A few days ago, I was sitting next to my wife on the couch reading Spark: The Revolutionary Science of Exercise and the Brain written by John Ratey, a professor of Psychiatry at Harvard University. As the title states, it goes well beyond the adage that exercise is good for you, and takes a much deeper, and more scientific look at how research in this area can be (and is in certain places) used to address all kinds of everyday needs.
I found myself saying out loud, “Now this what psychiatry should be doing.” By psychiatry, I didn’t just mean those positioned only in academia, but more those who are delivering services to patients on a daily basis. This morning, in reading Dr. Hickey’s thought-provoking article on the field of psychiatry and reflecting more on Dr. Deacon’s creative NIMH Mad Libs post, I again found myself thinking more about the field of psychiatry in general. Beneath all of the criticisms regarding questionable science and potential harmful effects inherent in the current psychiatric model, it seems there is an equally important question: Just how is the practice of psychiatry relevant and practical in our daily lives?
As a spouse, a father, a member of a large extended family, and as just a human being, it is difficult for me to separate my life as a pediatric psychologist from my personal life. Like everyone else, there are certain basic functions that need to be executed in order to provide a framework to keep myself healthy, including psychologically.
Psychiatry by its nature seems to be the profession best posed to ask the following question: “What factors (unlimited) may be contributing to your psychological difficulties?” And more importantly, “What factors may contribute to your psychological health?” Unfortunately, all medical professions, including the field of psychiatry, have long struggled to be defined by what goes wrong (pathology), and not what can go right (resiliency). In doing so, as noted by Dr. Hickey, we look at psychological difficulties as a disease, and not necessarily a conglomeration of various features which may lead someone to become significantly impaired and/or distressed in the self-professed important aspects of his or her life.
In 2011, Dr. Robert Walsh published a seminal article in American Psychologist entitled Lifestyle and Mental Health. In this article, he detailed the various ways that many lifestyle factors can be directly linked to a person’s psychological adjustment. That same year, the Monitor on Psychology published its December edition with the cover that read “New Research on the Link Between Exercise and Mental Health.” Details of the article indicated that exercise alone could be a powerful form of treatment for mental health issues, rivaling medication and therapy.
Meanwhile, studies continue to pour in about the negative effects of poor diet on mental health. Two headlines in 2013 published through Medscape indicate the following: Stop the Pop: Soda Linked to Aggression, Inattention in Kids and Early ‘Junk Food’ Exposure Risks Kids’ Mental Health.
In the world of sleep research, we finally are coming to realize just how important somnolence is for mental health, and uh, everything, as was noted in a recent article in Scientific American posted on MIA. And large meta-analyses (e.g., Koenig, McCullough, Larson, 2001) have consistently indicated the potential buffering effects of spirituality and religion, which seems rather important since 90% of the world’s people are involved in some type of spiritual endeavor. The relevant tie-ins to mental health and our daily life are endless, and for anyone that has ever engaged in clinical practice, it becomes supremely obvious just how important these factors are.
I realize that, for many, this is all old news. But what isn’t old news is why many in the practice of psychiatry and, to be frank, in my own field, are not truly engaged in this research in a way that matters to the families that come see them. What I really want in a psychiatrist (or prescribing pediatrician or family physician) whether as a parent or patient is someone who can — and will — speak intelligently, honestly, compassionately and hopefully about how many different factors may be affecting our physical health. Beyond the social, spiritual, and psychological factors, I want a psychiatrist who will take the time to consume the research, screen patients thoroughly, and then speak in layman’s terms about a plan that would incorporate changes to a patient’s daily life that could improve their mental health.
Beyond my immediate urges to decrease symptoms and appease the participating parties, I really want to know if physical factors – such as sleep, hormonal issues, fitness, media/technology exposure, etc., and beyond – are integral in the anxiety or attention problems that are presenting themselves. When I have worked with psychiatrists that practice this way, it is a real joy, but I must admit that my experiences in this type of collaboration have been rather limited.
What I do not want is a 15-minute appointment to start the trial and error process of seeing which medication might work, without considering all other options — first and ongoing. Once this happens, years and decades of the revolving medication circuit often go by without really knowing what has gone wrong. To me, it is the true integration of physicality and psychology where psychiatry could uniquely shine again. It is where I can hear highly qualified medical students saying “You know, I really could see psychiatry as a very rewarding and interesting field to pursue.” Until then, I have to admit that many prospective students will likely look at the field as one-sided and unrewarding.
In saying all this, I want to be clear that psychotropic medications may at times be necessary to alleviate psychological issues that persist. As Robert Whitaker clearly indicated and profiled in Anatomy of an Epidemic, medications used strategically and in a time-limited manner may provide a much-needed boost to a more healthy existence. But when prescriptions occur on the front end, with little or no attention to the myriad factors that may actually be creating a situation of poor mental health, then the profession stops being a scientific, deductive practice; instead becoming simply a disseminator of concoctions that may or may not work — especially in the long-term. Imagine, though, if the field of psychiatry, both in research and practice, devoted less attention and financial resources to developing new medications and uncovering hypothetical biological underpinnings, and more on how what we do everyday can help make us feel better. Wow . . . just how relevant would that be!
