Leader in World Psychiatry Calls for Radical Change

Kermit Cole
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Dinesh Bhugra, MD., who next year will become the first openly gay president of the World Psychiatric Association, has told the Guardian newspaper in the U.K. that psychiatry, as it rethinks its conceptions of mental illness, should focus on social functioning rather than symptom reduction as a primary goal of treatment. He also calls for psychiatry to apologize for its past treatment of lesbian, gay, and bisexual people, and, more generally, to women. “There is no doubt psychiatry hasn’t covered itself in glory. I think we ought to be apologizing for all of the areas, not just one bit – like the treatment of women. I remember seeing a patient admitted to a psychiatric hospital when she was 16 because she got pregnant outside marriage. She died there in her 80s.’

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

18 COMMENTS

  1. This is hardly something to celebrate.

    I read the whole article and all he seems to be saying is that some of the DSM/ICD labels of the past especially when it came to the pathologization of homosexuality and some other behaviors targeted at women were wrong. He doesn’t seem to be opposed to the notion of self appointed APA or WHO guardians pathologizing behaviors via voting. Nor do I see any calls to abolishing coercive psychiatry.

    Today, millions of people have been told that they are “mentally ill” because a group of self appointed mind guardians think so. These labels impact their lives both legally and socially.

    In some respects, I feel that some gay psychiatrists are using psychiatric labeling in the same way it was used against homosexuals up until the 1970s: to impose a particular vision of what should be socially acceptable.

    Why is it wrong to call homosexuality a “mental illness” but it is OK to say that somebody is “mentally ill” if he/she mourns the death of a loved one for more than two weeks?

    At the end of the day, psychiatry was, is and will continue to be all about behavioral control. It was wrong when the mind guardians of the day said that homosexuality was a mental illness, and it is wrong when the mind guardians of today say that the behaviors that they themselves dislike are a “mental illness”, even if their most visible representative is gay. It continues to be the same tyranny, even though the targets of their tyranny vary.

  2. Just what sort of mentality do people have that they think it’s okay to FORCIBLY remove a fetus from a mother’s womb?

    These people who like to STEAL KIDS and PRETEND that they’re saviors and heroes (they’re really not) have gone way too far. They need to wake up and realize THEIR OWN mental status. They need THEIR heads checked.

    http://www.telegraph.co.uk/news/uknews/10486452/Woman-has-child-taken-from-her-womb-by-social-services.html

    What a LOST, LOST world. Damned. I have absolutely NO hope.

    And I don’t believe in a “leader” of world psychiatry. We are a gargantuan mass body of life of over 7 billion people. There are NO leaders – no man, no woman, no religion and no country is a leader, in this world, on this planet, in my eyes.

  3. There is much one can say about this fawning article and it’s subject. I agree that it is all about Public Relations and is nothing to celebrate. I also like this comment, at The Guardian, by “babypie”:

    “Sounds like he’s describing some complex issues that need exploring in detail. Or, more likely, they can write some more prescriptions….”

    I don’t see that Psychiatry has anything else to offer (aside from shock treatment and “psychosurgery”), regardless of its statements of intent. This story is merely a re-branding effort.

  4. “I remember seeing a patient admitted to a psychiatric hospital when she was 16 because she got pregnant outside marriage. She died there in her 80s.”

    … Just how old is this guy? 100? 110? 115?

    Why not apologize for damaging millions of children’s brain’s with neurpleptic drugs, completely ruining many of their lives. Oh, that’s right; it’s still going on. Gotta wait until they’ve made all their money first, then maybe 50 years from now when the well all dried up, they’ll apologize for it… but surely not for all the money they made doing it.

    • “… Just how old is this guy? 100? 110? 115?”
      Ha-ha, I noticed that too, JeffreyC! (I read that section four times!) The “CV” below the article states that he is 61 years old. Presumably, he was either misquoted or misspoke, regarding the lady who had been hospitalized.

      I don’t think it’s likely that he will be apologizing for damaging children’s brains with drugs, as he thinks that
      “every school should have a health professional knowing the basics about mental health.” He thinks “that would be a great step forward.” It would be a step forward towards what, more “early intervention”? Granted, it is a rather vacuous statement, but given Psychiatry’s track record, it most likely means more drugged children.

      The article also describes Bhugra’s priority as “getting people back to work rather than eliminating symptoms.” This sounds like an improvement to the status quo, but is it really? What difference can this possibly make to “treatment” when Psychiatry’s palette is monochromatic?

      Bhugra is quoted as saying, “I have patients who, in spite of hearing voices, are still holding down perfectly responsible jobs. By my account they are a success – they have managed to contain their symptoms and function.” This is a nice story, but I’m left wondering if these people to whom he is referring are a success by their own account. In my view, “shut up, take your drugs, and get to the workhouse” is just as ominous as “shut up, take your drugs, and go to IOP (or your cell, or whatever).”

      I don’t see any radical changes being proposed. Or am I missing something?

  5. “I read the whole article and all he seems to be saying is that some of the DSM/ICD labels of the past especially when it came to the pathologization of homosexuality and some other behaviors targeted at women were wrong. ”

    This happens all the time here. It really stabs at the credibility of this site when you read through the archives and see all these headlines suggesting that the article supports the opinions and concerns common at this site, but then read the article and it doesn’t. Because of this, people come away from this site assuming the people here have no ground to stand on, and are just drawing into things that aren’t there.

