Towards a Hermeneutic Shift in Psychiatry

Pat Bracken, MD
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I know that this might sound odd coming from a critical psychiatrist, but I believe that psychiatry has a future. Furthermore, I maintain that a good deal of psychiatry as practised now is helpful and that many psychiatrists manage to play a positive and therapeutic role in the lives of their patients. However, I also believe that we are at our most helpful when we depart from the current biomedical ideology that has come to dominate in our profession.

We are most helpful when we see ourselves less as technical experts and more like medical facilitators whose job it is to help make sense of states of madness, distress and dislocation. If our profession is to have a positive future, we will need to conceptualise and practice a form of medicine that is not just focused on the brain but one that is able to grapple with the problems of meaning that lie at the heart of most mental health difficulties. In this paper from World Psychiatry, the journal of the World Psychiatry Association, I argue that, as a first step, we need to get beyond the reductionism that currently guides most psychiatric research and education.

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Of further interest:

Psychiatrist Pat Bracken speaks on the current “crisis of legitimacy in psychiatry,” and the growth of the international “service user” movement at the Forum for Existential Psychology and Therapy this past June. The root cause of the crisis is not attributable to psychopharmacology or “a few mistakes in the DSM” that more research would get right, he argues; the root cause lies deep in the dominant paradigm; a “modernist” agenda to frame all human problems in scientific and technological terms. Dr. Bracken supports a post-modernist view; an understanding of the limitations and dangers of such an approach, and accepting that some human problems will not be solved by science and technology, and that mental health is such a problem.

Another paper by Pat Bracken:

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50 COMMENTS

  1. Pat

    You say: “… I believe that psychiatry has a future.” This may be more wishful thinking on your part than any type of firm belief based on historical necessity.

    I know it may be hard to imagine letting go of one’s professional identity, especially when so much personal ego, work, emotion, and economic stability is dependent on it. Please step back for a moment and take an objective look at what your profession has become and how much harm is being perpetrated by a sizeable percentage of those practicing it.

    Psychiatry at this point in history cannot be reformed or reworked in any way, shape or fashion to make it somehow useful to humanity in the long term. No kind of seismic shift, Ted William’s shift, or Hermeneutic shift can save it.

    To focus people on trying to salvage psychiatry at this moment in history is like asking people stuck in a burning building to stop and take some time to study the science of fire fighting before attempting to leave the building.

    With phrases such as: “…these approaches are simply inadequate…” it is clear that the essential message of this blog does not even approach grasping the gravity of the current crisis facing those people being harmed (and destined to be harmed) by the current paradigm of mental health “treatment.”

    Human psychological distress and out of the norm thoughts and behaviors are not “illnesses” and cannot be understood or helped with this kind of understanding. When you say “… and the specialized insights given to us in medical training…” what do you possibly mean here as it relates to helping people in a psychological crisis? This line of thinking still seems to have one foot firmly stuck in the oppressive medical model.

    Pat, I appreciate you and the critical psychiatry movement, but I don’t believe (given the current crisis that exists) that the main efforts of critical or dissident psychiatrists should be directed towards finding a way to salvage the profession by turning back the clock to a time when psychiatry was more focused on doing therapy than genetics, brain diseases, and psychopharmacology.

    As a working therapist in the community mental heath system, I am also hopeful that the role of therapy and therapists will very soon leave history’s stage as well.

    Yes, psychiatry may have a BRIEF future ahead (hopefully only measured by several decades) and there is some VERY POSITIVE WORK that dissident professionals could be doing in the coming period of time. For example:

    1) Study the science of psychiatric drug withdrawal and open clinics and/or private practices (working with knowledgeable survivors) that are focused on helping people with withdrawal problems and ways to minimize dependency on psychiatric drugs.

    2) Develop organized resistance and disruption of “business as usual” within all mainstream psychiatric organizations.

    3) Join with psychiatric survivors and other dissidents in the mental health system in various forms of direct action and educational actions targeting all aspects of Biological Psychiatry within our society.

    In the course of future battles ahead (which ultimately involves challenging the capitalist system itself from which Biological Psychiatry is now inseparable) there will evolve new ways to evaluate the role of current professional entities in the so-called “helping professions” to determine what will be useful for humanity going forward. We all have to dare to perhaps give up something to make this world a better place. “Dare to struggle, Dare to win.”

