Can Psychiatry “Re-Engage” with Pharma?

Sandra Steingard, MD
76
119

On August 1, Jeffrey Lieberman, M.D., the current President of the American Psychiatric Association,  wrote an open letter to Psychiatry News asking whether is was time for psychiatry to “re-engage with pharma.”

Dr. Lieberman asserts that although there are problems with the way the public perceives drug companies, he thinks it is time for psychiatry to re-evaluate  its connections to the industry.  He reports on a recent meeting of the American Psychiatric Foundation Corporate Advisory Council with representatives of 14 pharmaceutical companies.  He states these representatives “desired re-engagement with physicians and researchers, and most importantly, they understood that all such interactions must be transparent, rigorously monitored, and without conflict of interest.” It is clear from Dr. Lieberman’s post that this desire is mutual.

This article left me confused and not overly confident that much change is underway.  Dr. Lieberman does not seem to acknowledge that physicians and the APA share some responsibility for past transgressions.  He writes, “Drug companies aren’t held in high esteem by the public” due to their aggressive marketing and high prices. But when he writes about the role of physicians and professional organizations, he states “these problems arose when companies engaged in aggressive marketing practices in the guise of educational activities and paying clinicians and researchers – so–called key opinion leaders – for their advice or research in ways that were perceived as potential conflicts of interests.” (underlining mine).  He goes on to state that “Ironically, somehow in this process, our field [psychiatry] became the poster child for physician misbehavior”.  We know from his previous statements, that he accuses those who are critical of psychiatry of being “anti-psychiatry“.

I am not clear what he means by re-engage. Dr. Lieberman lauds the guidelines that the APA put in place as “the strictest ethics policy of any professional association for members participating in key programs such as the development of practice guidelines and the revision of DSM.”  None of this precludes psychiatrists from collaborating with pharmaceutical companies. Does this “re-engagement” signal an attempt to remove some of these measures?  It seems that way since he goes on to state, “Speaking for myself, I believe that the rules and models for informational, educational, and research engagement can and should be developed and applied in ways that allow for our optimal engagement with companies” (underlining mine). I thought the intention of the more recent guidelines was to allow for interaction that reduces conflicts.

Dr. Lieberman’s essay seems short on acknowledging any personal or collective responsibility for the problems that arose in our profession’s interactions with the pharmaceutical industry.  This is conveyed in his line about “perceived conflicts of interest.”  This implies that the conflicts were not actually present but only appeared that way.  This sentiment is further betrayed by his finding irony in psychiatrists becoming the “poster child” for conflicts of interest.  The language he uses for the role of the industry is active (they engaged in aggressive marketing) and that of the professions is passive (they were  sought after for their advice and expertise).

Dr. Lieberman’s influence in psychiatry cannot be understated. In addition to serving as the current APA President, he is also Chairman of Psychiatry at the Columbia University College of Physicians and Surgeons, Director of the New York State Psychiatric Institute, and Psychiatrist-in-Chief at NewYork Presbyterian Hospital-Columbia University Medical Center.  This is one of the most respected medical schools and research institutions in the world. Dr. Lieberman has a long and distinguished research career.

Nowhere in this essay is there any acknowledgement of the harm to patients that arose from these practices.

Nowhere in this essay is there a serious response to those who have offered thoughtful critiques of research conducted in collaboration with the pharmaceutical industry.

During this past week, I was also reading two books, Ben Goldacre’s “Bad Pharma and “Recovery from Severe Mental Illness” edited by Larry Davidson, Courtenay Harding, and LeRoy Spaniol. These books served as an interesting contrast to Lieberman’s post.

Goldacre explains in great detail the many problems in our current system of drug research and he makes concrete suggestions on how the system could be improved.  Lieberman’s essay was lacking in specifics; a call for any academic who worked with Pharma to have free access to all data, an elimination of ghost writers, and a requirement that all trials be made available for review would go at least some way to restoring my own confidence in believing psychiatry was on the right path.

In the Recovery book, I was struck by an essay by John S. Strauss. He was a co-investigator with William Carpenter and John Bartko on a landmark study of long-term outcome for individuals diagnosed with schizophrenia.  His essay, “What Is the Reality About Severe Mental Disorder?” is in part a reflection on his experience of conducting a study that led to findings that contradicted the prevailing belief of the time.  He trusted the process of research even if it yielded results that were not expected. He also trusted the process of listening to what patients were telling him even if they contradicted prevailing ideas of the nature of mental illness. He struck me as a researcher who was truly engaged with the human beings he was trying to study.  He seemed to not only understand but to embrace the complexity of human behavior.  This is a level of complexity that is quite hard to characterize with our various rating scales and assessments.

For instance, when describing the variable nature of experiences such as hearing a voice, he writes, “some people described experiences that were ‘sort of like a voice’  in that they could ‘sort of hear it’ but that were also ‘like a thought.'”  This led him to suggest that “to understand mental illness and its origins and to create optimal treatments, we might need to think in terms of ‘more or less’ rather than in terms of  ‘does this person have this illness or this symptom or not.'”  He was amazed and at times angry at the reluctance of colleagues to accept the results of the research.   He wonders, “How is it that our field continues to teach and to act as though patients with schizophrenia can’t improve in spite of all (literally all) the data to the contrary?”  His candor was refreshing.

Dr. Strauss’ essay led me to wonder what it is about our field that it continues to ignore the role we have played in promoting treatments – fraught with side effects – that are at best mildly or modestly effective in the short run and perhaps even less effective in the long run?  The aggressive marketing tactics of the drug companies would not have succeeded if there were not scores of physicians working with them to promote their message.

 

76 COMMENTS

  1. “No where in this essay is there any acknowledgement of the harm to patients that arose from these practices.”

    Hmm, Lieberman’s hubris reminds me of Ariel Castro clinging to his self-serving belief that the women he kidnapped, tortured, and held for years weren’t harmed.

  2. “Dr. Lieberman’s essay seems short on acknowledging any personal or collective responsibility for the problems that arose in our profession’s interactions with industry. ”

    What about the profession’s interactions with the state? and the state’s citizens by force? The collective, and personal, responsibility for the problem…

    Reminds me of people who stand before courts of law and tell judges that that a citizen is ‘mentally ill’ and therefore should lose their right to own their own body and be forcibly drugged.

