Threats, Coercion and Chemical Restraints for Distressed Children

Maria Bradshaw
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185

“You need some medicine to help you get back in control. Take this medicine or we may have to give you a shot.”

While this may sound like a line from One Flew Over the Cuckoo’s Nest, it is in fact, the phrase used to secure the agreement of children aged 5-12 to taking liquid Risperidone as part of a clinical study conducted by psychiatrist and pediatrician, Dr Gabrielle Carlson.

In the face of concerns that large numbers of children were being incorrectly diagnosed with pediatric bipolar disorder, the DSM–V introduced Disruptive Mood Dysregulation Disorder (DMDD) as a new mental disorder in children, a disorder characterized by persistent (rather than episodic) irritability and severe and frequent temper tantrums. In the scramble by drug companies to produce evidence that their drug should be prescribed to this new population of mentally ill children, Janssen Pharmaceuticals, the manufacturer of Risperidone, paid Dr Carlson of Stony Brook University Medical School, NY, to test their drug on a group of children hospitalized for ‘rage.’

The study does not investigate whether treatment with Risperidone has any therapeutic benefit to the children, whether it cures or treats DMDD or ‘rage outbursts.’ It is quite open that Risperidone is being trialled for its efficacy as a chemical restraint. As Dr Carlson explains:

The goals of this pilot study were to determine acceptability (whether the child would take the liquid medication when angry), safety and efficacy of liquid risperidone in rage outbursts in general, and in children with severe mood dysregulation and/or possible bipolar disorder in particular, and to compare liquid risperidone to usual treatment (i.e. seclusion and restraint) in terms of time to behavioral control, and need for a 2nd intervention.[1]

In the results of the trial, Dr Carlson reports that all but one child agreed to take the medication. This is hardly surprising given they were threatened with an injection if they refused. Agreement obtained through the use of threats and coercion is identified in the domestic violence literature as a classic tactic of an abuser and in the law as not constituting consent.

Children are scared of injections. They hurt. Of course children will choose to drink a drug rather than be injected with one. Dr Carlson could have achieved the same results if she had told the children that if they didn’t take their drug she would punch them.

As a psychiatrist and pediatrician one would expect that Dr Carlson has worked with children who have been coerced into sexual, criminal or other harmful activity in the face of threats of violence if they resist. Undoubtedly she views this as abhorrent and if asked to give an opinion would consider the child did not consent as their cooperation was obtained under duress. It would appear however that being paid by a pharmaceutical company to support their claim that their drug is suitable for a new indication, Dr Carlson has been blinded to the abuse of power inherent in threatening children with with actions which are painful, and of which they are afraid, in order to test a drug on them.

So who were the children Dr Carlson carried out her experiment on? They were 23 children hospitalized for ‘rage outbursts’ who had 3 or more outbursts during their hospitalization. The demographic data from the study shows they were children more likely to be younger, living away from their parents, to be in special education, to have severe expressive language difficulties and to be victims of domestic violence, than those children who did not display rage. The greatest common factor between these children was not their life experiences or cognitive status however, but the fact that 21 of the 23 were taking atypical antipsychotics on a daily basis prior to, and during, their hospitalization.

And how did Dr Carlson define ‘rage outbursts?’ In her words,

Rages were operationally defined as agitated/angry behaviors requiring seclusion or medication because the child could not be verbally redirected to “time out.[2]

A rage outburst was defined as sufficient agitation and loss of control such that the child was unable to “time out” (i.e. sit in a chair for 10 minutes on being told to do so) or was a danger to himself or others and a higher level of intervention was needed.

Note the ‘or’ in that sentence. Risperidone was not being used as a chemical restraint only in circumstances where the child was at risk of harming themselves or others but also where the child was unable to sit in a chair for 10 minutes.

This is in direct contravention of every published standard for restraint and seclusion including the Consensus Statement of the American Association for Emergency Psychiatry Project, the regulations developed by the Centers for Medicare and Medicaid Services (CMS), and the guidelines of the Child Welfare League of America amongst others which all require that restraint or seclusion only be imposed to ensure the immediate physical safety of the patient, a staff member, or others.

According to Carlson, children’s rage outbursts are important because they disrupt ward functioning, create management challenges, may indicate greater psychopathology, and are associated with longer hospitalizations.[3] According to both the CMS regulations and guidelines of the Child Welfare League of America which state that restraints should never be used for purposes of discipline, retaliation and convenience, none of these factors justify the use of restraint.

