Cognitive-Behavioral Therapy
Beats Antipsychotics for OCD

Kermit Cole
22
197

Research from Columbia University and the University of Pennsylvania, published in JAMA Psychiatry, finds that although practice guidelines recommend antipsychotics as a first-line treatment for obsessive compulsive disorder, 80 percent of patients receiving cognitive behavioral therapy for OCD responded with reduced symptoms and improved functioning and quality of life, whereas only 23 percent improved on risperidone. The study concludes that patients with OCD should be offered exposure and response prevention (EX/RP) therapy before antipsychotics “given EX/RP’s superior efficacy and less negative adverse effect profile.”  The study’s lead author, speaking in the New York Times, says “It’s important to discontinue antipsychotics if there isn’t continued benefit after four weeks.” Results were published in JAMA Psychiatry.

Article →

Simpson, H., Foa, E., Liebowitz, M., Huppert, J.; Cognitive-Behavioral Therapy vs Risperidone for Augmenting Serotonin Reuptake Inhibitors in Obsessive-Compulsive Disorder. JAMA Psychiatry. Online September 11, 2013. doi:10.1001/jamapsychiatry.2013.1932

Of further interest:
Behavior Therapy Aids Obsessive-Compulsive Disorder (NY Times)

22 COMMENTS

  1. As a “victim” of an OCD label (and the consequences of that label), I have to ask, because I haven’t seen it in the study. What variant of “OCD” are they taking about :D?

    Honestly, for somebody like me who was labelled as “OCD” for fearing HIV/AIDS, all these studies are nonsensical. Fear of HIV doesn’t come from an imbalance in serotonin (which is what SSRIs target) or dopamine (which is what neuroleptics target) but from having grown up during the 80s watching on TV horror stories of scores of people dead of HIV infection. In my neighborhood there was a guy rumored top have HIV/AIDS and he scared the hell out of me when I crossed path with him.

    Now, just as it happens with other fears, like fear of flying, not everybody has the same degree of fear, or reacts the same way, to the things he/she fears most.

    In the case of the HIV infection, the leaders of Cuba during the 80s seemed to have the same level of fear that I have because they implemented a quarantine policy that turned out to be extremely effective in containing the HIV epidemic in Cuba. To this day, Cuba remains one of the countries with the lowest HIV prevalence worldwide http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688320/ .

    To be clear, I am not defending that the US adopts a Cuban policy with respect to HIV/AIDS. All I am saying that that to call exaggerated fear of HIV/AIDS “OCD” is preposterous. It is yet another invented label which serves no purpose other than stigmatizing those whose fear of HIV/AIDS is beyond what the medical establishment finds “appropriate”.

  2. Also from the article,

    “Conflict of Interest Disclosures: During this study, in addition to medication at no cost from Janssen Scientific Affairs LLC, Dr Simpson received research funds from Transcept Pharmaceuticals (2011-2013) and Neuropharm Ltd (2009), served on a scientific advisory board for Pfizer (for Lyrica, 2009-2010) and Jazz Pharmaceuticals (for Luvox CR [controlled release], 2007-2008), and received royalties from Cambridge University Press and UpToDate Inc. Dr Foa was a consultant to Jazz Pharmaceuticals (for Acetelion), and she receives royalties from Bantam and Oxford University Press for book sales, including a manual of cognitive-behavioral therapy for OCD. Dr Liebowitz received research funds from pharmaceutical companies (Abbott, Allergan, AstraZeneca, Avera, Forest, Cephalon, Endo, Gruenthal, GlaxoSmithKline, Horizon, Indevus, Jazz Pharmaceuticals, Johnson & Johnson, Lilly, Lundbeck, MAP, Novartis, Ortho-McNeil, Pfizer, PGX Health, Purdue Pharma, Sepracor, Takeda, Tikvah, and Wyeth), consulted (to AstraZeneca, Avera, Eisai, Lilly, Otsuka, Pfizer, Pherin Pharmaceutical, Takeda, Tikvah, and Wyeth), presented talks or posters (for Pherin Pharmaceutical, Pfizer, and Wyeth), has equity ownership in Pherin Pharmaceutical, ChiMatrix LLC (ended 2011), and the Liebowitz Social Anxiety Scale, and has licensing software for the Liebowitz Social Anxiety Scale for Avera, Endo, GlaxoSmithKline, Indevus, Lilly, Pfizer, Servier, and Tikvah. Dr Hahn received research funds from Pfizer, GlaxoSmithKline, and AstraZeneca. No other disclosures were reported.