But in the interest of full disclosure, we know that many barriers exist to this beautiful possibility. The first is that psychiatrists, like many of us with advanced degrees, have to be willing to live on the salaries that we earn, and not small fortunes we pursue through sponsored ventures and triple-booked patients. We must be willing to unwed ourselves from parties that may cloud the truth. As a father of six, I realize that no money ever seems enough in these uncertain times, but we all must acknowledge the role that greed plays in obscuring reality.
Secondly, we have to stop giving in to the pleas and demands and anxiety of our patients, of parents, and schools. We must have the fortitude to let all know that this may take some time, and the insight and knowledge to provide other options as we search for clarity. More than any profession, the reality of “fix my child now” is never more real than for my psychiatric colleagues, and for that, I sympathize with them.
Finally, though, the field of psychiatry, as all fields, must find great joy in reaching the true pinnacle of becoming a complete profession. As Ireneus once said, “The glory of God is man fully functioning.” It seems this would be the glory of any profession, and in helping others realize this in themselves.
Years ago, shortly before I enrolled in graduate school, I had my first real exposure to the psychiatric world, as a mental health technician in a local inpatient unit. Every morning, we would meet as a team to discuss the youth on our unit and these meetings were usually led by one of the psychiatrists on staff. Almost as he was walking into the meeting, I could hear him proclaim to other staff, “He is definitely a Buspar kid” or a “Zoloft kid” or any other medication-hinged name.
This was long before I had any adequate knowledge about clinical practice. But I distinctly remember to this day the dehumanizing effect that discomforted me. I couldn’t help but think that this “Zoloft kid” was a boy who had only slept for five hours a night, whose parents had both used drugs and had spent time in prison. He had been sexually abused by his older cousin, and he struggled with school due to a reading disorder. But most of all, he was a kid — one in need of great care and understanding — one uniquely important to the human race in ways that I would never understand.
When psychiatry, or any other profession for that matter, ignores critical aspects of humanity, it is destined to fail. The failure of the medical model is that it seems to largely confine itself to only one dimension of our being, and fails to truly embrace just how our social, psychological, and spiritual existence blend with our physical selves to create one person. And in doing so, it departs from the relevant things in our daily lives, those that involve being a spouse, a father, a brother, a friend, a worker, and most importantly, one human being uniquely positioned in the entire human race. It loses its calling, its relevance, and its face in the mirror.
The relationship between exercise, diet ,and sleep and health, mental ,physical,and then some. you seem most interested in are better understood and explained in the field of Traditional Naturopathy from whom many contemporary “doctors “of all types have been taking bits and pieces and chunks,without giving Traditional Naturopathic Physicians the credit due to them.
Another field which is really at the cutting edge of healing was developed by Kam Yuen 35th generation Shaolin from northern China. You can see it at Yuenmethod.com This system looks at the human being as being inter related on 6 different levels : Spiritual,Psychic,Mental,Emotional,Psychological,and Physical and is a truely east meets west system incorporating Quantum Physics,Biology,and Psychology from the west and Quiong, acupuncture ,and Tai chi from the East. You would truly love it and be amazed.
I appreciate your hope and enthusiasm but I have a very dim view of psychiatry and believe it’s destiny is in the dustbin of history.Its Practitioners Have Committed Too Many Crimes And Continue To End,Shorten ,And Threaten To Many Lives.
I greatly appreciate Robert Whitaker’s books Mad in America and Anatomy of an Epidemic.
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I also have a dim view of psychiatry…..
http://www.annals-general-psychiatry.com/content/6/1/8
Abstract
For the first time in history, psychiatrists during the Nazi era sought to systematically exterminate their patients. However, little has been published from this dark period analyzing what may be learned for clinical and research psychiatry. At each stage in the murderous process lay a series of unethical and heinous practices, with many psychiatrists demonstrating a profound commitment to the atrocities, playing central, pivotal roles critical to the success of Nazi policy. Several misconceptions led to this misconduct, including allowing philosophical constructs to define clinical practice, focusing exclusively on preventative medicine, allowing political pressures to influence practice, blurring the roles of clinicians and researchers, and falsely believing that good science and good ethics always co-exist. Psychiatry during this period provides a most horrifying example of how science may be perverted by external forces. It thus becomes crucial to include the Nazi era psychiatry experience in ethics training as an example of proper practice gone awry.”
A worthy article although it misses the main point that psychiatry was discussing killing its patients in the 1920 and continued to kill them as long as three months after WW11 ended.
The t4 programm http://en.wikipedia.org/wiki/Action_T4 was a psychiatry led program that the Nazi only permissioned. Psychiatry asked for it and was enthusiastic about it.
Psychiatrists in the six killing centres (psychiatric hospitals) channeled patients into the gas chambers, psychiatrists opened the gas taps and psychiatrists falsified the death certificates.
Critically many of the psychiatrists from the T4 program then went on to work for the extermination camps set up under Operation Reinhard. http://en.wikipedia.org/wiki/Operation_Reinhard These were Treblinka, Sobibor and Belzac due to their percieved expertise at industrial killing. Some of the equipment was taken from the hospitals and reset up for reuse… Of course psychiatrists also worked the ramp at Auschwitz-Birkenau selecting who would be gassed straight away and who would do slave labour….