So what did Dr Carlson and Janssen Pharmaceuticals achieve with this study. Very little judging by the conclusions which were that kids who throw tantrums in hospital are kids who are taking antipsychotics, who are frustrated as a result of limited ability to communicate, who threw tantrums before they came to hospital. They are not kids whose tantrums are predicted by their psychiatric diagnosis. She found that giving kids more antipsychotics “appeared to shorten the duration of the last rage episode, though the episodes still continued for almost 30 minutes” but she also noted that it is possible that order effects and other interventions are responsible for the decreased duration of tantrums.

As a result of her study, Dr Carlson decided that “given that outbursts are similar to tantrums in age trends, causal associations, factor structure, and temporal organization, we propose the working hypothesis that they are indeed prolonged and exacerbated versions of ordinary childhood tantrums.”

The Consensus Statement of the American Association for Emergency Psychiatry Project notes that both physical interventions and drugs for the purpose of restraint have short-term and long-term detrimental implications for the patient and the physician-patient relationship.[4]

What did the children learn from being part of this experiment? No one of course asked them, but I guess they learned to fear doctors and other medical staff, to fear hospital and to fear injections. Given their very real risk of developing diabetes and/or cardiac problems from their use of antipsychotics, these fears could significantly affect their willingness to seek and engage in life saving procedures in the future.

I guess they also learned that using threats and coercion against people smaller than you is ok, that adults can’t be trusted, and that they are bad kids. They learned that they need drugs to control themselves. As a mother and a teacher, I’m willing to bet that these messages will negatively impact their self esteem, their ability to form relationships and their prospects for health and happiness in the future.

 

 


[1] Gabrielle A. Carlson, MD, Michael Potegal, PhD, David Margulies, MD, Joann Basile, RN, BA, and Zinoviy Gutkovich, MD Liquid Risperidone in the treatment of rages in psychiatrically hospitalized children with possible bipolar disorder Bipolar Disord. 2010 March; 12(2): 205–212.

[2] Gabrielle A. Carlson, Michael Potegal, David Margulies, Zinoviy Gutkovich, and Joann Basile, Rages—What Are They and Who Has Them? J Child Adolesc Psychopharmacol. 2009 June; 19(3): 281–288.

[3] Potegal M, Carlson GA, Margulies D, Basile J, Gutkovich ZA, Wall M. The behavioral organization, temporal characteristics, and diagnostic concomitants of rage outbursts in child psychiatric inpatients. Current Psychiatry Reports. 2009;11(2):127–133.

[4]Daryl K. Knox, MD* and Garland H Holloman, Jr, MD, PhD Use and Avoidance of Seclusion and Restraint: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Seclusion and Restraint Workgroup West J Emerg Med. 2012 February; 13(1): 35–40.

 

 

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42 COMMENTS

  1. Carlson has been in receipt of quite a substantial amount of funding from Pharmaceutical companies – Pfizer, Merck, Janssen and Lilly. She also has a number of videos on YouTube that fly under the banner of the Child Mind Institute.

    Ironic that the words ‘child’ and ‘mind’ should fall together given that it appears Carlson doesn’t want a child to have a mind.

  2. Tragic, infuriating, heart-wrenching and, for someone working within the public system of mental health – so incredibly discouraging and defeating I don’t even know where to begin.

    The task of challenging automatic assumptions made from positions of power for the purpose of maintaining power and control seems so overwhelming I’m left feeling mostly helpless to act.

    So sad.

  3. “Take this medicine or we may have to give you a shot”.

    I lived the threat of a chemical rape. I know those are standard operating procedure. Kind of distressing the first time you hear it.

    But because they are ‘treatment, not punishment, they can be criticized only by fellow-experts and on technical grounds, never by men as men and on grounds of justice…

    “If you prick us, do we not bleed? If you tickle us, do we not laugh? If you poison us, do we not die? and if you wrong us, shall we not revenge?”

    – William Shakespeare, The Merchant of Venice.