    Richard

    • Great intro for discussion of this post, Richard–

      I applaud your first suggestion for dissident psychiatrist’s :

      “1) Study the science of psychiatric drug withdrawal and open clinics and/or private practices (working with knowledgeable survivors) that are focused on helping people with withdrawal problems and ways to minimize dependency on psychiatric drugs.”

      seems [to me]like a “community service” option to jail time and million dollar range fines!

      To your eloquently stated argument, I would add:

      It wasn’t *psychiatry* that was a target of pharmaceutical company’s marketing strategies, ( as Dr. Bracken stated in the intro to his paper), but licensed medical doctors who were co-opted into sharing the profits of the salesmen who created the *medical model for psychiatry* . Isn’t that reason enough to abolish psychiatry as a subspecialty of medicine–?? for starters…

      Ergo, the future of *psychiatry* becomes a moot point.

      • Sinead

        Good to hear from you again at MIA. Thanks for the positive feedback.

        I agree that we too often let regular doctors off the hook when it comes to the peddling of psychiatric drugs. Very frequently after someone is suffering from prolonged use of Benzos or SSRI’s (prescribed by their PCP) they are referred to the community mental health system to deal with all the related iatrogenic problems. Then they are often exposed to additional mood stabilizers and neuroleptics which only adds to the damage done.

        All of these drugs (with their addictive properties and withdrawal syndromes)guarantee an unending stream of patients forced to return to their doctors on a regular basis. And for some, these regular doctor’s visits may now become in between periodic admissions to the psych wards of area hospitals. What a racquet this has become!

        Richard

        • Hey Richard 🙂

          What if psychiatrists were NOT considered REAL doctors, and thus did not have prescribing authority in the 1980’s? Could the crafty pharmaceutical minions have gained the power they have today?

          What subspecialty of medicine was the gateway for the now wide spread corruption of our long standing ‘gate keepers’, academic medical centers?

          I take issue with the author’s use of the word ‘psychiatry’ in the following context, in which he is outlining the causes for what he calls, the current crisis of confidence facing ‘psychiatry’.
          “… it is clear that *psychiatry* [my *s] has been a particular target of the marketing strategies of the pharmaceutical industries.”

          That is a boldly misleading statement! I have worked in the field of psychiatry for 26 years, following 14 years of practicing ‘medical/surgical’ nursing. I can state with clarity and certainty that ‘psychiatry’ should never have been included in the specialties of medical practice! Why? Because even before the exposure of the ‘neuro – transmitter imbalance/cause for the symptoms of mental/emotional “disorders” as a SCAM, it was clear to me that MOST psychiatrists had less than rudimentary medical knowledge. These bungling clowns were an easy target for the most hair brained pharmaceutical rep. AND, had they not been so hungry for a slice of the pharma – profits pie, even these clowns might have objected to *bad science* as a basis for creating and treating ‘psychiatric disorders’!!!

          Persisting in their role as MDs , psychiatrists dismiss REAL science and continue to diagnose and treat their patient/market with no apparent concern for the lies they telling and the harm they causing.

          By using the term for the ‘field’ [psychiatry], rather than naming the fools[psychiatrists] who accepted the concocted musings of businessman as their new paradigm of care, Dr. Bracken fails to confront the only real cause for the “crisis of confidence in psychiatry”.

          There is a history lesson here. The psychiatrist who has done the most thorough job of documenting it is, Dr. David Healy. I am amongst the 30+ year mental health professionals who can attest to every misstep Dr Healy points out, that was taken by psychiatrists that has led to the scourge that is a very close runner up to the AIDS travesty in America. In other words, Psychiatrists, themselves, led the way to exploiting vulnerable people for obscene profit.

          IF no one can accurately question the behavior of licensed medical doctors– except the brotherhood of licensed medical doctors– AND this brotherhood persecutes as a heretic, any doctor daring to expose the scam that is literally killing people, then what exactly IS the medical specialty known as, psychiatry? Psychiatry, to any health care professional who was trained and educated before the pharmaceutical industry took over as major educators and financial support for doctors; to us, psychiatry IS a cult with mafia backing–

          Dr. Bracken appears, like so many critical psychiatrists, to be pleading that we not throw out the baby with the bath water. His misleading statements about a major cause for loss of confidence in psychiatry is typical of this group, who cannot simply state the problem and maintain their own sense of confidence. Dr. Healy is one of a very few publicized examples of the fate of a ‘heretic’, evoking fear from the Dr. Brackens in the field.