As was stated at Nuremburg “If it wasn’t psychiatry the holocaust wouldn’t have happened”.
National Socialism (bad enough) didn’t infect psychiatry….psychiatry infected National Socialism and showed the Nazi how to kill…
To much water under the Bridge to trust this profession ever again.
Dr. Breggin has written and lectured on the role of psychiatry in helping to bring about the holocaust in Nazi Germany.
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A number of years ago, I made a radio documentary on the Nazi extermination of people with psychiatric and other disabilities.
http://www.albany.edu/talkinghistory/archive2/ua-penney-before-auschwitz-56.ram
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One more great irony to add to all of this discussion regarding psychiatry and Nazi atrocities. Out of all the horror emerging a few remarkable lights, some of which would change generations to come for the better. One of these, of course, was Viktor Frankl, a psychiatrist himself who found the ability to transcend all of the horror only to provide the world with inspiration that would change the lives of millions.
Maybe naively, then, I am reluctant to completely discard a profession, despite all of its tremendous misgivings, when there remains individuals previously and now that seem to actually take on a noble call in this profession.
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There is no doubt that much of psychiatry has a sordid history, with its large scale involvement in the Holocaust being the nadir for sure. I greatly appreciate the resources included to provide me with a better sense of the atrocities committed through the Nazi regime. The practice of psychiatry has undoubted been tainted from the beginning, but the same argument could be made regarding the medical profession in general, including other professional involvement in the Holocaust. I certainly understand sentiments as yours and others regarding a general distrust that would be difficult for the public to ever move forward with, but I do feel the premise of psychiatry (as I perceive), i.e., the integration of physicality and mental health in understanding the whole person, remains a noble pursuit even if the practice has fallen woefully short. As was noted by Fred, there may be healing traditions better suited to address this holistic practice, but at least in the current professional climate, the shell of the profession suggests that it could be suited to taking on this cause. But I realize that the changes would have to be massive to allow for this to happen. Wouldn’t be the first time in history, though, such a large scale paradigmatic change occurred.
Appreciate your thoughts and resources.
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The fact that Psychiatry’s ugliness is paralleled by general medicine does not make me feel more forgiving. Allopathic medicine was absolutely BRUTAL in the late 19th and the 20th century (and continues at a more subtle level to the present day) in framing any other practice as ‘quackery’ and assuring that midwives, chiropractors, homeopaths, naturopaths, and any other medical specialty was either subordinate to the MD or was eliminated from competition completely. The results were particularly ugly in the field of childbirth, where ineffective and dangerous methods were instituted and the death rate for women and children rose after birth was moved from home to the hospital, mostly due to uterine infections caused by physicians who did not wash their hands, even after having come directly from working on a cadaver. While maternal and infant deaths have decreased dramatically since, it appears to me mostly due to an increase in antiseptic procedures plus the introduction of antibiotics. Home birth still comes out as a safer option, and doctors still make things worse in the hospital with dozens of unnecessary and often counterproductive interventions.
And that’s just childbirth. From dropping the recommended cholesterol levels based on industry-inspired “studies” that supported more drug sales through the impressive “Vioxx scandal,” allopathic medicine has a pathetic record when it comes to recognizing the need to change its practices or recognizing the potential contributions of other healthcare professionals. Psychiatry fits very nicely under the AMA’s mantle.
—- Steve
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Psychiatry is a failure. Why wait another couple of decades and hope, that psychiatry will become a “complete profession” or scientific? We don’t need psychiatry as a profession, when there is biology, neurology, neuroscience, psychology, gastroenterology,…
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http://en.wikipedia.org/wiki/Alfred_Hoche
http://en.wikipedia.org/wiki/Life_unworthy_of_life
http://en.wikipedia.org/wiki/Action_14f13
http://en.wikipedia.org/wiki/Bernburg_Euthanasia_Centre
http://en.wikipedia.org/wiki/Irmfried_Eberl (A must read this one…When the T-4 Euthanasia Program commenced, Eberl was a willing participant. On February 1, 1940, at just 29 years old, Eberl became the medical director of the killing facility at Brandenburg. In the fall of 1941 he assumed the same position at Bernburg Euthanasia Centre.)
The psychiatrist Eberl then went on to be the first camp commandant of Treblinka…
http://en.wikipedia.org/wiki/Treblinka_extermination_camp
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You wrote “…to start the trial and error process of seeing which medication might work”
There is nothing wrong with the brain to start off with, so you are seeing what DRUGS (not medications) might alter the patients behaviour.
Legal drug pusher.
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I agree with the commenters here that this blog article has some major idealistic hopes and dreams about psychiatry abstracted from the actual oppressive history and day to day practice of the profession.
This raises the following important question: What about the current minority of psychiatrists in the field who truly went into their profession with good intentions to help people and are sickened by the brain disease/drugging model promoted by the leaders of Biological Psychiatry?
Should we advocate that they wake up to this reality and just quit their profession and do something else more productive in the world?