    Irregardless of any pharma shenanigans people know they can buy stocks in pharma and be assured of many forced customers, the purchases of drugs forced into unwilling human bodies… at the behest of ‘community’ psychiatrists asking judges for permission to enter citizens NEVER-PROVEN-DISEASED bodies by force, or do I make an error?…. clearly society and those who stand before justice must not consider these bodies human… otherwise those humans’ clearly stated refusal of consent would be respected… because respect for humans saying ‘no’ is what treating people humanely is all about… but buy stocks in pharma, because no matter what happens to the market there will always be those condemned to ‘accept’ drugs into their bodies by psychiatrists who stand before judges and use their academic credentials to convince a judge they are experts on brain chemistry worthy of owning humans… kind of the like the market for iron chains in the mid 19th century. Inelastic demand. Economics 101.

    • I agree with you that state-supported forced drugging is a travesty. However, I think it would be interesting to look at the actual numbers here. I imagine that 80%-90% of psych drugs are taken on a voluntary basis – voluntary in the sense that they are not administered by physical force. Psychosocial forms of coercion, advertising, and the application of mistruths are very often at play even when physical coercion is not.

      I wonder how much forced recipients really affect the bottom line. I’m wondering instead if the existence of forced treatment provides a sort of cognitive feedback loop which justifies these drugs’ prolific use in more “mild” cases because “we use these drugs on the really tough cases and we know they work.”

      • I imagine that 80%-90% of psych drugs are taken on a voluntary basis – voluntary in the sense that they are not administered by physical force…

        I took them because I was dependent, If I didn’t take them I couldn’t sleep and started having anxiety attacks. It wasn’t exactly “voluntary”.

        There was a physical force so to say.

  3. I’m considered to be severely mentally ill. I consider myself to be a condemned devastation of absolute ruination and destruction. I am in no denial that health and well-being will never be lived or experienced by me, in this lifetime.

    IF ever I was to have any and all things required to “heal” and “recover” myself, and rebuild structure, in order to LIVE – the amount of resources it would take are enormous and psychiatric drugs are NOWHERE on the list.

    A drug cannot satisfy ANY of my “mental” or emotional needs. As for my energy and moods, well … excellent, rich nutrition would be my first choice for “treatment”. Most of what I eat comes out of a tin can. I want to know what it would be like to eat truly healthfully, every day for 3 straight months. Would it improve my overall health and functioning? Of course not. Thank you, Spaghettio’s.

    And as for personal relationships, sorry. I don’t want doctors, social workers, counselors and therapists, and “friends” who serve as surrogates to them, as my life of living anymore. But because my entire life IS all pathological, I’ll never fit in or belong ANYWHERE (other than the land of the Hurt and Sick). So I remain isolated and alienated. Family isn’t an option. A life of sexual abuse means a lover or spouse is not an option.

    Psych drugs can’t be my lover or friend or companion. Psych drugs can’t be my source of nutrition. Psych drugs are not the education I was ever looking for in this world. Psych drugs can never be my Justice. Psych drugs will never make me healthy. Psych drugs will never be my INCOME, but they can be YOURS.

    Psych drugs can provide me with nothing of benefit or value, only harm and damage. That’s just abundant experience talking.

    I’d like the APA to send me coupons for Vita Coconut Water. It’s so pricey that it’s way out of my league.

    • mjk writes, “…A drug cannot satisfy ANY of my “mental” or emotional needs. As for my energy and moods, well … excellent, rich nutrition would be my first choice for “treatment”. Most of what I eat comes out of a tin can. I want to know what it would be like to eat truly healthfully, every day for 3 straight months. Would it improve my overall health and functioning? Of course not. Thank you, Spaghettio’s….”

      mjk,

      Upon reading your very meaningful comment, I’m wondering why you say, “Of course not…” (in that passage I’ve quoted, in italics, above)?

      Do you say “Of course not…” as a reflection of doubting that you’ll ever get the opportunity to eat that way (i.e., “truly healthfully, every day for 3 straight months”)?

      Though I barely know you (i.e., I know only what little I’ve occasionally read, of your comments), I think it’s well within the realm of possibility that you could eat truly healthfully every day for 3 straight months.

      I’ve experienced many years of eating very healthfully, and I know that’s been very good for me.

      And, IMO, it would be great for you to know, firsthand, what 3 months of eating that way, is like; if it’s possible for me to help you to gain that experience, I’d like you to have that experience (and, IMO, it doesn’t seem as though too much to ask for).

      Please understand, I don’t have the money to offer you; yet, I think it’s very possible that funds could be collected (from a few people who could easily afford to offer such funds), so you could “know what it would be like to eat truly healthfully, every day for 3 straight months.”

      Really, that’s not a far-fetched wish you’ve presented…

      And, I’d be willing to help collect the needed funds; but, of course, I must ask: would you want that kind of help?

      Would you be willing to accept it?

      And, if you decide you’re willing to accept such help, then I wonder: as you’ve been eating mostly out of cans, wouldn’t you need help with more than just that task, of raising funds to pay for the food?

      (Maybe you’d need some guidance when it comes to choosing, which foods to eat?)

      You say,

      “I don’t want doctors, social workers, counselors and therapists, and “friends” who serve as surrogates to them…”

      (I believe I get what you mean when you say that.)

      You also explain,

      “because my entire life IS all pathological, I’ll never fit in or belong ANYWHERE (other than the land of the Hurt and Sick). So I remain isolated and alienated.”

      mjk, I can’t help but wonder if that way of looking at your life (most particularly, your line: “my entire life IS all pathological”) isn’t, perhaps, holding you back?

      (IMO, no ones “entire life IS all pathological.” “Pathological” is a heavy term, which can be terribly misleading, so I don’t know if it serves you well to think of your life in such terms; but, in any case, I believe everyone has aspects of their life which are perfectly whole and good, exactly as they are.)

      And, I can’t help but wonder: what about help with changing your current way of eating?

      Making any sudden change in ones habits (e.g., in ones eating habits) can be somewhat difficult.

      Many people who are more or less suddenly determining to eat truly healthfully need help from someone who has developed expert knowledge in nutrition; and/or, they may need a bit of coaching; would you be willing work with such a helper, I wonder?

      Would you accept guidance on what would be the optimum way of eating for you, so that you would, in fact, wind up successfully eating truly healthfully every day for 3 straight months?

      I presume you weren’t expecting anyone to answer your comment in this way. So, please, feel no pressure whatsoever to hurry a reply.

      Respectfully,

      ~Jonah

      P.S. — I’m now going out for the day… will check back here in the evening.

      • I’ll do my best to clarify and explain.

