battery of fMRIs at 5 year intervals from birth to their natural deaths. Maybe then we would have some data worth talking about.

    Till next time.

  24. Hey, it’s been a while.

    Brain activity and perception have been super phenomenal for me. My environment has changed “in the blink of an eye”. Transformation.

    I understand this “kundalini” energy a bit better now. She is “reptilian”, her eyes blink with lenses and she clicks my ears and sinuses. We talk and communicate with each other. I’m not “crazy” and neither is she. She is not a hallucination or delusion. She is very real. I try to discern with the EXCLUSION of what hollywood and psychiatry would like to force feed. I like her.

    I still fight “psychiatry” and their brainwash belief system.

    There’s something about “tv” and manifesting / manifestation that gets my attention. My radio has been playing very, very unusual sounds. I believe it is galactic or something but when I get near the radio, I get that “feedback” sound.

    I do not like this “cloud technology”. I know that something has managed to “break in” to my mind. It can be too controlling. Mind control is a real problem.

    I am very different from you and you are very different from me.

  25. Hi Faith,

    I just read this article and wanted to say thank you for the thought provoking perspective. I am gaining so much expansive and clarifying insight from reading the blogs on this website. I found yours particularly meaningful along with the discussion threads via the comments. Also, my mind and heart was deeply affected by your poem, I found it quite exquisite, powerful and moving. Do you by any chance have a book of poems published?

    Yes words can never adequately describe who we are, or what makes us who we are, but sometimes they can evoke, with varying degress of clarity and feeling, the awesome mystery called you, me and us in relationship to life and each other.