          Dr Bracken does not rattle the brotherhood with his eloquent discourse. In fact, he supports the indefensible position that exonerates the criminal element he refuses to expose! Saying that ‘psychiatry’ fell prey to marketing strategies, rather than admitting that so-called medical doctors AKA psychiatrists, failed to meet the obligations and expectations of their professional license., breached the public trust, and for lack of desire to be eloquent, BROKE THE LAW.

          Worse, IMO, is the failure of licensed medical DOCTORS to execute yet another obligation, expectation of being a licensed medical professional, and NOW, I am talking about the duty to protect the public from known health/safety hazards and the duty to confront, report and vilify these misdeeds committed by their peers. This vital role has long been abdicated by the brotherhood of the ‘noble’ field of medicine.

          We have well documented histories of unspeakable acts of corruption in the most sacred institutions of our modern, civilized society. What purpose do these lessons serve? Well, that depends on who reads the authentic history.
          The inexperienced, naive reader may cringe with fear., and or become distrustful– even *paranoid*[expanding the market for psychiatry?]
          The average/ main stream reader will definitely share the info in whatever venue serves to educate, warn and protect those for whom she has the greatest concern.
          The seasoned well educated reader, already an active contributing member to create a more humane society, may mobilize aid for victims- advocacy and respite, or access regulatory agencies and legal venues to expose and punish the perpetrators. This group uses it’s influence/status within society to educate, and participate in creating solutions.
          BUT, these same well documented and supported histories of ‘profitable crimes against humanity’ are read by those who take home this lesson:
          IT WORKED !
          Money and power were the spoils– and very few, if any were brought to justice.

          The surest, quickest and perhaps the most vital element for the change we need to effect in the ‘field of psychiatry’ is psychiatrists, themselves. Unless in large number, psychiatrists stand up and perform their duty to those from whom they have been granted both trust and authority; unless the majority of psychiatrists confront, report and vilify the unethical AND criminal behavior of their peers– there is absolutely no reason to accept and tolerate psychiatry as a medical specialty. Period.

          • To put the same idea in a more colorful language: psychiatrists are to medicine what politicians are to the country’s elites:

            – Among the “elite”, or those who aspire to be “elite”, those who are truly talented become professors, scientists, businessmen (or businesswomen), lawyers, etc. Those who are just of average or sub-par intellect -including our current president- become politicians by engaging in deceiving messages like “hope and change”.

            – Similarly, among those who have an MD degree, those who are truly talented become cardiologists, surgeons, cancer specialists, infectious disease specialists, etc. Those who are of average or sub-par intellect become psychiatrists. No surprise then that they go to engage in the same type of deceiving tactics and strategies as politicians.

          • Sinead

            You have presented a powerful and scathing critique of the moral and political responsibility of those in the psychiatric profession, both historically and today. I cannot disagree with any major point you have made.

            Whitaker (Anatomy of an Epidemic) and others have detailed the symbiotic relationship between Big Pharma and the psychiatric profession, which was at its low point in the late 60’s and early 70’s. Both industries desperately needed each other (especially psychiatry) and both began to collude at the highest levels during that period, ultimately putting psychiatry on high doses of economic and political steroids as it grew exponentially in power and influence into today’s incarnation of Biological Psychiatry. Check out my previous blog series at MIA, especially Part 2 https://www.madinamerica.com/2014/07/biological-psychiatry-part-2-anatomy-power-control/ and Part 3 https://www.madinamerica.com/2014/07/biological-psychiatry-part-3-thoughts-hastening-demise/ These blogs get into very similar questions regarding the moral and political responsibility of modern psychiatry and what we can do about it.

            I would add a related point that I have made similar reference to in past discussions: I DON’T BELIEVE, IN TODAY’S WORLD, THAT SOMEONE CAN BE A TRULY EHTICAL SCIENTIST OR MEDICAL PRACTITIONER WITHOUT CONFRONTING THE FACT THAT WE LIVE IN A PROFIT BASED SYSTEM THAT INHERENTLY CORRUPTS BOTH PROFESSIONS.