    One cannot say that revenge is mean or cruel, just as one cannot say that one who engages in it is a bad person. Revenge is merely one person’s idea of “justice”, and therefore it is always “justifiable”, if only to the person performing it, who is retaliating for a wrong they believe has been done to them. Absent evidence to the contrary, or inappropriate use of force by them, there are few people who have a moral leg to stand on; if you’ve never felt the urge to avenge a wrong done to you or someone you care for, you’ve led a rather shallow life.

    Thinking up a plan or scheme is only half of revenge; actually doing it is another thing. In some cases, fantasizing, joking with friends or producing fictional accounts of one’s plans may be catharsis enough. But if you truly intend on following through, you need to justify your actions…to yourself! What consequences will befall the target? More importantly, what will happen to you? (Even if you pull it off beautifully, it won’t be very satisfying if you end up in jail or dead.) Will the scheme improve the overall situation? Will the target’s wrongdoings change or cease? Or do you just want to make them suffer? Or do you want to make an example out of them?

    “I will hurt you for this. I don’t know how yet, but give me time. A day will come when you think yourself safe and happy, and suddenly your joy will turn to ashes in your mouth, and you’ll know the debt is paid.”

    ― George R.R. Martin, A Clash of Kings

    Want revenge ? The pen is mightier than the sword.

    If psychiatry hurt you, start writing.

    http://www.makeuseof.com/tag/5-complaint-sites-pissed-consumers/

    • well said everyone! I feel the same outrage and sense that we must protect our children from the psychopaths who justify this abusive, insane behavior, as if anything could be gained from this kind of experiment. it seems like torture – they put kids on drugs (antipsychotics) which disable their brains and make them rage, which is normal behavior on the drug, then they threaten them with sadistic pain if they refuse to take another drug – a horrible poison, according to Dr. Fred Baughman, which will disable them enough to call it a “chemical straightjacket.” Is anyone wondering, as I am, why psychiatry as an industry is being allowed to function at all? what exactly are they adding to our lives? they are a group of psychopaths and for some reason, probably stupidity, we are taking advice from them on child raising.

    • They don’t ignore it , they chart it as a symptom to justify more of the same mistreatment.

      My medical record said “speech is rapid” but did not state that my speech became rapid after the threat of a chemical rape to coerce drugs.

      How did I get into a psych hospital ? I went with my own free will to the E.R with anxiety attacks caused by the drugs psychiatry gave me looking for help.

      I was chemicaly raped with Abilify for 2 weeks and then released.

  4. Abner Louima is a Haitian who was assaulted, brutalized and forcibly sodomized with the handle of a plunger by New York City police officers after being arrested outside a Brooklyn nightclub in 1997.

    Instead of toilet plungers these “doctors” use hypodermic needles.

  5. [from Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10. Nuremberg, October 1946–April 1949. Washington, D.C.: U.S. G.P.O, 1949–1953.]
    Permissible Medical Experiments

    The great weight of the evidence before us is to the effect that certain types of medical experiments on human beings, when kept within reasonably well-defined bounds, conform to the ethics of the medical profession generally. The protagonists of the practice of human experimentation justify their views on the basis that such experiments yield results for the good of society that are unprocurable by other methods or means of study. All agree, however, that certain basic principles must be observed in order to satisfy moral, ethical and legal concepts:

    1. The voluntary consent of the human subject is absolutely essential.

    This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision. This latter element requires that before the acceptance of an affirmative decision by the experimental subject there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonably to be expected; and the effects upon his health or person which may possibly come from his participation in the experiment.

    The duty and responsibility for ascertaining the quality of the consent rests upon each individual who initiates, directs or engages in the experiment. It is a personal duty and responsibility which may not be delegated to another with impunity.

    2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.

    3. The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study that the anticipated results will justify the performance of the experiment.

    4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.

    5. No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur; except, perhaps, in those experiments where the experimental physicians also serve as subjects.

    6. The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment.

    7. Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death.

    8. The experiment should be conducted only by scientifically qualified persons. The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.

    9. During the course of the experiment the human subject should be at liberty to bring the experiment to an end if he has reached the physical or mental state where continuation of the experiment seems to him to be impossible.

    10. During the course of the experiment the scientist in charge must be prepared to terminate the experiment at any stage, if he has probably cause to believe, in the exercise of the good faith, superior skill and careful judgment required of him that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject.

    http://www.ushmm.org/information/exhibitions/online-features/special-focus/doctors-trial/nuremberg-code

    “without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion”

    How could what this lady did to these kids not be a violation.