        There’s something wrong with my stomach and digestive system. According to my birth mother, I was allergic to baby formula and needed some special and expensive type. I was also a failure to thrive.

        Around 4 or 5 years old, I spent some time at the Children’s Hospital in Boston. They suspected Cystic Fibrosis but I ended up with a diagnosis of bronchial asthma (which I don’t have anymore and is a long story).

        I ended up growing very tall, very fast. From kindergarten through most of my elementary school years, I was a full head taller than all the other kids. I almost always had stomach aches, and it was almost always attributed to “mental” and “emotional”.

        I went through actual starvation in 2007. I was skeletal and weighed about 100 pounds. Some social workers believed that I was hiding a cocaine habit. I was beyond furious about that, since I’ve never touched that drug, nor would I. I was psych warded three times between 2007 and 2008. I suppose that means my starvation was “mental”. smh.

        Anyhow, I used to have to force feed myself (which is very painful). I would walk around in grocery stores, unable to feed myself, because I didn’t know what I needed and what was healthy and best for me (and because I had no way to prepare food and couldn’t afford pricier items). One day, in critical condition, I wandered a Rite Aid looking for something to eat. I found the baby formula section and I swear to god it saved my life. Three big gulps and I felt an INSTANT “boost”. Somebody actually gave the money to buy it.

        I think I’m malnourished. In fact, I KNOW I am. But more than that, I think I have some condition or disease that is undiagnosed.

        Most of my food comes from the Church – food pantry. I’m not getting fresh fruits and vegetables. It just isn’t possible for me to afford to eat the way I need to.

        “I can’t help but wonder if that way of looking at your life (most particularly, your line: “my entire life IS all pathological”) isn’t, perhaps, holding you back?”

        Just stating the truth. My truth.

        “I can’t help but wonder: what about help with changing your current way of eating?”

        The first instance is my specific nutritional needs and identifying whatever underlying condition there may be (because I’m convinced that there’s something). The second instance is the expense and that simply is not going to happen. The most I qualify for in food stamps is $25.00 per month.

        I just want to know. Seriously. If every day for 3 months, my food intake was nutritionally excellent – WOULD it improve my overall health and functioning? My “of course not” statement was sort of sarcastic because in fact, I think proper nutrition IS a large part of the solution – but ONLY a part.

        p.s. – see my comment on Kelly Brogan’s Faith Lost.

        https://www.madinamerica.com/2013/08/faith-lost/

        • “I just want to know. Seriously. If every day for 3 months, my food intake was nutritionally excellent – WOULD it improve my overall health and functioning? My “of course not” statement was sort of sarcastic because in fact, I think proper nutrition IS a large part of the solution – but ONLY a part.”

          mjk,

          Thanks for the reply.

          From reading your recent MIA comments, one can’t help but feel concern for your well being; so, it’s good to see Faith offered a thoughtful comment under her latest blog post — and Duane, too.

          Because I have read those recent comments of yours, which indicate the extent of your recent sufferings, I’m going to take the liberty here of offering some direct suggestions… as far as nutrition goes.

          First of all, yes, you would have felt a boost by way of drinking baby formula! That suggests to me, you’ll do well to improve the overall nutritional quality of your food intake — even as you feel you may have something physically wrong with you that might not be resolved through improved diet alone. (Of course, you may be right about that, and maybe you should speak with a holistic doctor; but, in any case, anyone who’s malnourished will, ultimately, benefit — in countless ways — from radically improving his or her nutritional habits for any number of months.)

          3 months of food intake that’s nutritionally excellent, would do anyone good — especially, one who’s malnourished. A healthy diet is key to a healthy immune system.

          You’ve been eating mostly out of cans. An educated guess tells me you’d not find it easy to quickly transition to a totally different way of choosing groceries, preparing meals and eating — especially, if you didn’t have coaching toward that end. Few people succeed in making such changes, on their own, in short order.

          As you said nothing about the suggestion of, perhaps, allowing for working with a nutritionist or coach, I’m letting that go for now. Instead, I’ll put my ‘counselors’ hat on, here, for just a moment.

          I’ll just suggest a bit of ‘uncommon common sense’ that you’re probably already aware of (hopefully, for your sake, I can keep this brief). E.g., I’ll ask: Hey, do you know what ‘superfoods’ are? If not, see this link (“Eat Healthy America: 52 Superfoods”): http://www.womansday.com/health-fitness/nutrition/eat-healthy-america-52-superfoods-25519

          Probably, you’ve heard of ‘superfoods’ and know that most producers of nutritional supplements these days market products featuring a blend of ‘superfoods’?

          The best way to gain 3 months of excellent nutrition, in the near term, may well be via receiving a supply of powdered ‘superfood’ supplements or ‘meal replacers’.

          So… If you’re interested, just email me ([email protected]), and I’ll find someone who can donate a 3-month supply of ‘superfood’; you’d need try a few samples first, to decide which brand appeals.

          (With many brands on the market, choosing the right one takes a bit of research and experimentation; some are better than others, nutritionally; and, some are more palatable than others…)

          Regarding your comment under Kelly Brogan’s post, you could check out the following link (“How a Physician [with a postgraduate degree in neurology] Cured Her Son’s Autism…”): http://articles.mercola.com/sites/articles/archive/2011/07/31/dr-natasha-campbell-mcbride-on-gaps-nutritional-program.aspx?np=true That web page is addressing autism, specifically; and, of course, that’s not what you’re discussing; but, nonetheless, there you can see the potential connections between early developmental processes, the quality of food that one consumes, gut-health (or lack thereof) and ones quality of moods and clarity of mind…

          Also (you’re probably aware), excessive consumption of sugar and other simple carbs can cause severely low blood-sugar, in some people — which can cause considerable mood swings. (I don’t know if ‘mood swings,’ per se, are something you’re struggling with, but as you mentioned a difficulty with “moods,” I’m mentioning hypoglycemia, just in case.)

          For anyone who’s struggling with ‘moods,’ I’d say, consider cutting down on sweets and increasing healthy fats (e.g., olive oil, raw almonds); that’s a good way to go; if you’ve never read about hypoglycemia, then Google and look into it when you get a chance.

          Caffeine, too, can be a mood de-stabilizer — much harder on many people than they realize or will easily admit (might want to cut down on it if you’ve been inclined to indulge, but be prepared for a couple of weeks of troublesome withdrawal effects if you’ve been consuming a lot of it and, especially, if you’re going cold turkey); also, artificial sweeteners can have effects (including chronic headaches) that go undetected — might want to cut out diet soft drinks (if you’ve been into them).