  6. I apologize if this is an inappropriate use of this space, but I just received an email with the following message (I had posted a comment on Steve Balt’s web site and requested notification of any responses):

    theresa w commented on If Medications Don’t Work, Why Do I Prescribe Them Anyway?.

    in response to stevebMD:

    I have a confession to make. I don’t think what I do each day makes any sense. Perhaps I should explain myself. Six months ago, I started my own private psychiatry practice (one of the reasons why I haven’t posted much to this blog, but I hope to pick up the pace again!). I made […]

    Hi this is a cry for help. My sister is losing it but won’t go inpatient as doesn’t believe in meds. there MUST be places around where you can get admitted and not be given meds? are there any? how would you find them? thanks so much theresa

    I don’t know resources like many commenters and bloggers on this site do – can anyone point Theresa in some helpful directions?

      • I don’t know what the writer means by “loosing it.” But come on – the woman feels she’s in real trouble and is looking for a way to deal with it without taking drugs. I was hoping for some actual helpful comments that might help her deal with whatever her problem is without getting drugged – and hopefully without going inpatient or even getting tangled up with the worst parts of the “mental health” industry.

        I told her of MIA’s resources section, and about Peter Breggin’s site, and hoped others on this site with lived experience could advise her about support outside the system. One thing any of these resources could do would be to answer the questions you ask.

        • I answered quite honestly.

          What does “losing it” mean? Those aren’t my words.

          Losing it? What? Well then, maybe, just maybe, the woman ACTUALLY IS “losing it”. Losing something, something is coming undone. LOOSING.

          That happens. It doesn’t have to be medicalized. It doesn’t have to be seen as a sickness, disease or illness.

          It could be that something is coming to the surface in her life.

          If it isn’t medical, then why waste time looking for doctors?

          Does she need a doctor? Is she sick? Blood poisoning or something?

          Is her problem personal or is it medical?

          Can’t help somebody when you don’t know what the problem is. I have no idea what “losing it” means.

          • The point was to get her in touch with someone who could help her sort this out in a way most people on this site would see as a better alternative to the “mental health” industry’s medical model. You are preaching to the choir here, and that isn’t helping this person who seems scared and without resource to find the resource she needs.

            Do you have any suggestions about where she could start to find support in deciding what she needs to do and how she can do it?

          • “The point was to get her in touch with someone who could help her sort this out in a way most people on this site would see as a better alternative to the “mental health” industry’s medical model. You are preaching to the choir here, and that isn’t helping this person who seems scared and without resource to find the resource she needs.

            Do you have any suggestions about where she could start to find support in deciding what she needs to do and how she can do it?”

            Yeah. I have a suggestion.

            Is she sick? Does she need a doctor?

            Is it personal or is it medical?

            That’s my response.

            NOBODY knows what her issue is in saying she’s “losing it”. How on Earth do you expect ANYBODY to give directory assistance for a complaint like that?

            Seriously. What if she’s toxic and has blood poisoning? Is she malnourished? Depleted of potassium?

            How do you expect anybody to point her in ANY direction where there’s NO INFORMATION? What does “losing it” mean?

            She already wants to steer far away from psychiatry. So, okay. Don’t get anywhere near psychiatry.

            Is she suicidal? Then point her to a multitude of directories for suicidal people.

            Come on, now. We have NO IDEA what her problem is. NOBODY can direct her in any direction when NOBODY has a clue what ails her.

  7. The writer posted this on a “progressive” psychiatrist’s web site, in response to the psychiatrist’s blog discussing the fact that psych drugs often don’t work. Both the place she posted her comment, and the content of her post make it more than likely that her sister has a problem she and her sister identify as related to her mental state.

    They seem aware that going to typical suicide hot lines, family physicians or most others in the medical establishment will result in her being referred to the usual “mental health” establishment, which they fear could result in hospitalization and psych drugs.

    That is a reasonable fear – most of the medical and “mental health” establishment embrace the medical model, with psych drugs as the primary “treatment” for “serious” mental problems. The medical and “mental health” establishment are conduits that suck “patients” into the drug and/or hospital scenario.

    The sister wants to see someone who can help her sort out what she needs (nutrition? rest? antibiotics? counseling? peer support? a respite house? a good therapist? help with her rent or with dealing with her kids? a combination of these things?). We don’t need to know what her specific problem is, to see that she doesn’t want to go to some establishment provider who will assume that any serious emotional issues means she needs psych. drugs, and if she feels suicidal she automatically needs to be hospitalized and drugged.

    She’s asking for resources like those advocated by people on this site. She’s afraid of the usual professionals who are irrationally biased in favor of psych drugs and are dismissive of the kinds of support advocated on MIA.

    • Oh, I think there certainly does need to be more information than “she’s losing it”, in order to point her in the right direction.

      Did you know that symptoms of low potassium can include mental fatigue and emotional instability?

      When people are SO brainwashed and mind controlled to think their every symptom is mental illness, when it COULD be an actual medical condition that is causing such chaos, alarm and stress, well. That’s a real problem.

      My question stands:

      IS SHE SICK? DOES SHE NEED A DOCTOR?

      Is it personal or is it medical?

      To say she’s “losing it”, even on a “mental” website just does not tell me, the reader, anything whatsoever about what sort of assistance she truly needs.

    • Enough, he says.

      That my responses are not what you wanted and not to your liking doesn’t mean I didn’t put forth an effort, and a valuable perspective.

      I happened to write this yesterday, just before I read your comment asking for help on somebody else’s behalf:

      “”we” are a massive mass of people, trying to develop some recognizable structure and system. and people want that system to be loaded, with a full directory of directory assistance.”

      I’ll be watching to see if anybody else responds. I’m very curious as to what they’d say and I’m curious why nobody else has said anything yet.

      ~ mjk