  6. Once the drug companies have sold drugs for one group of children they will try to seek a precedent for drugging another group of children to increase their profits. So they are trying to justify using this drug on another diagnosis. It’s the inevitable outcome of deregulated capitalism.

    Letters, custard pies, banner drops, ward invasions and spreading the word are our only hope.

  7. These children were really disturbed, they had really difficult lives and were in strange surroundings yet they were drugged when they got angry and could not sit still for ten seconds. Children in fairly normal families who are really angry and upset are unlikely to sit still for ten seconds. The whole procedure, even without the drugs, sounds cruel.

    I’d like to see this place shut down

  8. This article just makes me more and more furious. I can’t believe she has the arrogance to play God and not feel a need to question her own actions and wonder about the ethics of this kind of “treatment.” I looked her up on Google (wanted to find a contact email for her) and her picture looks smug and self-satisfied.

    The thing that’s most frightening about these monsters is that they actually think they’re doing some good. I think the parents of these children should be sued for neglect. It is just sickening how Big Pharma behaves.

    There is something profoundly sick about our society which only cares about money, status and conformity. It’s no wonder so many of us become mentally ill; we’re living in a mentally ill world.

  9. I was a nanny for a girl who went into rages. When she was seven years old, she bent a brass shaft in a door knob. Her rages were intense and very violent. She went into the door knob rage because I had calmly said, “No” to a request that she already knew was going to be answered with a calm “no”.

    When she went into a rage, her father and I would wrap her up with pillows, sitting on the floor, and hug her until she “surrendered” so that she wouldn’t hurt herself or us, and because we couldn’t afford to let her destroy the house. It took about six months of this as her tantrums decreased in intensity and frequency until they stopped.

    She had good reason to feel rage— her mother was a sociopath who severely neglected her and had strange and irresponsible people over to her apartment all the time to party with, which made the girl feel appropriately vulnerable.

    Her father and I were responsible, and over time, we helped her get work through her rage.

    Her mother stood her up three times with supervised visits so was no longer allowed visitation. Sad as it was for all of us, the girl no longer had to deal with weird scenes on the weekends, so she became more evenly balanced across the week and Mondays were no longer a struggle for any of us.

    Children need to know that they’re safe, protected, and that the adults they depend on are responsibly providing them with the material, social, and emotional stability that they need in order to relax and to trust.

    How sad and maddening it is when “experts” indicate to children that it’s their fault that they’re angry.

  10. Did the psychiatrists explain, point blank, to the children the consequences of not quietly sitting in the chair prior to judging them for not doing so? Did they rationally explain to the child that if the child did not abide by the unloving, mandated 10 minute “time out,” that the psychiatrists would force medicate the child with Risperdal, a drug known to cause growth of lactating breasts in little boys, a drug known to cause extreme weight gain and diabetes, a drug known to render people senseless, a drug within a drug class that is typically mandated for life. And that neuroleptics are now known to cause atrophy of the brain with long run use for any made up diagnosis; atrophy of the brain, exactly as has been found in long run medicated schizophrenics?

    When a person is dealing with “professionals” who’ve supposedly taken the Hippocratic Oath, and promised to “do no harm,” one doesn’t expect them to harm you for life, merely because you don’t abide by a 10 minute “time out.” That would not be commensurate with the “do no harm” promise. And as a mom, I know “time outs” should be varied in length based on the child’s age. Are the psychiatrists unaware of this?

    • I think that you’re assuming that the psychiatrists care. I maintain that they don’t really give a damn. Else how could they even consider doing what they did to these children? People are guinea pigs to be experimented on in bizarre ways to “prove” the wild assumptions that psychiatry comes up with these days. I don’t think that they consider people experiencing issues to be truly human so it’s okay to do these kinds of destructive things to them. And in reality it all has to do with more money and more power and more control over other people. It’s disgusting.

      • I know the psychiatrists, and American doctors, are worse than uncaring. I have medical evidence mine intentionally covered up an easily recognized medical mistake, with a complex one, resulting in a medically confessed “Foul up” with inappropriately given Rispedal in 2002, in part to also cover up evidence of child molestation for doctors and a pastor.

        But I keep hoping not all the psychiatrists are as evil as the unethical doctors I dealt with. Though I do agree, their theories do seem to be only about abusing their trust as “doctors” to have power over others, due to greed. I comment, and pass on my research to my former unethical doctors, in the hopes I may help educate and possibly inspire a change.