          Also, many will suggest (and, I do suggest) that people who face “mental health issues” should probably experiment with greatly reducing (or, better yet, experiment with eliminating) gluten consumption…, which means reducing (or, even eliminating) wheat products from ones diet (e.g., that might mean your days of eating Spaghettio’s might be numbered); try to get to the point of being ‘gluten-free’ for a few months, see if that improves how you feel.

          (Some individuals are, eventually, quite severely effected by gluten. After all, it can have an effect, on the lining of the gut, that winds up preventing absorption of essential nutrients, into the bloodstream. I.e., for some people, gluten becomes the ultimate cause of malnutrition.)

          See: http://www.celiac.com/categories/Celiac-Disease-Research%3A-Associated-Diseases-and-Disorders/Schizophrenia-%7B47%7D-Mental-Problems-and-Celiac-Disease/

          Hopefully, something I’ve said here may be of use to you (even if you’re already aware of it all); and, do email if you’d like a ‘superfood’ blend of some kind; or, maybe, if you’re not interested in that, then how about a quality women’s multivitamin?

          Again, I’ll admit I’m feeling concern for your well-being; but, at the same time, I trust you’re OK.

          Take Good Care…

          Respectfully,

          ~Jonah

          • Yes, your response is useful and thank you for it.

            I actually tried a gluten free product (Chex cereal) very recently (something I got from the food pantry, and not something I ever would have purchased for myself in a store). I was surprised at how “clean” tasting it was. I may try other gluten free items, just to see if there’s any consistency of a “clean” taste.

            I have heard about superfoods. Pharmacies (CVS, Rite Aid, Walgreens) have become amusingly competitive with their grocery and vitamin & supplement sections (and buyer’s rewards programs). I recently found Barlean’s Greens (advertised as a superfood) and wanted to get it for myself, but it’s about $40.00 and that isn’t the sort of purchase I can afford to make. Even if it was affordable, I’m just not sure if this is the correct way to go about primary nutrition. I get overwhelmed too easily, and then withdraw back into my dysfunctions and continue to suffer.

            From Dr. Mercola’s GAPS page (AWESOME, thanks!), she mentions probiotics. I have probiotic supplements and you know what? I got frustrated and angry. I have a cabinet in my kitchen that is full of vitamins and supplements. I thought, I NEED FOOD – not pills and supplements (or psych drugs!!). Then, again, I get overwhelmed and I just shut down.

            I do over-consume caffeine. Coffee. I drink it black though, no sugar and no cream. I rarely ever use sugar.

            In addition to lack of proper food intake and malnourishment, I also have a heart condition and a rather brutally severe circadian rhythm disorder (“delayed sleep phase syndrome”). I’m sick, and NOT in a psychiatric way.

            For me, because of my history, psychiatry is a MAJOR obstruction to getting the sort of attention and care that I need. In bitter sarcasm, I call it my “delusion” for wanting a medical malpractice attorney to accompany me, in seeking “medical” attention. But it is NO delusion and practically a demand. For me, this is very war-like. I’m hostile, and I make that well known.

            I do appreciate your very thoughtful, kind and generous offer to want to support me in my want for a trial of nutrition-for-health. I really just don’t know what’s best for me. I sometimes think a liquid-only diet with powdered supplements is the way to go, but that just seems so whacky. And dysfunctional.

        • “I have heard about superfoods. Pharmacies (CVS, Rite Aid, Walgreens) have become amusingly competitive with their grocery and vitamin & supplement sections (and buyer’s rewards programs). I recently found Barlean’s Greens (advertised as a superfood) and wanted to get it for myself, but it’s about $40.00 and that isn’t the sort of purchase I can afford to make. Even if it was affordable, I’m just not sure if this is the correct way to go about primary nutrition. I get overwhelmed too easily, and then withdraw back into my dysfunctions and continue to suffer.”

          mjk,

          Yes, I understand. (To me, it seems you could benefit from a bit of encouragement.) I will just say this: From doing a bit of research, online, it seems to me that the Barlean’s Greens products could be a good way to go, at least, as an ‘experiment’ for a few months — as long as you find it palatable. It’s never too late to start a new way of caring for yourself. Send me an email any time you decide you want to give it a try.

          Respectfully,

          ~Jonah

          P.S. — There’s no need for you to reply in a comment. After this comment, I’m going to let this topic rest, as it may be just a bit off-topic (from this blog). 🙂 ~J.

          • I don’t fully agree. I think it is exactly on-topic, although in a branch from the limb. But, highly relevant.

            Why should I consume a psychiatric drug, when my poor dietary & nutritional consumption is the Higher Priority? Is it not? What impact and effect DOES malnutrition have? Is it not severe?

            How often is malnutrition screening employed in the diagnostic processes, of any and every complaint of unwellness? While I suffered both SEVERE (severe) sleep deprivation AND malnutrition, at the same time, NOBODY ever considered those things. I was automatically PSYCHIATRIZED. And me, left with the FURY (excessive frustration) about it.

            Shouldn’t the first course in health care be all the basics?

            Proper eating
            Proper sleep
            Proper exercise

            and the development and cultivation of those things?

            In consideration of proper eating, I wonder about proper WATER intake – because I personally suspect that dehydration is a direct contributing factor of IBS. ARE people actually getting 64 ounces of water, daily? If not, that is a major contributing factor to overall unwellness, in my view. To expand in an even broader picture of drinks and beverages, my 18 year old daughter, who is about to start college and is looking to make an income, just emailed me about an ENERGY DRINK that she wants to sell. Again, ARE people actually getting 64 ounces of water, daily? Is it not critically important?

            I just think, coming from a background of some serious neglect (dysfunction), that the very FIRST course of “treatment” is in firmly establishing, developing, creating, cultivating a solid foundation of functional BASICS – such as consuming 64 ounces of WATER every day, consistently. I’d like to see a national poll, to reveal how many people do or do not DRINK WATER.

            I’m learning a LOT about Non-24 Hour sleep-wake circadian rhythm. I literally do not have the ability to create a consistent structure in my sleep. Never have had, never will. It is beyond me. There’s a Snap Fitness center in my neighborhood that is open 24/7. I sometimes laugh, just because if I ever wanted to incorporate fitness in my lifestyle (which is excessively sedentary), at least they’re open at 2 and 3 AM to accommodate my needs. LOL. I find it SO amusing.