OR do we advocate that dissident psychiatrists raise hell within their professional organizations uniting with psychiatric survivors and other activists in the mental health field with a clear strategy that targets the leaders of Biological Psychiatry and attempts to split their profession into two distinct wings?
I vote for the “divide and conquer” strategy that “unites all who can be united” targeting the Biological Psychiatry wing of the profession.
We are not going to win over open minded psychiatrists by telling them they have no right to exist. And besides if all NEW prescriptions for psychiatric drugs were ended today, there would still be several decades of vitally important work necessary to develop the science and practice of more humane tapering regimens to help the millions of victims of the current paradigm of so-called “treatment.”
Dissident psychiatrists, united in a radical movement to totally dismantle the current mental health system, could play a very important role in helping many people in the coming decades by exposing the true nature of Biological Psychiatry and working in the trenches with its victims.
As for the question of the long term future of the psychiatric profession, that is something that will be determined in the course of the revolutionary upheavals that replace the current status quo. I work as a therapist in community mental health; the same applies to my profession. It may also end up in the dust bin of history, but it is too early to make that determination or advocate for it.
Questions of strategy and tactics such as this can sometimes mean the difference between victory and defeat, or actually delay the achievement of our collective goals for a more humane society.
Richard
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Richard,
In addition to your excellent points, many people forget that 70% of all psych meds are prescribed by non psychiatrists. So even if psychiatry ceased to exist, the problem of over-prescribing these meds would not cease since many physicians think that drugs are the answer to everything and don’t want to take the time to figure out what is really going on with a patient. Or if they do, they feel pressured to do something quickly.
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Good points Richard…indeed, dividing out those psychiatrists willing to focus on “humane tapering regimens” would be a good strategic start. They still get paid, but they can start to unwind the damage.
And AA, very good point too…even if a movement of psychiatrists started doing this, GPs still prescribe the lions share of psychotropic drugs.
Advertising, alliance groups, doctor’s interests and influence as well as many people’s desire for a quick fix all make it seriously challenging to change the status quo.
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James, thanks for your post. I would love to see psychiatrists shift from a medication/disease model of treatment to something involving holistic care, focusing on nutrition, exercise, lifestyle primarily with drugs way down the list in their toolbox. But realistically, I don’t think that’s bound to happen. Psychiatrists are paid for short 15 minute sessions and are paid highly for medication management. Full stop. Unless that basic model is changed to pay doctors highly for simply talking and educating patients, there can be no revolution in psychiatry.
However, a very few psychiatrists are shifting how they prescribe and are suggesting tapering to a lower dose or getting off completely. This is how we can change psychiatry…emphasizing the low or no med model, emphasizing tapering if possible, avoiding multi-drug cocktails and prescribing to new patients as well as pointing them towards more holistic care. In this way, you don’t affect their bottom line….their ability to make a high salary.
And the sad fact is…once a person has invested ten years of their life and money in education, and then is offered 125 dollars for 15 minute sessions that are based on prescribing drugs…they are unlikely to adopt radical ways of practicing.
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Mortgages, car payments, vacations, lavish lifestyles….
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Richard, Jonathan, AA – really appreciate all your thoughts on this topic and agree with much of what you said. You are no doubt right in saying that there is a vein of idealism that runs through my post as I feel any large-scale proposal probably has. But I can’t escape the reality that hundreds into thousands of psychiatry departments/residency programs exist today, and probably will for the indefinite term, that seem to be churning out psychiatrists with a med-first mentality. You also make a great point that psychiatrists are doing a minority of the prescribing and that even if the profession went defunct, someone (likely even less qualified) would be prescribing psychotropic meds. Jonathan, as you mentioned, the $ plays a huge factor in this, and frankly many psychiatrists feel pressured by the current standard (that their hospitals likely abide by) regarding patient volume. Until these professionals are inspired to a more meaningful practice, one in which they would actually be wiling to take a pay cut, for a happier and more purposeful professional existence, I just worry the medication rates will continue to climb.
Thanks again for taking the time to share your thoughts
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James,
I appreciate your blog post. IMO, if more emphasis were placed on sleep, exercise and nutrition, we’d see a lot of “mental illness” run out of town.
Developing healthier lifestyles includes good relationships. When it comes to “severe mental illness” there is often the need to overcoming trauma.
But shrinks aren’t needed to do any of these things. In fact, their approach muddies the waters.
Duane
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Spot on.
Psychiatry is offering the opposite:
– prevents good sleep (by medication)
– keeps you out of sunlight and from moving your body (by physical and legal restraints, medication)
– disturbs your metabolism (by medication)
– (re-)traumatizes
It seems Psychiatry is designed for creating “mental illness”.
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Hi Duane, appreciate your thoughts, especially in regards to the importance of addressing issues with relationship, which of course includes past trauma and poor communication. It is always concerning when professionals themselves struggle to establish good, working relationships and deal with conflict, as this makes it increasingly difficult to address this core issue.
The social dimension certainly reigns extremely important in interaction with the other three.
Thanks again for your thoughts.
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An added note to the author of this blog who has promoted John Ratey’s book “Spark: The Revolutionary Science of Exercise and the Brain.”