    Funding/Support: This study was funded by National Institute of Mental Health grants R01 MH045436 (Dr Simpson) and R01 MH45404 (Dr Foa). Medication was provided at no cost by Janssen Scientific Affairs LLC.

    Role of the Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.”

    It is very suspicious that most of the authors have conflict of interests with manufacturers of SSRIs. The neuroleptic tested is manufactured by Johnson & Johnson, which only shows up in the list once, and only as one among the many companies Dr Liebowitz has received money from.

    I wonder why nobody tested against olanzapine or seroquel. Maybe the actual goal of this study is to put risperidone out of the OCD market?

    This study looks highly suspicious given the long list of authors with links to manufacturers of SSRI/SRIs.

  3. I can’t believe that the first line of treatment is neuroleptics for this!!!!! Of course, I really shouldn’t be surprised at all; if you stare too fixedly at something for longer than the quzcks think is necessary they want to put you on a neuroleptic.

    Anyway, there’s a psychiatrist who has done amazing work with people that are labeled as OCD and he uses mindfulness therapy specifically focusing on meditation dealing with compassion. He doesn’t use any of the toxic drugs. Of course, the quacks and the drug companies don’t want the public to know what he’s accomplishing. I forget what his name is but I’m sure that you can find him on Youtube if you search for OCD.

    • It is. The first line of so called “treatment” is clomipramine (an old TCA that has more side effects that you can possibly imagine) or SSRI, then “augmentation” with neuroleptics. I kept asking the psychiatrist what “augmentation” meant, but he said “augmentation means augmentation”. Go figure :D.

      In my case I was put first put on risperidone and then, after I developed dyskinesia, I was put on onlanzapine.

      Other than the classic criticisms to psychiatry, this study is suspicious on many levels, including the very small sample size, that all the so called “patients” were on drugs anyway and that only risperidone was tested against CBT, which happens to be manufactured by J&J.

      “Amazingly”, the neuroleptic in vogue, onlanzapine, manufactured by Eli Lilly was not tested against. If you take a look at the conflict of interests, the design of the trial makes perfect sense :D.

    • Stephen,

      I’m with you – *neuroleptics* for OCD? Are you kidding me?!

      Maybe we ought to make a list of all the things that work better than neuroleptics – for OCD, and any other psychiatric diagnosis.

      Cognitive-Behavioral Therapy would be on the list.
      I would think that other methods would be on the list too.
      It would seem that doing *nothing* would be better than taking a neuroleptic. IMO, doing *nothing* beats taking a neuroleptic for any psychiatric diagnosis!

      Duane

    • Hi Stephen,

      I’m glad you mentioned the famous work by Dr. Jeffrey Schwartz for OCD. Here is a Youtube video showing a paradigm breaking appearance by Dr. Schwartz and an explanation of his mind/brain changing program for OCD.

      http://www.youtube.com/watch?v=u0lPuN03b40

      I have been very impressed by Dr. Schwartz recently because his work involves the fact that one can change their brain with various techniques and programs. He is most famous for his groundbreaking work in OCD in his book, Brain-Lock using natural, non-drug methods.

      http://www.amazon.com/Brain-Lock-Yourself-Obsessive-Compulsive-Behavior/dp/0060987111

      Another more recent book is You Are Not Your Brain showing how one can eliminate bad habits, negative thinking and other such problems by retraining their brain thanks to its neuroplasticity:

      http://www.amazon.com/You-Are-Not-Your-
      Brain/dp/1583334831/ref=pd_sim_b_1

      Here is Dr. Schwartz’s web site about his programs and books:

      http://jeffreymschwartz.com/about.htm

      If you google his name, he also has many other videos about changing your brain to end addiction and other excellent programs.

      I give Dr. Schwartz a great deal of credit for developing these very successful non-drug programs to change the brain that really work. I think he is an amazing, great man!

      I agree that prescribing neuroleptics for this problem is criminal! That’s why we need more experts like Dr. Schwartz.