            Richard

          • Sinead,

            Regarding the passage of your comment (on October 4, 2014 at 1:44 pm) wherein you write,

            …Dr. Bracken fails to confront the only real cause for the “crisis of confidence in psychiatry”.

            There is a history lesson here. The psychiatrist who has done the most thorough job of documenting it is, Dr. David Healy. I am amongst the 30+ year mental health professionals who can attest to every misstep Dr Healy points out, that was taken by psychiatrists that has led to the scourge that is a very close runner up to the AIDS travesty in America. In other words, Psychiatrists, themselves, led the way to exploiting vulnerable people for obscene profit.

            IF no one can accurately question the behavior of licensed medical doctors– except the brotherhood of licensed medical doctors– AND this brotherhood persecutes as a heretic, any doctor daring to expose the scam that is literally killing people, then what exactly IS the medical specialty known as, psychiatry? Psychiatry, to any health care professional who was trained and educated before the pharmaceutical industry took over as major educators and financial support for doctors; to us, psychiatry IS a cult with mafia backing…

            Sinead, I appreciate your critiques of psychiatry, emphasizing, as you do, this reality, of psychiatrists’ general lack of credibility, as physicians. They are good critiques you’re offering, imo.

            You emphasize the way psychiatrists have, in the main, sold out, to Big Pharma — and how their selling-out was largely a result of their being relatively poorly trained and/or under-practiced, in real medicine, as a rule (in comparison to other licensed physicians). I agree with you, on that.

            But, I seriously question: do you mean to paint the psychiatrist, David Healy, as some kind of heroic “heretic” and place him somehow morally ‘above’ Pat Bracken? (That seems to be your intent.)

            While I personally view psychiatry as being, at best, a superfluous profession (it’s really unnecessary, in my opinion, so I have no use for it), I can say, hypothetically speaking, were I ever to be again forced into accepting the professional ‘help’ of a psychiatrist, the blogger posting on this page (Bracken) could well appeal to me, as an ‘OK’ choice of psychiatrist; he’d be acceptable to me — if I was being legally compelled to consult a psychiatrist.

            On the contrary, Healy would be amongst the very last choices (of any psychiatrist living today, whom I know of) that I’d ever recommend to anyone, under any circumstance.

            I would not ever recommend his ‘services’ to anyone, under any circumstance, because, after all, he’s a true-believer in the supposed ‘good’ of electro convulsive “therapy” (a.k.a., “shock treatment”).

            In fact, Healy is a major promoter of ECT… even runs a shock ‘therapy’ clinic.

            His professional views of ‘best’ practices in psychiatry are, to some extent, chronicled in his book, which he co-authored, with Edward Shorter, Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness (2007).

            (It’s really an ECT industry promotional tome — the writing of which was reportedly funded by one of the world’s foremost shock-docs.)

            Here, as follows, are just a few excerpts of that book, by Healy and Shorter:

            “Our research convinces us that ECT is an important, responsible, and reliable therapy that deserves to be more widely used…”

            “…there should be little controversy over whether it is safe or effective. Somatic therapies like ECT easily trump anything in the psychopharmaceutical medicine chest as the most effective treatment for such severe illnesses as melancholic depression, catatonia, or manic excitement; it also has a place in the treatment of schizophrenia…”

            “ECT is, in a sense, the penicillin of psychiatry. We would be baffled if the benefits of penicillin were not widely touted in the patients’ world, lauded by the press, and accepted as a matter of fact by medical doctors. Why has this not happened with ECT? The question is especially important because there are a great many people with depression who do not respond to antidepressant drugs.”

            Along with his co-author (Shorter), Healy calls ECT, “in a sense, the penicillin of psychiatry.” In my humble opinion, that’s an absolutely outrageous line — which, in and of itself, tells me that I’d never want myself (nor anyone whom I care for) to have anything to do with Healy.

            If, perhaps, you are unfamiliar with the well-chronicled problems of ECT, I suggest to you the following link — to an article that was authored by John Read and Richard Bentall, “The effectiveness of electroconvulsive therapy: A literature review” (2010):

            http://www.breggin.com/ECT/ReadAndBentall_ECT_2010.pdf

            [Note: As it happens, Bentall was once a student of Healy.]