            Actually, I went to the Church’s food pantry yesterday and was thinking of emailing a list of the items to you, which, to do here, I agree – WOULD be off topic. If it’s okay with you, and if you’re interested to get a picture of what my primary food intake looks like, I’ll spend my free time typing the list.

            Sorry if this comment is formationally rambling or incoherent, messy. I feel like I’m splattering things all over the place. At least I can laugh at myself. Eh.

            ~ mjk

            Edit: How much of SSDI and SSI people are malnourished??

            Dietary intake and dietary quality of low-income adults in the Supplemental Nutrition Assistance Program.

            http://www.ncbi.nlm.nih.gov/pubmed/23034960

          • OH YEAH, one more thing – which is highly relevant.

            Fasting is a psyche-activating mechanism. Psyche by definition means Spirit, or sometimes Soul (but the true synonymous term is Spirit and NOT Soul – because Spirit and Soul are not the same thing).

            If somebody is in supposed “psychosis”, they might need a quality meal, rich in nutrients, vitamins and minerals – SPECIFIC to that individual.

          • mjk,

            Please excuse me for the delay, of this comment, in response to your last comments (above).

            Immediately after posting my last comment to you (above, on August 7, 2013 at 10:00 am), I posted one more comment on this page (to Hermes) and then took a long break from the Internet.

            Except for occasionally checking email, I went completely offline for a couple of weeks…

            Just now, I’ve read your comment of August 7, 2013 at 10:56 am; and, I see that, in the end, you were suggesting you might write me a list of what you feel are your dietary needs.

            Please, feel free to do so anytime.

            Respectfully,

            ~Jonah

    • Copy_cat.

      This is a great site but I did want to share a personal experience that made me realize that the issue of doctors taking money from drug companies isn’t always a black and white issue. The neuropsych/sleep specialist that I would see in a heartbeat if he was in my area takes lots of money from them. But because I know how helpful he has been to people whose opinion I greatly respect, I don’t hold that against him.

      Contrast that with sleep doctor number two who takes a whole lot less money. But because I feel he hasn’t been helpful, even if he took zero money, I would still be pissed off.

      But it is a good site to check, particularly when psychiatrists write articles that seem way too pro meds without any scientific evidence to back up what they are saying.

      • Ask your doctor about this:

        In the early 1990s, psychiatrist Thomas Wehr conducted an experiment in which a group of people were plunged into darkness for 14 hours every day for a month.

        It took some time for their sleep to regulate but by the fourth week the subjects had settled into a very distinct sleeping pattern. They slept first for four hours, then woke for one or two hours before falling into a second four-hour sleep.

        Though sleep scientists were impressed by the study, among the general public the idea that we must sleep for eight consecutive hours persists.

        In 2001, historian Roger Ekirch of Virginia Tech published a seminal paper, drawn from 16 years of research, revealing a wealth of historical evidence that humans used to sleep in two distinct chunks.

        Read more http://www.bbc.co.uk/news/magazine-16964783

        • Thanks Copy_cat. As an FYI, my problem is being able to stay sleep on my apap machine which I need to be able to do thanks to having sleep apnea. I can sleep in segmented sleep off of the machine but not on it. Unfortunately, that isn’t good for my apnea.

          Great article though and people with plain old vanilla insomnia would do well to read it.

  4. Mr Cohen;

    Please forgive me for constantly back linking to my site. If I could find better explanations through examples of these issues I’d gladly connect your readers to them. BUT:

    WHEN this Industry stops openly violating Federal Racketeering Statutes:

    http://psychroaches.blogspot.com/search?q=18C95

    WHEN this Industry stops openly violating Federal Civil Rights Statutes:

    http://psychroaches.blogspot.com/search/label/California%20Diversion%20Programs

    WHEN this Industry stops openly violating Federal Health Care Fraud statutes:

    http://psychroaches.blogspot.com/search/label/SFMHB%2006%2F13%2F07

    WHEN this Industry stops violating Federal Mail Fraud statutes:

    see above 3. Using the United States Mails and Electronic Mail to Bill Insurers, Consumers, and the Tax Payers is Mail Fraud:

    WHEN this Industry quits condemning Everybody who walks in the front door as seriously and persistently Mentally Ill like This National Training Center for Racially Preferential Psychologists as cover to defraud $16.3 Million of other people’s money into its own pockets:

    http://psychroaches.blogspot.com/2010/11/rams-cultural-crapulence-in-san.html

    THEN, this Industry and its minions can stop dancing around the fraud pole with idiot scenarios like re-engaging with the makers of Psychiatric Drugs.

    We are Way past the point of merely discovering that this Industry is deserving of the same Congressional scrutiny which Congressman Issa is currently serving the IRS.

  5. The APA appears to be a branch of organized crime at this point. It is astounding that it never seems to occur to them that the reason they are “perceived” as having a conflict of interest is because they DO have a conflict of interest. And that the reason their profession isn’t trusted is because it has proven untrustworthy over time. After all, how much can you trust someone who thinks an electric-shock-induced seizure is a “treatment” for depression?

    They are criminals, plain and simple. They want your money without providing a product of value, and they know that is the case. They can justify it all they want, but that’s criminal behavior.

    —- Steve

      • They never did. But many of these organizations such as APA have been functioning with large amounts of money drawn from pharma. Lately the money from pharma to psycho drug research has been drying out and these organizations can’t maintain anymore the amount of research, etc, that they did earlier. This causes a panic reaction inside organizations: either start kicking people out or start getting more money.

        • Yes, I understand that Pharma doesn’t see psych drugs as the cash cow they were in the 90’s and the 2000’s, as they’ve played out all the “new delivery forms” and other sleazy tactics to get new patents, and are getting hit up with a lot of damaging lawsuits. Not sure what Lieberman or the APA would have to offer them that would change this viewpoint. It’s same-old, same-old at the APA!

        • But all of their research was bogus in the first place. I haven’t seen much of any scientific value come from biopsychiatry and the drug companies in the way of true scientific research. In any so-called “research” that they do they already know the answer that they’re going to come up with. And if they don’t come up with that answer they just hide and ignore the study!

  6. Sandy,

    Thanks for another helpful piece. The main thing I would change:

    “The aggressive marketing tactics of the drug companies would not have succeeded if there were not scores of physicians working with them to promote their message.”