        • Honestly guys,

          I just watched that video with the Jeffrey Schwartz interview.

          Needless to say, I found the interview disgusting, just as I found the trailer of that movie they mention, Machine Man, equally disgusting. The main reason stigma exists is because of people like Jeffrey Schwartz and that movie. After watching both, if I didn’t know better, I would make sure to stay as away as possible from people who suffer a “debilitating disease” that is causing them to have “dangerous thoughts”. Jeffrey Schwartz’s “you are not your brain” message begins by saying that so called “OCD” is a brain disease.

          There are people who have been given an OCD label who have dangerous thoughts, so what? Aren’t there a lot of homosexuals who are also pedophiles and sexual predators? In 1967, Mike Wallace did an special for CBS on homosexuality. You have a recap version here https://www.youtube.com/watch?v=-AXAOT_swIE . The terms in which homosexuality is described there, especially during the first 2 minutes, is no different from the terms “OCD” is shown in those two videos. The psychiatrist who bashes homosexuals around minute 1:22 sounds no different than Jeffrey Schwartz when he speaks about OCD.

          Just as a lot of MIA readers were sympathetic to the phenomenon of voice hearing after watching Eleanor Longden’s great talk, I hope you guys understand that there is also meaning in what psychiatrists describe as OCD.

          In my own case, this ability to obsess with certain issues has served me well. I never give up even when I face what for most people would be “insurmountable obstacles”. It’s how I managed to enjoy my current American life making a living out of being highly educated, despite growing up in an environment where very few people went to college in the first place, or what makes me be engaged in this struggle against psychiatry.

          • I learned a long time ago that I could pick and choose what I found useful in someone’s work or research without having to take everything that they offered. Just because Dr. Schwartz uses a word here and there that I may find offensive doesn’t mean that I can’t use some of the good work he’s accomplished.

            The enemy of my enemy is my friend. By the fact that he’s willing to work with people without putting them on the toxic drugs puts him at odds with conventional psychiatry. I call that a plus and makes for some “common ground” where he and I can pitch our tents and camp together, even though he may not see and understand everything exactly as I do. At least that common ground may lead to some beneficial dialogue. Finding that “common ground” with most psychiatrists is an impossibility so when I find one who I may be able to at least “talk” with I’m not going to dismiss him outright.

          • Hi Stephen,

            Thanks for your wise, impartial view regarding Dr. Schwartz’s great work, which is very opposite the bogus DSM stigmatizing and forced drugging, ECT and other brain damaging pretend treatments of mainstream psychiatry.

            As you so rightly point out, it is highly unlikely that we would agree with every word of Dr. Schwartz as is true of any other human being since we are all totally unique individuals with our very own thoughts, ideas, views, strong/weak points, talents, etc.

            As always, I truly appreciate your wise, compassionate posts not because you necessarily agree with me, but because I know they come from a very insightful “wounded healer” who has encountered human suffering personally and through empathic work with other sufferers, which gives you very keen insights into what helps and what hurts.

            I think if you read more about Dr. Schwartz and his famous work, you would see he is more on the side of psychiatric survivors fighting for recovery than the vile main stream biopsychiatry paradigm that does more harm than good.

            Also, let’s bear in mind the topic of this post is questioning the use of neuroleptics for “OCD,” which is in keeping with the mental death profession/Big Pharma cartel pushing these lethal, lucrative drugs for every minor ailment they can imagine in their most evil dreams and humanity’s worst nightmares.

            Therefore, Dr. Schwartz’s great work serves as an antidote to the perils of mainstream psychiatry, so it is unwise to look a gift horse in the mouth.

  4. cannotsay13,

    Reading your comment about the work of Dr. Schwartz had me wondering if you read about the same man I posted about. Thus, I re-watched the YouTube video I posted and stand by all I said and disagree with you vehemently.

    You obviously ignored all the great things about Dr. Schwartz’s nondrug, self directed program to recover from OCD and other compulsions/addictions completely. He also says he thinks drugs are overused and not the best treatment for OCD and related problems. Thus, he obviously does not think these are permanent biological brain diseases requiring stigmas and drugs for life never mind forced treatment or the typical lies of biopsychiatry/Big Pharma. Perhaps he might use the language of his profession at times, but he sees the brain quite differently than the typical biopsychiatrist in that he believes one can change his/her brain due to its neuroplasticity he wrote about in a book on that topic described on Amazon. All of his work relies on this belief that one can change one’s own brain through one’s will and following his programs using mindfulness and various other strategies he sets forth.