It needs to be pointed out that John Ratey is co-author with Dr. Edward Hollowell of the book “Driven to Distraction.” This was one of the major theoretical and practical guides promoting the bogus diagnosis of ADHD which has ultimately harmed millions of children and made Big Pharma billions of dollars.
These authors should be spending ALL their time undoing the enormous harm they have done promoting the so-called brain disorder of ADHD. How can we trust or want to give credence to any other theories they may be promoting?
It is interesting fact that I once saw Edward Hollowell on the news talking about one of his own son’s development. Apparently he diagnosed one of his sons with ADHD but said the stimulant drugs did not help him. Instead he had him enrolled in a special school that used various forms of exercise to help children create more favorable conditions to learn.
So think about it, now Hollowell has his son is off all these dangerous drugs and getting this special form of education. WHAT ABOUT THE MILLIONS OF OTHER CHILDREN IN THE WORLD WHO ARE NOT SO FORTUNATE AND ARE BEING DAMAGED BY BOTH THE DIAGNOSIS AND THE DRUGGING THAT HE SO VIGOROUSLY PROMOTED? Is there no shame?
Richard
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Promoting this book is the most troubling part of this post. From the book:
“In 2006 he charted how various treatments influence BDNF, including all available antidepressants, as well as less common forms of treatment such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). They all boost BDNF in the hippocampus, and Duman pointed out that ECT, the most effective treatment, raises it by 250 percent.
But how is it that a blunt physical manipulation such as ECT — which sends an electrical current through the brain to induce a seizure — can work like drugs, therapy, and exercise? I think ECT provides a useful metaphor. If we look at depression as a sort of brain lock, then we can see a common thread between these approaches: They are all shocks of a sort. They send sparks flying to change the dynamic in the brain. Some parts are stuck in a constant whir, and others are locked in place. The key, I think, is to wake up the brain and the body so you can pull yourself out of the downward spiral.”
and about ADHD:
“Experts estimate that just over 4 percent of American adults — that’s thirteen million people — have ADHD, which is not to say that the remaining 96 percent of the population is completely free of attention problems. To a certain degree, everyone suffers from fleeting attention. And as I’ve mentioned, there are varying degrees of severity for many mental health disorders — shadow syndromes, which are personality traits that don’t necessarily meet the full checklist of symptoms doctors rely on to make diagnoses. People with shadows of ADHD might have constant problems with romantic relationships, for example.”
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Which book are you quoting?
A) John Ratey – ‘The Revolutionary Science of Exercise and the Brain’
B) John Ratey and Dr. Edward Hollowell – ‘Driven to Distraction’
In fairness, the blog author only referenced the first book, and only in the context of the benefits of exercise on mental health.
I’ve not read either book, and would like to know which the quotes came from. I thought the blog author’s post was positive and full of optimism. I hope those quotes were not in the book he referenced.
Duane
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In addressing concerns noted along this line of comments, I was fully aware that John Ratey was co-author of Driven to Distraction, as I actually purchased this book during graduate school after it was recommended by professionals in the program. I, like those of you have posted, am also curious about the seeming departure from this previous book to the author’s current body of work. However, I think that we have to be careful about dismissing any book based on the author’s previous endeavors – this would be synonymous with saying that we should not be allowed to evolve in our careers (and for that matter any belief) and that any work we do can easily be dismissed because of our past practices. As Abraham Lincoln once said (and I apologize for the paraphrased, likely butchering of eloquence)- I will continue with my current practices for time being, but if someone clearly shows me a better way, I must be willing to change. In a similar vein, I appreciate the concerns voiced regarding the quotes pulled from Spark, but I think again it is a dicey proposition to dismiss an entire body of work based on a few excerpts that do not fit with what we believe. In fact, to this point in my life, I have yet to read a book by a professional that I completely agreed with all of the observations and assertions made, even for those I have come to highly respect. Again, IMHO it is definitely important to have a healthy level of skepticism, but not dismiss entirely. That is again why AOAE moved so many people – Whitaker did not dismiss the allopathic practices of psychiatry altogether, but raised enough questions that many people started saying, “Hmmm, this doesn’t make sense.”
As with any recommendation that I make to my patients or the general public through my writing, I only do so if I feel the potential gains far outweighs possible negative consequences. In this case, I felt there were two huge potential gains in recommending this book. One has already been stated clearly in my post. Despite the concerns regarding the quotations above, what I have no doubt of is that any reader of Spark will come away with a new, and clarified appreciation of how strategic, and well-planned exercise can improve academic performance, and decrease depressive, anxiety, inattentive, addictive, hormonal, among other issues. The author clearly conveys how exercise can make drastic changes in these areas, and should often be used in lieu of more traditional psychiatry practices, including medication and ECT. In fact, the author also acknowledges his own professions reluctance in admitting that exercise is a bona fide method of potential change.