    Really, it is so much more than “scores of physicians” who actively or passively promote the message. A survey showed something like 2/3 of psychiatrists in Minnesota had taken money from PhARMA in the prior year. I would guess thousands of psychiatrists have been actively complicit with PhARMA, most making signifiant profit from it (either directly or indirectly via grant funding); or at the very least playing along with PhARMA and medical model myths to advance their careers. Virtually all of psychiatry colludes passively – some because they believe, some from indifference. Constantly in the background for all is the realistic fear for their careers if they step out of line.

    • And we musn’t forget those wonderful lunches that the drug reps fund for the entire offices of psychiatrists, and other medical specialties. Even if they don’t take money directly from the hand of Big Pharma they sure do like the lunches! Come on!

      The reps don’t provide those lunches just because they themselves are such nice and thoughtful people and because they just love the doctors and all their assistants in the office! Who are doctors, of all specialties, kidding????? What doctor isn’t going to order a ton of drugs after receiving treatment like this? We won’t talk about the coffee mugs, pen and pencil sets, etc. KOL’s in the psychiatric community are wined and dined and handed nice, little checks all the time.

  7. In this anti-anti-psychiatry article, Lieberman argues:

    “Being “against” psychiatry strikes me as no different than being “against” cardiology or orthopedics or gynecology—which most people, I think, would find absurd. No other medical specialty is targeted by such an “anti” movement.”

    http://blogs.scientificamerican.com/mind-guest-blog/2013/05/20/dsm-5-caught-between-mental-illness-stigma-and-anti-psychiatry-prejudice/

    But maybe this situation is not because of just those evil antipsychiatrists, maybe it’s because psychiatry is not the same as cardiology, orthopedics or gynecology! Maybe there are some *reasons* people still don’t think of psychiatry in the same terms as they think cardiology. I can at least walk away from a gynecologist or cardiologist without a fear that they’ll call cops who shut me down to an establishment where experts will forcibly perform gynaecological experiments, and I will stop the analogy before it gets out of hand. This besides many of those treatments actually have much more long term proof of their their beneficial effects vs adversal in long term use than have psych drugs.

    • “I can at least walk away from a gynecologist or cardiologist without a fear that they’ll call cops who shut me down to an establishment where experts will forcibly perform gynaecological experiments, and I will stop the analogy before it gets out of hand. This besides many of those treatments actually have much more long term proof of their their beneficial effects…”

      Hermes,

      Yes, exactly. Very good comment.

      Dr. Steingard does good, on this website, by questioning the efficacy of automatic and long-term use of neuroleptics… and by questioning the collusion between psychiatry and Big Pharma.

      Also, I appreciate her willingness to engage, in respectful conversations, via comments, under her blog posts.

      However, IMO, she remains, by this point, notably, somewhat insensitive to the plight of MIA readers who’ve had psychiatric ‘treatments’ forced upon us.

      IMO, her comment (on August 6, 2013 at 3:31 pm) regarding her agreement with Dr. Lieberman, is a prime example of such insensitivity. Thank you for addressing it.

      Respectfully,

      ~Jonah

  8. Dr Steingard;

    Readers might also be interested in knowing that neither Dr Nardo nor Bernard Carrol even know the Constitution, the Bill of Rights, and the Declaration of Independence from one another.

    http://1boringoldman.com/index.php/2012/12/18/speaking-of-infringement/

    But yet, they know how other people think because the State Certified them as Experts in Mind Diseases.

    Readers might Also be interested in the fact that, As Per Psychiatric SOP, Rather than continue the discussion After founding their arguments on Feelings and facts that are flat out Wrong, Dr Nardo shut of the comments rather than accept information from people who DO know the Facts.

    When does this Industry ever get sick and tired of being Full of, . . . itself?

    • Dbunker, out of curiosity, I reread the blog entry on Dr. Nardo’s blog that you linked to. The discussion was about 2nd amendment rights vs. the 1st amendment after what happened in Newtown.

      By the way, just because someone expressed concern about gun rights as it seems Dr. Nardo and Dr. Carroll did, doesn’t mean they are ignorant about the constitution. Even people who aren’t psychiatrists like me have expressed concern about 2nd amendment rights. You obviously disagree but that doesn’t mean you are right and we are wrong:)

      Perhaps I have missed something but I have not had a problem with what Dr. Nardo and Dr. Carroll have written. No, they are not the Peter Breggins of the world but personally, I find them reasonable although I don’t agree with them on everything. By the way, when I pointed out to Dr. Nardo that psychiatrists needed to start screening for things like sleep apnea, he was very gracious about it. He then linked to my comment in his next blog entry.

      Contrast that with a psychiatrist from a psychology today blog who denied that insomnia causes depression. I am not joking.

      Dr. Nardo cut off comments because things were getting out of hand as that is his right to do so. I have seen people who agree with us do the same thing so I really can’t find fault with him.

      • Hi AA;

        Yes, that site is the intellectual property of Dr Nardo and he does own the Right to shut off the comments.

        Bernard Carrol, Whoever he is (I’ve tried to get the Dr. Bernard Carrol of HC Renewal to either confirm or deny that the person posting under the name Bernard Carrol on Dr. Nardo’s post was him: to no more avail than being rebuffed at Pharmalot – I presume it’s him – with a dismissive and evasive “I rest my case”.)

        AA: You said ‘Things were getting out of hand.’ That’s what usually happens when bullshit is trotted out as the best argument one owns.

        Bernard Carrol’s ludicrous position was the He found a Right To Life in the First Amendment to the Declaration of Independence which owned some controlling authority over the 2nd Amendment to the Constitution.

        Would you be kind enough to Show me that Right to Life in the First Amendment to the Declaration of Independence?

        Got a Link?

        Then BC trots out Natural Law as his clincher, and tops it with the United Nations?

        “doesn’t mean they are ignorant about the constitution. ”

        Ohhhhh, . . . kay.

  9. dbunker,

    I appreciate your comments and blog very much.

    Unfortunately, I could not figure out what you were talking about in this paragraph:

    “Readers might Also be interested in the fact that, As Per Psychiatric SOP, Rather than continue the discussion After founding their arguments on Feelings and facts that are flat out Wrong, Dr Nardo shut of the comments rather than accept information from people who DO know the Facts.”

    What is SOP? Could you give a link to what you are talking about and be more clear by explaining what you are talking about here? I am totally mystified by this paragraph and don’t have a clue about what you mean here, but I am curious.

    Thanks for your consideration.

  10. Hi dbunker and Anonymous,

    Thanks for the information. I’m not a big user or fan of acronyms, so I sometimes miss those that seem obvious, obviously.