    You took his statements at the end out of context when he cited Howard Hughes who became so identified with his obsessive thoughts about germs that he destroyed his life, which is exactly what Dr. Schwartz’s program addresses along with other thoughts that could become dangerous if a person does not get them under control through his own will through such programs described here. But, Dr. Schwartz is convinced that such person can change such thoughts that may be dangerous to themselves and others, but this was only a minor comment in the whole program at the end based on a question by the interviewer.

    I think your knee jerk comments attacking Dr. Schwartz and his great work are very unfair to others suffering from OCD and other compulsions/addictions since so many have benefited greatly from his work. Dr. Schwartz is known to be a world renowned expert on OCD based on his best selling book, Brain-Lock.

    I urge you to reconsider your very negative stance on throwing the baby out with the bath water based on your harsh, narrow standards that I don’t think even apply in this case.

    Thank you for your consideration.

    • I don’t think I have narrow standards. Certainly, they are not narrower than the homosexuals of 1967 that watched that video from Mike Wallace and felt, rightly so, offended. Let me copy/paste a portion of your comment, and replace OCD with homosexuality,

      “program addresses along with other thoughts that could become dangerous if a person does not get them under control through his own will through such programs described here. But, Dr. Schwartz is convinced that such person can change such thoughts that may be dangerous to themselves and others, but this was only a minor comment in the whole program at the end based on a question by the interviewer.

      I think your knee jerk comments attacking Dr. Schwartz and his great work are very unfair to others suffering from homosexuality and other compulsions/addictions since so many have benefited greatly from his work. Dr. Schwartz is known to be a world renowned expert on homosexuality based on his best selling book, Brain-Lock.”

      I don’t suffer from “OCD” anymore than a gay person suffers from “homosexuality”. And just as I could bring some extreme cases of homosexuals that prey on children to justify the harsh words that that 1967 psychiatrist had about the dangers of leaving homosexuality “untreated” I can bring extreme cases of any DSM invented label.

      Reasoning by “extremes” or “anecdotes”, which is what Mr Schwartz and most mainstream psychiatrists do, is the prime reason stigma exists. Now, the problem with Mr Schwartz and the like is that they cannot have it both ways. The prevalence of OCD is estimated at 1%. That would be 3 million of Americans that could become dangerous is left so called “untreated”.

      In case it is not clear this far, let me be more explicit. I am happy with what the DSM describes as OCD, just as Eleanor Longden and other voice hearers are happy with their voices and most gays are happy with their homosexuality. So called “OCD” has served me well in life.
      Now the reason I was abused by psychiatry is because some psychiatrist said to a judge that if my so called “OCD” was left “untreated” I was destined to become homeless in less than one year. Guess what, several years later, free from psychiatry, I make more money than ever, and I enjoy the highest standard of living I have ever had. The prediction of that psychiatrist, just as most catastrophic predictions made by psychiatrists about individual people, turned out to be wrong. Very wrong.

      The idea that every (or even most) people who exhibit so called “OCD” behavior is destined to become homeless or engage in dangerous behavior is preposterous. With a pool of 3 million people, and just 1% of them being dangerous, the news would be full of the “dangerous things” done by 30000 “OCD sufferers”.

      Mr Schwartz contributes to the stigma that exists around so called “mental illness”, and so called “OCD” in particular, and that has to be denounced.

  5. cannotsay2013,

    First, I in no way see any connection between OCD and homosexuality or any other totally false comparisons like those you made for the purpose of shaming and intimidating anyone who disagrees with you. As long as one feels comfortable with their sexuality or even OCD for that matter, there is no problem in mine and many others’ opinion. I believe OCD only becomes a real problem when it interferes with someone’s life and “drives them crazy” so to speak. Thus, I resent your saddling me and others with the homosexuality and OCD or any other such ludicrous and odious comparisons to shame and intimidate someone like me who is impressed with Dr. Schwartz’s program and might benefit from it. In fact, I think his book, You Are Not Your Brain, might help me to replace some bad habits that bother me greatly with good habits and I have borrowed the book from the library to read it. I have read Dr. Schwartz’s web sites, many reviews of his books, articles about him and his work, watched videos and done other “homework” about him as opposed to your knee jerk reaction to a few words in a video you claim to have watched.