But as importantly, and maybe even more, I felt the potential gain in recommending this book came from informing, and empowering the general public, in making demands of psychiatry that went against the current grain. I think it is fair to say that 99% of the general public feels that when they are going to the psychiatrist, they are going for one thing: to get medication (the second maybe being to get a diagnosis). So the conversation almost always stops there. But, if the public begins to realize that psychiatry can, and should mean, much more than medication, then conversations, and eventual demands, can drive the profession in a different direction. Comments like, “Doc, you know for the last couple of years we have only talked about my meds, but recently I have been reading more about the powerful effects of exercise, and I wonder why we haven’t talked about this” created thousands of times over can shift the practice. In fact, whether we like it or not, we all know that professions, just like the marketplace, are largely driven by consumers, or in this case, patients. Until we provide consumers (patients) with different ideas about a practice, they will likely continue to acquiesce to the current trend.
As a psychologist, I can talk to the end of time about how I think the practice of psychiatry should change, but I will likely be dismissed as just one more outsider who should take care of his own profession. But if I can use those in the profession itself to make the case, and even better use someone who is highly regarded, then suddenly my legitimacy goes way up, and then who knows what possibilities are in store.
In the interest of ending what may be the longest comment in the history of MIA (I apologize -brevity is not my strong suit), I ultimately feel that the book presents much greater opportunities than potential consequences. As an aside, I did contact John Ratey personally in hopes that he would be willing to engage around these topics – we will see if that happens.
Thanks again for all the time spent and your passion in helping those who very much need it.
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Thanks for responding. I thought this clarified things pretty well:
“The author clearly conveys how exercise can make drastic changes in these areas, and should often be used in lieu of more traditional psychiatry practices, including medication and ECT. In fact, the author also acknowledges his own professions reluctance in admitting that exercise is a bona fide method of potential change.”
Be well,
Duane
http://discoverandrecover.wordpress.com/exercise/
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The quote are from his newer book “Spark: The Revolutionary Science of Exercise and the Brain”
I’m astonished, that books like this are promoted on MiA. There not much in it besides exercise is good for your brain (which we know already), repeated over and over again embedded in psychiatric language and ideas.
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@Oli,
OK, thanks for clarifying.
I made the false assumption that it must be the other book…
In this case, I do not think the book should have been promoted.
Duane
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When I was a kid the image I had of a psychiatrist was he was that guy who could hypnotize people by saying “watch the watch” and “your getting sleepy” and then found out what was troubling then and fix it.
Oh well.
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James and Others,
Can I suggest a resource everyone IMHO should read especially anyone working or wanting to work in any mental emotional or physical health field in any capacity especially in the United States and Europe as well as the rest of the world.It is the entire 500 page book “War Against The Weak” by Edwin Black .It is a necessary read for anyone who wants to understand historical events previously obscured now in their real context, chronologically what happened here in the United States that were uncovered by 50 researchers searching archives all over the world including copies of correspondence destroyed in the United States but found in archives in other countries. Everything having to do with discussions on this web site and in our discussion here. I feel it is vitally important to understand , think , and talk about this history if we are seriously wanting to best direct our efforts.
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Psychiatry is not going to clean up its act on its own. It has no reason to do so and all kinds of incentives, especially monetary and egotistical reasons not to.
It will not turn loose of its power and privilege on its own and it will not set people in the system free. It will have to be forced to do so just as slave owners were forced to free the people that they supposedly owned. Some people seem to want to form a circle and join hands with psychiatry and sing Kumbaya in hopes that it will see the light and do the right things. People in power almost never do the right thing simply because it’s the right thing to do. They have to be forced to do the right thing.
Psychiatry has no relevance to me or my life. I have no use for psychiatrists when I can get better treatment at the hands of friends and other professionals who don’t look upon themselves as some kind of gods that I need to bow down to. At one meeting with a psychiatrist she immediately began talking about how she would give me “medicine.” She didn’t ask what was wrong or why I was there. I stopped her and stated that I didn’t want her “medicine” and that I would never take such “medicine,” ever. She looked at me incredulously and said, “If you don’t want medicine then I don’t know how to help you!” Enough said! Many psychiatrists are totally clueless and absolutely useless to me.
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Steven Gilbert, I totally agree that psychiatry is not going to clean up its act on its own, and they are not going to give up their power unless they are forced to. I see that you and I share the same perspective, and I would very much like to be in touch with you. I don’t want to post my email or phone publicly, but if you would like to be in touch, please contact me through MIA. There is a box on the upper right corner of the home page where you can do this. I hope to hear from you.
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A couple comments, when I went to a therapist then psychiatrist, I went to them not because I wanted to be labeled with some “lifelong incurable genetic mental illness” or because I wanted drugs. I went to them because I was suffering from withdrawal symptoms from being improperly weaned off a supposedly “safe smoking cessation med,” that wasn’t remotely safe. My point, however, is I don’t think most patients go to any doctor because they want to be stigmatized or drugged, they want the problem causing them issues pointed out and fixed. I believe most people go to doctors because they want to be made well.
Second comment, my psychiatrist claimed that my continuing to exercise moderately for an hour a day, even while whacked out of my mind on six psychotropics – all with major drug interaction warnings according to drugs.com – was proof I was “manic.” Personally, I’m quite certain my “manic” regular moderate exercise was one of the things that helped me survive the complete insanity of psychiatry.