    I have been impressed with many of Dr. Nardo’s posts, but I have noted the same things that you have with Dr. Nardo and his regular fellow psychiatrists/psychologists (so called experts) posting. I have been very upset that this little fan club seems to be great advocates of ECT and main stream psychiatry in general and have said so there.

    They had their own little DSM 5 or 6 committee “voting in” the supposed mental illnesses they believed to be biological with no evidence of course, as you say. I objected to this citing Dr. Insel’s recent admission that the DSM is invalid junk science to no avail.

    The article below verifies the real agenda of such bogus eugenics and other blaming the victim theories in biopsychiatry especially since it has been given the greatest power to destroy countless lives with impunity based on total junk science, lies, abuse, torture treatments and violation of every conceivable democratic right as you also point out. It is to absolve corporate/government cronyism, predation, exploitation and indifference to all the harm they cause to the majority of people while profiting from such harm by blaming the victims for any harm done due to their supposed faulty genes, brain wiring, chemical imbalances and other lies to further profit from their suffering with bogus biopsychiatry with its toxic drugs, ECT and other brain damaging/disabling “treatments.”

    I’ve posted this elsewhere on the recent ADHD article, but I think this article is crucial for people to understand as to why we have such corrupted science and so called medicine and many other psychopathic institutions including schools, the courts or so called legal system, politics, government, etc. They’ve all been created by and for psychopaths’ best interests now that they’ve hijacked the globe per Political Ponerology book and web site.

    http://truth-out.org/news/item/17916-science-as-social-control-political-paralysis-and-the-genetics-agenda

    As I’ve stated elsewhere, the supposed science and claims of those like Dr. Jeffrey Lieberman and Dr. Thomas Insel are so obviously bogus and junk science, it is even more scary that the psychopaths in power aren’t even pretending that this evil ideology is science or trying to cover up the corruption for the most part. This is obvious when Dr. Insel, Head of NIMH, announces the results of future “mental illness” research in advance wasting more billions on this garbage that it will deal with faulty brain circuits only, which shows he is talking ideology and not science at all. Rather, scientism.

    The fact that Big Pharma is being allowed to screen children in schools due to the latest school and public shootings most likely caused by psych drugs without even a pretense of the cover of a government agency or drug company front group like NAMI is very scary indeed.

    Obviously, those like Dr. Insel and Dr. Lierberman are trying to win Big Pharma back to the fold with the new lies from the boys crying wolf in the emperor’s new clothes. This hardly matters in biopsychiatry because those not seeing the wolf and the supposed clothes will be forced to submit by the wolves in power and pretend they see the clothes as their lives are destroyed.

      • Donna;

        Thanks for the links.

        Here’s a couple more Legal Issues for discussion, because if anyone wants anything actually changed, they’re going to need a Legal peg to hang it on.

        1: The abuses of the Doctrine of Therapeutic Privilege by Psychiatry:

        Couple the outright Lies offered, and excused under Therapeutic Privilege, as Psychiatric treatment with the following:

        http://en.wikipedia.org/wiki/Therapeutic_jurisprudence

        “The approach was soon applied to the way various legal actors–judges, lawyers, police officers, and expert witnesses–play their roles, suggesting ways of doing so that would diminish unintended antitherapeutic consequences and increase the psychological well-being of those who come into contact with these legal figures”

        Back to my earlier comment Re: Federal Civil Rights Statutes:

        The people Selling Diagnosis are having it cleaned Off of Their Own Records and the records of other actors in the system. This is Illegal under Sec 1 of the 14th Amendment, especially since Psych Diagnosis is supposedly Forever, completely Incurable.

        AND: coupled With the CEJA concocted excuse to Lie, we find judges, lawyers, police officers, and expert witnesses Acting as Psychologists/Psychiatrists: coloring Their Legally binding Actions with Their Own Psychological Opinions.

        In Effect, it’s Carte Blanch to do whatever they damn well please and F**k the Law.

        (And people wonder how Psychiatry continues to get away with its act.”)

        Psychologists, even With their Degrees CAN’T CURE ANYONE, but actors in our Legal System even Without those years of Training in Psychological Hogwash, are Also acting as if They are Psychologically Qualified to determine what will or will not be “Therapeutic”.

        2: Informed Consent with Psychiatric Drugs is Legally Impossible.

        Go Back and re-read the actual Fed Racketeering Statute I cited:

        Psychiatrists know that they are selling a Homicide Risk. There is no way in hell they can legally disclose it, so they ignore it or lie about it.

        IF, they inform the patient OF that risk -documented By FDA’s Medwatch – the Patient Can NOT Legally agree to take the drug.

        IF they DO, they become a willing, knowing Co-conspirator with the prescriber to violate US 18C95 Sec 1958, and can also be incarcerated for up to 10 years.

        • dbunker,

          I agree with you and Attorney Jim Gottstein that human rights violations are a matter of course for anyone who has been given the evil “yellow star” (see Seuss’ The Sneeches) eugenics stigma of a bogus DSM label that renders them a target for torture, harassment, poisoning, ostracism, violence, constant lies and false charges against them including bogus claims of psychosis, delusions and being “labile” or “decompensating” and other BS, brain/body damage for life if not driven to suicide first by the lethal drugs or the total despair of being “selected” for this death trap as a scapegoat for our increasingly very evil, unconscious, violent, scapegoating, psychopathic, narcissistic society.

          http://psychrights.org/index.htm

          Also, see book, Whores of the Court, about how the mental death profession has helped hijack the court system to get their pound of flesh from those tortured by our evil, psychopathic court system whereby the best psychopathic liar and corrupt Prince Of Darkness attorney wins so that abusers routinely win custody and all the marital assets leaving the mothers and children often homeless, penniless and at risk for permanent abuse by both the original abuser, the courts and its minions, but also the so called retraumatizing “help” from the mental death profession that should be avoided like the plague it is. Lundy Bancroft, Domestic violence expert describes this vile state of affairs in articles and books like Why Does He Do That? and The Batterer as A Parent. This is well described in books like Divorced From Justice and even Dr. Peter Breggin exposes the destruction of women’s lives once stigmatized by psychiatry with loss of everything including custody of children in TOXIC PSYCHIATRY. Women and children along with elderly women especially are the greatest victims of biopsychiatry, which shows it is very cowardly since they avoid dealing with narcissists and psychopaths like the plague since it hits too close to home and its easier and more lucrative to prey on their traumatized victims. The same horror show applies when one becomes one of the increasingly common victims of school/work/community bullying/mobbing whereby the victim gets blamed, scapegoated, stigmatized, poisoned with psych drugs and driven to suicide as was the tragic case with Phoebe Prince while the bullies become more popular and entrenched unless school officials and the legal system intervene even if too late as was true in the Prince case.