    Dr. Schwartz does not speak of forced treatment at all. He only speaks of people who have repetitive, very intrusive thoughts that make their lives miserable that could be helped from his system that I described above with links to his video, web site and books. He also advocates mindfulness training, which many also find a very helpful, natural treatment.

    Since you gave some examples based on your own very narrow view, I will give one from my own situation. I used to be a smoker who desperately wanted to quit and one could say with any such addiction one gets constant intrusive and obsessive thoughts to have that next cigarette, dish of ice cream, drug, etc. I ultimately found a system to quit smoking long ago and was very grateful for it (Alan Carr’s The Easy Way to Quit Smoking and the patch). I believe smoking and binge eating are now in the DSM, but I question if this would be cause for forced commitment or drugging. I find this somewhat comparable to “dangerous” thinking of OCD since such smoking and binge eating/obesity can be hazardous to one’s health and sometimes others with second hand smoke, etc. I think this is from the stand point of the sufferer especially though people do harass smokers and even the obese more and more today now that so called “health” has become the new “morality.” The mental death profession has played a great role in this by hijacking our language and pretending that evil versus good thoughts and behaviors equal healthy and unhealthy thoughts and behaviors, which I believe is grossly evil in itself, making biopsychiatry the mostly evil, deadly, fraudulent profession it has become.

    I find it hard to believe and bizarre that you suffered such forced, horrific treatment and rights abuses due to OCD since I am not aware of that regularly happening at least here in the U.S. as you admit. However, I admit I am concerned that the health care/Big Pharma/government cartel is getting increasingly fascist in all of medicine with the government forcing vaccines, chemotherapy, neuroleptics for behavior control and other questionable, dangerous treatments on parents/children for maximum profits despite parents’ lack of consent and resistance and the huge harm to children not to mention everyone.

    But, I in no way agree that Dr. Schwartz’s non-drug program to utilize the brain’s neuroplasticity that mainstream biopsychiatry denies to change the brain in his programs to alter OCD and other addictive/compulsive thinking habits compares with the type of egregious rights violations you constantly cite, but rather, advocates for the opposite view.

    I think you are insulting homosexuals, voice hearers (misdiagnosed as schizophrenics quite often) and others including most suffering from OCD and/or compulsive, addictive thoughts by using such grossly false analogies. While it is true that most people with differences or minority status including gays, women, blacks, various religious groups, “the mentally ill” and others suffer prejudice, I don’t think such a broad brush should be used to discredit a world renowned psychiatrist whose natural, drug free programs have helped countless people. Dr. Schwartz also majored in philosophy, which is rare for psychiatrists in addition to the fact he’s a Christian for which he’s taken quite a bit of heat.

    I rest my case and will not continue this absurd, false argument to avoid hijacking this post as has been done with such issues in the past all too many times. I urge anyone who thinks they could benefit from the great work of Dr. Schwartz to do your own homework to find out about his work.

    • Donna,

      You have made several points that need to addressed individually:

      – First, I do not intend to intimidate anyone nor I have received any feedback that my comments in this entry were intimidating to anybody. If you felt intimidated, I am sorry, but that was not my intention at all.

      – Second, the reason I use homosexuality as a way of arguing that a diagnosis of OCD, or of any other DSM invented label for that matter, is totally irrelevant to a person’s well being is because homosexuality is a very clear example of a label that was used in the very recent past, and I provided a Mike Wallace documentary as evidence, in the same way today psychiatrists use schizophrenia, bipolar, OCD or whatever to justify medicalization of otherwise naturally occurring behavior. People born in the 50s have seen homosexuality described in the same terms as Schwartz describes OCD in the above video by “respected psychiatrists” (whatever that means) to have homosexuality decriminalized to have gay marriage recognized in many US states and at the federal level. I could have used past examples of psychiatric travesties, like Drapetomania or female Hysteria, but homosexuality is a very recent one for which the “psychiatric consensus” has changed dramatically in 40 years as to how “dangerous” homosexuality is or whether homosexuality is a mental illness in the first place. What sets homosexuality apart as well is that it fits the “reliability” requirement that most DSM diagnosis do not. There is also a lot studies done on the possible biological origin of it, at least in part, with identical twin studies. So here we have a “pattern of behavior” whose definition is 100% reliable, that is known to have some biological origin of sorts that until very recently was considered a disease just because self appointed APA mind guardians said so. With the Voice Hearing Movement and stories like Eleanor Longden’s we are probably assisting to a similar shift in the whole concept of schizophrenia to the point that I wouldn’t be surprised if in a future edition of the DSM (if the DSM is not killed earlier), voice hearing alone might not warrant a “mental illness” diagnosis anymore.