        Life’s a journey, and I’m still “motoring.” I’m just a little “sister Christian” trying to figure out how to change enormous crimes against humanity – especially children – to which I’ve been enlightened. The psycho/pharmaceutical industries’ most recent crimes against humanity still stagger my mind, at this point.

  11. This is one of those discussions that always frustrates me. Yes, what Maria describes in this article is horrible. As someone who had my entire childhood taken away by psychiatry, I am especially disturbed by what I read here.

    But I’m also very disturbed, and certainly Mad in America is not unique in this way, by the lack of real discussion of what we can do to stop this.

    We should realize that even the general public is not so “spellbound” (Peter Breggin’s term) about psychiatry that they would shrug off stories like this. Our movement has almost completely stopped the kinds of actions that all other movements for liberation used in the last half-century to get their freedom.

    This doctor would be a great target for demonstrations, sit-ins, civil disobedience, all the actions that strong movements of oppressed people have always used to get freedom and respect.

    The public responds much more positively when the victims of oppression are children. A campaign focused on one or two people like Biederman and Carlson would succeed in reaching the public. Just talking to each other won’t do anything, until we leave our bubble and start reaching out to the public. Preaching to the choir does not make converts.

      • My own personal sense is that throwing terms like “nazis” or “swastikas” into the mix is a fast way to alienate the very people we are wanting to awaken to the severity of this crisis. Doesn’t really matter how “right” it is or not. Being right is not always the same thing as doing the “wisest” thing.

        Having said that, I’m not about to insist that my sensibilities and ideas on the best advocacy approach be everyone elses. We have to embrace the idea of diversity of tactics because if we don’t, we’ll never have a functional movement — all we will have is infighting.

        So….. I’ll stand right next to you and your nazi sign and, while I won’t be holding my own, I’ll hopefully bring my distinctive contribution to the cause. 🙂

        • The Nuremberg code is very serious business and it’s writers did not exempt medical experiments for the effects of brain disabling Risperidone on defenseless children who can’t or refuse to sit still for 10 minutes.

          The Nuremberg code was written to protect children from things like this.

          I can skip the 卐 sign so we don’t look like crazies, that makes sense, but my sign at a protest would say something about the Nuremberg code violation.

          The Nuremberg Code was introduced in August 1947, after the Nuremberg trials. In these trials, Nazi doctors were convicted of the crimes committed during human experimentation concentration camp prisoners. It attempted to give clear rules about what was legal and what was not when conducting human experiments.

          The code consists of ten points. The first and most important is that anyone participating in an experiment must give informed consent. This means nobody can be forced to participate in human experiments. All participants must understand the potential risks.

          “Take this medicine or we may have to give you a shot”

          The Nuremberg code also gives rules for running the experiments. For example, participants can leave the experiment if they want.

          The children subjected to Dr Carlson and Stony Brook University Medical School’s Risperdal experiment did not have the option to leave the experiment if they wanted and I’m am sure that was on the very top of there want list at the time. That’s why the door is locked.

          The 卐 sign can go, is calling them “chemical rapists” ok ?

          • # 4 in Nuremberg code states.

            4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.

            —–

            This is what came up today but these effects were known when Dr Carlson and Stony Brook University Medical School’s Risperdal experiment forced this stuff on the kids.

            For Healthcare “Professionals”

            Applies to risperidone: intramuscular powder for injection extended release, oral solution, oral tablet, oral tablet disintegrating

            Nervous system

            Nervous system side effects have frequently included insomnia (26%), dystonia (18%), akathisia (16%), extrapyramidal symptoms (17%), headache (14%), dizziness (11%), parkinsonism (6%), asthenia (4%), somnolence (3%), and hypoesthesia (2%). Increased dream activity, nervousness, impaired concentration, increased sleep duration, dysarthria, vertigo, stupor, paraesthesia, confusion, and amnesia have also been reported. Delirium, withdrawal syndrome, yawning, aphasia, cholinergic syndrome, hypoesthesia, tongue paralysis, leg cramps, torticollis, hypotonia, coma, migraine, hyperreflexia, choreoathetosis, seizures, neuroleptic malignant syndrome, tardive dyskinesia, and sleep related eating disorder (SRED) have been reported rarely. Head titubation and dysgeusia have also been reported.