          This Kafka like monstrosity is set up to be a crazy making no win nightmare for anyone targeted for destruction deliberately and by design for psychopathic sadistic glee in many cases, so there is no point in pretending that it can be fixed with any honest dialog or good will or good intentions by the perpetrators who profit and gain/maintain power from it. There is tons of information about these issues on the web, in books and other sources I’ve cited before. the book, Working With Monsters and its companion pocket book by Dr. John Clarke gives a good idea of what victims are up against per the many experts exposing this evil of psychopath predation. Obviously, biopsychiatry is only about social control by the power elite and has nothing to do with medicine or anyone’s health except the “healthy” profit and power for the 1% hijacking global wealth and power by enslaving and destroying the rest of us with biopsychiatry a perfect eugenics, euthanasia agenda and means to their psychopathic ends.

          In many instances laws dictate how long medical or psychiatric records must be kept from 7 to 20 years I’ve been told by doctors and or insurance.

          It’s really pretty meaningless in that it’s just an excuse to run the U.S. as a fascist, totalitarian dictatorship with the government able to rob all human and civil rights of any citizen without due process and torture them to the point of death with impunity.

          I hope all in the biopsychiatry profession are proud of themselves that this is the horrific legacy they are leaving to our current and future children who are already living in the United Stalinist Dictatorship of America. Even Putin of Russia is trying to show more enlightenment and freedom now by rescuing Snowden the whistleblower for alerting us to our spying government.

          I think all in biopsychiatry should lay down their arms and their needles and drugs at the end of those arms and refuse to act like the Gestapo of pretend democracies any longer. Otherwise, as with Hitler’s Germany, they are colluding in massive evil that will be seen as such if the world ever escapes these latest years of infamy.

  11. Funny, but very enlightening article by John Horgan about the many articles in newspapers and journals about amazing gene finds by journalists when they mostly turn out to be bogus, which is not so eagerly reported if even mentioned in small print at the back of the publication.

    John Horgan like others including me speaks of the huge dangers
    and evils that have come about by trying to locate inferior genes and traits in certain people based on color, race, sex, religion, sex preferences, country or place of origin and others. As far as I can see to date, nothing but much evil has come from the genetic and related research on supposed causes of “mental illness” because all the claims have been based on bogus, non-replicated studies as exposed by these articles and Dr. Jay Joseph while the lies from them about bipolar, schizophrenia and ADHD being genetic and other junk science have been repeatedly stated as fact by just about everyone in the mental health/death profession ad nauseam. Some studies that have proven accurate show that when such bogus, nonexistent “mental illnesses” like bipolar are claimed to be genetic or otherwise due to inferior brains, it greatly increases stigma and causes more rejection, ostracism, scapegoating, contempt, isolation and a horrible downward spiral for the victims. So, Dr. Thomas Szasz was quite right when he called psychiatry the science of lies. Biopsychiatry has perpetrated a massive amount of lies as exposed in Dr. Mosher’s resignation letter from the APA and in my opinion, when they do this, it just kills their credibility all the more not to mention causing much anger among those who have been conned and harmed as a result.

    http://www.johnhorgan.org/do_our_genes_influence_behavior__43701.htm

    http://truth-out.org/news/item/17916-science-as-social-control-political-paralysis-and-the-genetics-agenda

    Sandy, do you really think it is fair to suggest that the victims of powerful biopsychiatry get the laws changed. In my opinion, the only real hope for change may be if enough of those in the mental health profession come to see that they should be doing far more good than harm and try to do something about it by joining with survivors and reformers. In my opinion, the only hope for any area of medicine is for those who really wish to help people achieve and maintain wellness to resist and fight against corrupt doctors, excess drug/device company influence, disease mongering and other current dangers of the medical profession.

    I know that you are trying hard to learn about new things and changes you can make to improve your own work and I applaud you for that.

    • Donna,

      IMO, bio-psychiatry is based on political science, not medical science.

      Understanding and appreciating aspects of our own humanity is what good counseling is all about.

      Real doctors are busy helping facilitate healing. They don’t have time to try to control other people’s behavior.

      Duane

        • Duane,

          Thanks for your comments and usual wise validation of our reality when dealing with such literal nightmares from which we can only hope to wake up from in the future.

          Your take that psychiatry is about politics and not medicine is also very astute especially when you juxtapose them both as so called science when psychiatry has no place in medical science since it has hijacked life problems and medicalized them for the soul, soulless purpose of profiting from people’s normal, typical human suffering.

          And of course, long term human crises and stressors can lead to one’s immune system being compromised to the point of physical illness or a stress breakdown, but this is in no way a biological “mental illness” as with the vile pretense of the DSM and its bogus, victim blaming stigmas to push lethal drugs on patent to profit from human suffering while inflicting all the more pain/loss and destroying countless lives.

    • Biopsychiatry is a descendant of eugenics. It continues the search for proof that some of our population is genetically inferior and can therefore justifiably be treated poorly or eliminated. And with death rates so much higher for recipients of psychiatric “treatments,” the results aren’t so different from the early 20th-century eugenicists, except that it takes longer to kill off the “undesirables.” Reframing it as “medical treatment” allows the effort to become more palatable for the masses. But the underlying assumptions are the same: those in power deserve to be in power, those who don’t “fit in” to the schemes of the powerful are labeled as genetically deficient and are physically, psychologically and socially restrained or attacked, with justification provided by their “inferior” status.

      Makes me ill to think about …

      —- Steve

      • People don’t like to hear this but the Nazis were not the ones to come up with the “showers” and the ovens. German psychiatrists under the protection of the German government were the ones who developed these things so that they could be used to get rid of what they called the “useless and diseased eaters,” otherwise known as the “mentally ill” and people with developmental disabilities. Everyone in the asylums at that time had to fill out a petition. Each petition was reviewed by two psychiatrists. Two thumbs down got you sent to one of the six cities where the “showers” and ovens were located and you were toast. Everyone got two thumbs down.

        When the Nazis came along they had the psychiatrists train them in the use of the “showers” and the ovens. As a nursing home chaplain I took care of the lawyer who proscecuted some of these psychiatrists at the Nuremburg Trials. Some of them were sent to the gallows. His name was James McHaney.