      – Third, Mr Schwartz, or any other psychiatrist for that matter, doesn’t appeal to possible consequences of leaving OCD so called “untreated” gratuitously. Psychiatry is a so called “medical specialty” that is onto itself a conflict of interest. That, among other things, sets psychiatry apart from other medical specialties. If you are the director of a big research hospital, like say MGH, and are doing your planning on the needs for doctors in the next 5 years, for normal diseases you have it easy, you just need to measure the prevalence of particular conditions, like cancer or infectious diseases, in the area that the hospital serves, then take into account population growth, retirements, etc and you get a pretty good idea of how many doctors you need to hire for a particular specialty. Psychiatry is different. The very existence of a psychiatric department depends on psychiatric labeling, which is not biologically based, and in the idea of “need to treat” those labels. This is why psychiatrists have a tendency to exaggerate the consequences of leaving their invented diseases “untreated” and why every time that you have a tragedy like this week’s in DC Key Opinion Leaders go on TV warning people of the consequences of leaving label X untreated. If leaving so called “OCD” untreated was as dangerous as Schwartz suggests and if only 1% of people who exhibit OCD became that dangerous, we’d have 30000 pretty dangerous people in circulation. As it so happens, with OCD but also so called “schizophrenia” or “voice hearing”, we have free will. Not everybody who hears voices urging them to do bad things end up doing them (in fact the vast majority who do hear such voices do not). Similarly, having OCD thoughts onto itself is not as dangerous as Schwartz makes it look like.

      – Fourth, as I have explained numerous times, my abuse happened in a European country where psychiatrists enjoy the type of power to civilly commit somebody that was the norm in the US until a series of US Supreme Court decisions in the US made it illegal except for cases where there is “dangerousness”. This is another reason why psychiatrists continuously appeal to “dangerousness” because under US law https://en.wikipedia.org/wiki/O%27Connor_v._Donaldson “a State cannot constitutionally confine without more a non-dangerous individual who is capable of surviving safely in freedom by himself or with the help of willing and responsible family members or friends”.

      Final point. I don’t think that there are any DSM labels that are more justified than others. All of them are fraudulent labels that have no biological justification to call them “illness” in the sense cancer is a biological illness. While some people might find solace in learning that their particular pattern of behavior is found also in other people, that should not be used as an excuse to label, demean or dehumanize anybody. Statistically speaking, I think I could find a lot of commonality in behavioral patterns among young blacks living in inner cities, including a very high probability of ending up in jail. We do not call these blacks victims of “living in an inner city” or preemptively lock them up to reduce violence. That is my whole point with OCD or any other DSM label in those cities. A pattern of behavior alone, that is not criminal, should not be treated as if it it was criminal or “potentially criminal”. And this is also why the conversation with homosexuality is relevant. The vast majority of the pedophilia scandals that were covered up by the Catholic Church, though not all, were homosexual in nature. Does this mean that all homosexuals are potential pedophiles? Not at all. Same thing happens with OCD, schizophrenia, voice hearing or whatever.

  6. cannotsay2013,

    I agree with most of what you say about the bogus DSM that has been admitted to be totally invalid even by Dr. Thomas Insel, Head of the NIMH. Everyone who has done the least amount of homework knows that the DSM is total junk science. I also agree that the human rights violations of biopsychiatry with their life destroying stigmas like bipolar to push lethal drugs, ECT and other brain damaging assaults as so called treatments in bed with Big Pharma and corrupt government hacks is evil and rotten to the core.