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@Someone Else,
“Personally, I’m quite certain my ‘manic’ regular moderate exercise was one of the things that helped me survive the complete insanity of psychiatry.”
Good for you!
Duane
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James Schroeder PhD, you state in your blog post,
“To me, it is the true integration of physicality and psychology where psychiatry could uniquely shine again.”
That sounds quite nice, but most talk of rainbows and unicorns sounds nice, too.
Can you (or any of your readers) please explain to me exactly what is meant by this phrase “psychiatry could uniquely shine again,” …i.e., by putting it in a historical context?
Was there a Golden (‘shining’) Age of Psychiatry, which I somehow missed in my admittedly cursory studies of World History? To my knowledge, no era of Psychiatry ever bore a “shine”.
Need I go back and read of some chapter of history, that I inadvertently overlooked? And, as I am in that study mode, need I locate a copy of a certain recent best-seller – that is a book written by a Harvard professor of Psychiatry – in order to find myself better appreciating this age old advice, that “exercise is good for you”?
Surely, it would be great if any number of psychiatrists became what you, Mr. Schroeder, wants them to be (apparently, personal life-style coaches?); only, I don’t believe that’s going to happen (not in this millennium anyway); certainly, it won’t occur on any significant scale. (Maybe, at most, one or two psychiatrists will actually make that switch, as they hit retirement age; and, perhaps, a small handful more of them will make that switch, superficially — but not more than a few.)
On the other hand, it may be somewhat possible that a fair number of psychologists could ( maybe) find themselves working on a nearly equal footing, with their counterparts, in psychiatry, in some “hospital” settings.
If that possibility comes to be the case, then, I imagine, maybe some psychologists might (possibly) convince certain key “hospital” administrators that the psychiatric “diagnostic” systems (in particular, the DSM) should be questioned (if not totally moth-balled).
I may be dreaming an impossible dream, in these respects.
However, it seems to me a possibility; some forward thinking American ‘health maintenance organization(s)’ could implement the sort of suggestions that are offered by MIA foreign correspondent blogger Lucy Johnstone. (Here I recommend to you Lucy Johnstone’s first blog post, that’s titled with the question, “Time to Abolish Psychiatric Diagnosis?” http://www.madinamerica.com/2013/01/time-to-abolish-psychiatric-diagnosis/ )
From firsthand experience, I know of the harms that can be created by psych-labeling – and also the risks of being labeled in ways that may increase the probability that one shall wind up being drugged against once will (an experience that’s quite traumatizing and, hence, is an experience I pray to never repeat).
To be sure, I’ll not ever seek ‘mental health care’ from my HMO, considering what I know can come of such…
Yet, for the sake of those who do seek such ‘care’ without foreknowledge of the risks of doing so, here I humbly suggest to you, as a psychologist, possess considerable influence; you could question the use of psych-labeling; and/or, at the very least (I imagine the possibility), you could inspire some number of your fellow pediatric psychologists, they needn’t necessarily go on utilizing psychiatric labeling; nor need they con forced drugging — at least, not of children.
Kids should be spared the harms of psychiatry…
Maybe you, Mr. Schroeder, could contact your above-mentioned, recommended Psychiatrist/best-selling-author (John Ratey) – who is apparently interested in healthful living.
You could urge him to explain, what exactly is going on, amongst his fellow Harvard Psychiatry professors, currently, at Boston Children’s Hospital… And/or, you could suggest to that Harvard professor of Psychiatry, he could maybe integrate his promotions of daily exercise with a bit of political activism, by publicly addressing (if not also condemning) the activities of his fellow colleagues, who are clearly tormenting their young “patients” at Boston’s Children’s Hospital.
(I don’t know which MIA bloggers read each other’s posts. Maybe you have missed Ted Chabasinski’s most recent blog post, wherein he explains that BCH is a teaching hospital for Harvard Medical School.)
I urge you, if you have not already done so, please, do follow this link, to read a most urgent recent MIA blog post (and the comments which it generated): http://www.madinamerica.com/2013/12/justina-pelletier-case-shows-public-psychiatric-power-control/
While you offer, in your blog post, above, such a pie-in-the-sky view of one Harvard psychiatry professor, I think it might be good, were you to expose yourself to the effects of Harvard psychiatry, generally…
And/or, it would be good if you, as a pediatric psychologist, were to address your MIA readers, with your take on those happenings at BCH.
Respectfully,
Jonah
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Note, there’s a missing syllable, in the text of my comment, above: I wrote “con” when intending to write “condone”.
That sentence should read as follows, at last…
…you could inspire some number of your fellow pediatric psychologists, they needn’t necessarily go on utilizing psychiatric labeling; nor need they condone forced drugging — at least, not of children.
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Jonah, I love the way you express yourself, and thank you for bringing up the situation at Boston Children’s Hospital. I invite you also to contact me through MIA. I think those of us with the same point of view should be in contact with one another, so that we can figure out together what we can do about the horrors of our current mental “health” system.
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Thanks for the kind words Ted — especially for the invitation to contact you… I will do so tomorrow. ~J
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I don’t know if every med student who chooses psychiatry as a profession these days intends to become a pill pusher. Maybe, given the state of the profession, they do. But it didn’t used to be like that, and there are still a bunch of “old dogs” who have never been pill pushers.