            Sedation may occur, particularly at higher doses. Blurred vision, vertigo, impaired concentration, increased appetite and decreased appetite have also been reported.

            Read more http://www.drugs.com/sfx/risperdal-side-effects.html

            http://www.google.com/search?q=risperdal+side+effects

          • As I said before, I believe that effective advocacy and activism is about more than being confident you have the “truth.” I also think its about delivering your message in ways that are most likely to be heard and be persusive.

            But I also want to restate something else I said before: I’m not about to insist that my sensibilities and ideas on the best advocacy approach be everyone elses. We have to embrace the idea of diversity of tactics because if we don’t, we’ll never have a functional movement — all we will have is infighting.

            So, its not for me to tell you what signs you can or can’t hold, and I’ll certainly stand right beside you. But I also think some tactics are more effective than others, and I’ll try to tailor my own advocacy accordingly.

            Let me use an example from outside mental health advocacy: I can tell you that an organization like PETA, with its shock-tactic approach to advocacy, doesn’t do anything for me other than turn me off. I’m not even interested in listening to them because they are so obnoxious and ridiculous. Instead, I work with and donate other organizations that make persuasive arguments and foster dialog rather than monologue.

            But that opinion simply reflects my own sensibilities. People are different. Am I going to mount some campaign to attack PETA or bring them down? Of course not. Talk about counter productive. But at the same time, my personal assessment is that they are generally more counterproductive than productive to the cause. That’s what I want to avoid with my own advocacy.

            The question I ask myself is usually, “why am I doing this? Is what I am about to do really about meeting a personal emotional need of my own? Or its it because I really think this is the best possible way to advocate for change?

            I can’t answer that question for anyone else. But I can share my own opinion, then leave room for other people to disagree and do it differently. When that happens, we’re still allies. 🙂

  12. Dollars for Docs

    How Industry Dollars Reach Your Doctors

    3 Disclosures Found for Payments to “Gabrielle Carlson”

    GABRIELLE A CARLSON » ↳ Payee: RESEARCH FOUNDATION OF THE STATE UNIVERSITY OF NEW YORK STONY BROOK N.Y. Pfizer 2012 Research $23,381
    GABRIELLE A. CARLSON » STONY BROOK N.Y. Eli Lilly 2009 Consulting $5,000
    Gabrielle A Carlson » ↳ Payee: THE RESEARCH FOUNDATION OF SUNY STONY BROOK N.Y. Merck 2012 Research $21,465

    http://projects.propublica.org/docdollars/search?utf8=%E2%9C%93&term=Gabrielle+Carlson&state%5Bid%5D=&services%5B%5D=&period%5B%5D=&showall=true

  13. I can say from my personal experience that people have been locked up for “rage” for a long time, under the label intermittent explosive disorder (essentially meaningless until subjectively defined by a “clinician” or questionable motive and qualifications). And, of course a dose of an atypical antipsychotic is going to shorten the “episode”. Those medications are powerful tranquilizers, in case anyone has not heard.

    Anyway, I cannot make enough public amends for the damage I caused in my former clinical career. I am way beyond caring what I “look like” as an activist, or what mainstream rules I might follow in order to be more acceptable and better heard. If Ted has to go to the rest room, I will happily hold his NAZI sign…

    Sharon Cretsinger, XLISW
    KENT EmPOWERment Center, Kent, OHIO

  14. Children often have difficulty expressing themselves with words when they are suffering, sometimes leading to these prolonged tantrums. Here’s the problem when we just punish (or torture, in this case): I once had the pleasure of getting to know an incredible child who, as a toddler, would sporadically throw temper tantrums and attack one particular person (I’ll call him “X”). I chalked it up to “terrible twos” and would bring him to the corner for a “time out,” and I would sit next to him and tell him that it’s not okay to hurt people and ask how he would feel if X did that to him. His response was, “X makes me angry,” and I told him that even when we’re angry, it’s not okay to hurt people. A couple of years later, he told me that X was abusing him. I wish that I had been listening to the message this little boy was trying to send me. I wish that everyone who is responsible for caring for a child who has “excessive” tantrums or acts out violently would look just a little further and question what in that child’s life upset him so much. I learn from my mistakes- why can’t psychiatrists?