    The problem is that human beings do have certain traumatic and other reactions to typical life stressors, which biopsychiatry has hijacked and medicalized to our great peril as you also claim and with which I agree totally if you read my other comments on MIA.

    I have only cited the work of Dr. Schwartz as a means of excellent self help that one can use on their own to help them with obsessive, addictive, compulsive thoughts and behaviors that can be the result of life stressors, traumas and other typical but horrible events that cause much human suffering. I totally agree that they should not be medicalized or used to stigmatize people to violate their human rights with forced drugging, ECT and commitment.

    So, I think you are greatly misunderstanding me here in that I don’t think one has to go get an OCD DSM label for their so called OCD or compulsive, addictive thinking to benefit from Dr. Schwartz’s work. Rather, one can buy or borrow his books and privately read and follow his program and if it works that’s great; if not, the person is free to try something else.

    Where I think he and I are coming from is when the obsessive, compulsive, addictive thoughts are making a person miserable and harming their lives in their own opinion and they are desperate to try to find a solution that is helpful rather than the harmful stigmas and drugs of biopsychiatry. I cited my own wretched experience with smoking for which I sought many desperate measures and finally found helpful programs that helped me quit for good that I cited above. I did it totally on my own with books and my own research. Though smokers are seen as lepers for the most part today, nobody is rounding them up for forced treatment. Thus, Dr. Schwartz and I see broad application for his work way beyond your obsession with OCD and other DSM stigmas used to routinely instigate gross human rights violations, which I abhor.

    Unlike mainstream psychiatry, Dr. Schwartz sees behaviors that are called OCD and compulsive, addictive thinking as bad habits that can be conquered through the will that actually change the brain due to its neuroplasticity, which is the total opposite of mainstream psychiatry’s agenda. The negative thinking habits that changed the brain to one’s detriment causing bad habits can be reversed through one’s will to good thinking and good habits through Dr. Schwartz’s programs.

    Again, I intend to use his book, You Are Not Your Brain, to change other bad habits to good ones in a completely private manner without involving the mental death profession at all whatsoever. Obviously, Dr. Schwartz feels the same way or he would not have written his great life saving books like this one or Brain-Lock, a world renowned book on natural treatments for what is called OCD.

    You are right that what is called “OCD” has meaning because it is known to be related to anxiety problems or traumatic events. The TV show of Monk is a perfect example of this in that Monk suffers from “OCD” symptoms due to the violent tragic death of his beloved wife he cannot accept. I have read about such “OCD” reactions that are comparable to PTSD reactions to life stressors, crises, etc.

    So, you have my full sympathy, empathy and agreement with my complete disgust with what was done to you in the guise of the OCD DSM stigma and I want no part of that either. Since you don’t find your so called OCD thoughts to be a problem, then they aren’t a problem. Same with homosexuality, drapetomania and other vile DSM stigmas to push a fraudulent, human rights abusing paradigm. Whether these thoughts and behaviors are a problem is in the eyes of the beholder or sufferer so to speak.

    I did not see Dr. Schwartz advocating forced treatment, commitment or other human rights violations, but rather, the opposite in that his program helps people to rely on their own will and human agency to overcome thoughts they find harmful and intrusive to the point of destroying their lives. The video I included speaks of his work as an advisor on so called OCD for the film, The Aviator, about the horrible descent of Howard Hughes due to his sole focus on obsessive thoughts about germs. Dr. Schwartz laments the fact that Hughes may have been helped with his program because his increasingly damaging obsessive thoughts about germs resulted in the loss of a brilliant and great man.

    So, I do agree with you about the vile human rights violations of mainstream psychiatry while I also believe that what Dr. Schwartz is advocating is the complete opposite to this disgusting medicalization and predation on all too typical human suffering, crises, losses and traumas.

    So, I hope you see that I am not trying to violate anyone’s rights by sharing the great work of Dr. Schwartz. And I would be the last one to recommend that anyone see a mainstream biopsychiatrist to use his work given that Dr. Peter Breggin has warned that since psychiatry sold out to Big Pharma in the 1980’s, the most dangerous thing one could do is to visit a psychiatrist.

    I hope this helps to resolve what you perceive to be great differences in our views while I think many of our views are quite similar. That’s why I am very enthused about non-drug, natural, self-help methods one can use on their own in private without involving stigmas and rights violations of biopsychiatry.