Jungian psychiatrists practice Jungian analysis, not pill pushing. Psychoanalytic psychiatrists practice psychoanalysis, not pill pushing. All the alternative treatment programs in the Bay Area–including Diabasis and Soteria–and around the world, were started by radical psychiatrists. When I was 25, and ready to kill myself, an existential psychiatrist (a follower of Victor Frankl) saved my life. He didn’t try to push pills, either.
Whenever I read something by a psychiatrist who seems to be awaking from the biopsychiatric dream, even if s/he seems barely awake, I try to encourage them. Many of them actually did go into the profession to help people. They too have been hoodwinked–especially the private practice docs who just know what they were taught, and what they’re told by the drug companies.
They believe that crap! Nobody taught them critical thinking. I don’t think it’s a good idea to write them off. But teaching them critical thnking is harder. Passing out really good literature at conventions could be a start.
Maybe we could form a front group and get a table at a convention! Or maybe we could treat them like politicians and meet with them at their offices, just like the Big Pharma sales crew does.
Lisa
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Hi Lisa,
I really appreciate your thoughts, and definitely agree that many medical student who seek out psychiatry, as in other disciplines, certainly do so with helping others as the primary reason. But, as you said, they often become caught in a billing/coding/reimbursement system that emphasizes medication administration/management over any other type of practice.
In doing so, i also hate that it overshadows contributions that psychiatrists have made over history despite the evident atrocities of which some have been involved. First in my mind is always Frankl as you mentioned (if you check out my column at http://www.stmarys.org/aticles, you will see him cited more than once), whose development of logotherapy I still feel is one of the most important advances in psychology. Unfortunately, I feel at least in the US, its tenets/practices have been way underutilized.
Regardless, my hope is that more psychiatrists enter this conversation (as Dr. Martin did with the most recent post), and will work to change the profession from within as those of us from beyond do in the same way.
Always curious to hear more ideas. Thanks again.
JFS
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PS: check out this young psychiatrist!
http://www.youtube.com/watch?v=R3TEYOzCogM
If we start a group, they will come out of the woodwork
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About Victor Frankl: in spite of promoting some nice rhetoric about the meaning of life, Doctor Frankl was a strong proponent of shock treatment. This from a man who was a survivor of a Nazi concentration camp. I can’t understand this, but it is unfortunately true.
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The change that is needed in psychiatry, and the mental health field, in general, is the infusion of humility on the part of clinicians. Until then, they will not get the information they need if they want to truly support a client’s healing and personal growth.
Reforming the system = trying to get psychiatry to be effect = trying the same thing over and over again, expecting different results = insanity.
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I also feel that the issue of Nazism is more about the metaphor that psychiatry and mental health system reality is more like a concentration camp of the mind.
Clients/victims are branded and weakened for easy control, and the penalty for–well, for just being, really–is some kind of suffering and asphyxiation, in the most degrading ways.
Perhaps it’s toward those that speak up in their own defense of abuse (only to be condemned as ‘non-compliant,’ ‘rebellious,’ and ‘oppositionally defiant’ of course); or perhaps it’s more random than that, simply standard operational procedure, due to such condemnation and utter disregard for the spirit of those branded human beings. At least I feel this is true in the unconscious mind of many clinicians. It is the norm in that particular society, of that I feel certain.
In the mind and heart, this can feel like barbed wire, inescapable in that moment. Post traumatic stress causes this to linger in all sorts of ways, so it adversely affects society as a whole–very directly, imo.
While I know that this can be resolved and healed, I also know that it can certainly not be resolved within the community that caused it in the first place!
Like Anne Frank, I do believe that, somewhere deep down inside, everyone is good at heart. But I also believe that this heart can be buried under layers and layers of fear and resentment that our world has caused many to feel. Just as people feared and hated Hitler, they fear and hate the APA, and other such organizations, along with the entire mental health system.
Whether good hearted or not on a deep spiritual level, some have been, and still are, acting like monsters.
Not all. Some are just doing what they’ve been taught, and not questioning their authority. The defense of the Nazis that were tried at Nuremberg was, “I was just following orders.”
I respect when people hold out hope for something, I think that feeling of hope is a good one. But hoping that psychiatry and the mental health system heal and reform will only drain hope for those who are suffering now.
Just from my humble voice on the outside, here, after having been enmeshed with all of this for years before breaking free of it all and healing from how all of this ailed me–I don’t think psychiatry or the mental health system are worth hanging onto at this point. So much effort and energy simply to, more than likely, create more suffering, while ignoring the ones that are because THEY haven’t thought of the answers. That really seems crazy to me.
There are sooooo many much better ways to heal and find support, that are natural, humane, and neither politically nor financially motivated. These would be the paths to truly integral well-being for everyone. Contrary to some beliefs, that is not reserved for a privileged few.
I guess I’ve made my position clear, and it’s effort to keep repeating this, so I wanted to put it as thoroughly and directly as I knew how so I can move on with my own life. This gets draining after a while.
Really, it boils down to three words for me at this point: gimme a break.
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