    Best wishes.

    • Again, several points :D:

      – It might be the case there is more commonality than difference here, especially with respect to coercive psychiatry. It seems that we are both on the same page about not condoning coercive psychiatry (and in fact denouncing it). If that is the case, then we are in agreement with the only issue I care about psychiatry in general: the abolition of coercive psychiatry.

      – Having said that, I do agree that people do endure mental distress. It has never been my position that mental distress doesn’t exist or that it doesn’t cause suffering. My point is that what the DSM calls “mental distress” is only the opinion of a bunch of guys who say “that pattern of behavior is pathological because we say so”. It’s an opinion that should not have any more bearing than somebody else’s opinion. The fact that the guys of the APA have an MD degree shouldn’t be used to give any more credence to determining which behaviors are pathological and which behaviors aren’t.

      – From that point of view, what Mr Schwartz’s thinks is to me, an opinion, which is not more or less worthy than the opinion of a different mind guardian. I dislike though his language of making appeals of “dangerous thoughts” because that is the language used by defenders of forced interventions whether he defends involuntary commitment or not.

      – The notion that Howard Hughes would have benefited from Mr Schwartz’s proposals is again an opinion and should not be given any more value than that. When we start to make definitive statements about person X will benefit from treatment Y from mind guardian Z, we open the door to the paternalism that justifies all kinds of forced interventions by government. As Jacob Sullum brilliantly said here http://www.cato-unbound.org/2012/08/24/jacob-sullum/legal-moral-problems-involuntary-commitment “retrospective gratitude could be used to justify all manner of paternalistic interventions, whether or not they involve a psychiatric diagnosis. If the government began kidnapping obese people and forcing them into a strict diet-and-exercise program, how many newly thin former captives would eventually be thankful for the help? Let’s not find out.”. All sort of evils have been perpetrated in history under the excuse of “doing good”.

      – Finally, I do not believe in any kind of forced intervention by the state on psychiatric matters. None, as in NONE. All I am asking is that given that psychiatry claims to be “just another medical specialty” that it is given the same deference as other medical specialties by our legal system. Chemotherapy cannot be imposed to unwilling cancer patients. HAART cannot be imposed to HIV positive people. Psychiatry cannot have it both ways. If it is “just another medical specialty”, it should have the same legal status as the others, and that would involve the abolition of coercive psychiatry. If it wants to keep its coercive status, then it is clearly not “just another medical specialty” and as such, it should be treated differently from other medical specialties.

  7. You know, growing up I had ticks. They weren’t severe though and they didn’t interfere in my life in anyway. They were relatively mild but they were weird. One tick, for example, was that I would sort of shake my head once every few minutes. Another would be me rolling my eyes once every few minutes. Two ticks were (as far as I remember) not present simultaneously and each tick lasted for a short time. But on the whole, I had only a few types of tics.

    I also grew up with an extremely religious parent. Said parent would teach me to not touch or use certain things because of “bad vibrations” (her term). Due to this sort of behaviour, I had a “learned OCD” component.

    The similarity between ticks and obsessions/compulsions is that people (usually) know that they are irrational but they still engage in them*. So because I had ticks, I was perhaps “predisposed” to having obsessions and compulsions (there seems to be a statistical correlation between both) later in life.

    The thing is, the ticks went away automatically (before the age of 10), and the obsessions and compulsions went away through “training my brain” for a year or two. This “training” was in terms of thinking in a more rational, logical and probabilistic sense. I was always uncomfortable with religious beliefs because I could not fit them and the way the world works into a logical framework. The work of people like Richard Dawkins (and many others) just validated this. Learning more about the working of the human brain helped immensely. Truly, knowledge can help you get rid of obsessions and compulsions.

    I’m now completely free of all obsessions and compulsions that warrant an OCD diagnosis without any medication whatsoever. So, obsessions and compulsions are not immutable. They do go away for many people. This “training your brain” is very important (and it may be unique to you as a person). Medication may just ease things for a while, but if you truly want to get rid of obsessions, you’ve got to work on them. The knowledge that they are indeed irrational is a very powerful force if used properly.

    *It’s more complicated than that, but I won’t go into details.