            Consider, if nothing else, the summarized ‘Conclusion’ of that paper, which (on its first page) reads, in part:

            “Given the strong evidence (summarised here) of persistent and, for some, permanent brain dysfunction, primarily evidenced in the form of retro-grade and anterograde amnesia. and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.”

            Essentially, Healy can be considered a ‘heretic’ when it comes to his critiquing Big Pharma in its failure to come clean, in regards to the real effects of its drugs; yet, meanwhile, he has not the least interest turning that critical eye of his to the harmful effects of his own, most beloved psychiatric tool of choice (ECT) in psychiatry’s ongoing, ever-lasting battle against so-called “mental illness”; Healy has nothing but praise for electro-shock/ECT…

            Of course, we all know certain unflattering terms that are used to assail the quality of character of one who is apparently choosing to condemn certain decidedly bad practices amongst his/her colleagues whilst nonetheless turning a blind eye (and even highly praising) equally bad practices that just happen to provide the basis for his/her own income.

            Some such terms, of course, come to mind, as I write about Healy’s love of ECT; but I will not include any terms of derision, in my MIA comments, for then there would be the risk of having my comments removed (as they could become less than civil in the view of the MIA moderators). Just, please, understand, Sinead, I have not the least respect for Healy, as a professional; but, I do not mean to critique your views overall; indeed, I quite appreciate your professionally informed, clearly impassioned commenting, in this discussion and elsewhere on this website (including the extent to which you are here challenging the expressed views of MIA’s newest blogger, Pat Bracken).

            Respectfully,

            Jonah

  2. Hi Dr. Bracken,

    I see how your discussion of the limits of the medical model draws from the understanding of the fatal limitations of methodological indivdiualism in reductionistic, psychological understanding. Very few behavioral healthcare workers doubt that their services provide the potentially comprehensive response to the expertly identified “mental illness”, whichever nonentity it is that plays the leading role in the patient’s life. They will likely believe that there are hitches and glitches and imperfections, but not something vastly wrong in the academic and professional world that guarantees a climate for producing error, sweeping in currents that flow as often top-down as bottom-up, always creating the greatest of opportunities for ignoring those errors.

    Such as in diagnosis. You can’t get a doctor to take his nose off the label on a page, not that I’ve met. You can’t find anyone at all who reacts intellibly to a discussion of the problem of isolating the social existence within the skull of a single individual, if that’s most convenient to do, since that’s where the mental illness is. No one where I live who works and earns their living in behavioral healthcare will have heard of the well-known problems of methodological individualism, and I’ve never met one inside who had lately tried to make sense of Wittgentstein or Merleau-Ponty. They would also not be fast to relate to the idea that psychology can’t offer stand-alone scientific conclusions of human potential and suffering, or simply of human behavior. They don’t see why not.

    As fast as you can believe, my efforts aim to seeing that none of my children’s children believe in mainstream acounts of behavioral problems or that its clientele’s best interests are the first order of business for clinicians. Non-patient-advocacy is the universal default position.

  3. Thank you for this article reminding psychiatrists that each of us has a story. Although we are made of cells, we are complex beings, each with a rich history of relationships and life experiences, which often include sadness, trauma and joy. Compassionate, supportive relationships can help heal both our neurochemistry and our souls, without the neurotoxic side effects of psychiatric medications.

  4. Dr. Bracken,

    Welcome.

    As a psychiatric survivor who is now thankfully more than a quarter-century free from psychiatry and its ‘meds’ — and who is also minimally familiar with your work as a psychiatrist (that is, I have exposure to various selections of your writings and talks online), I say without hesitance, thank you for your work’s message, I am truly glad to see you posting on this website.

    Though I wish you’d keep the terms “mental illness” and “patient” sandwiched in quotation marks, what you offer here, in your first posting, is positively meaningful (and is, I believe, fairly representative of the over message in your work). It’s a good sample of your professional wisdom overall.

    But, regarding your suggestion, that what you’re describing could somehow become the (really, incredibly bright) dawn of a new chapter in psychiatry, well, I feel certain you are expressing an impossible dream.

    Psychiatry cannot be what you want it to be, Dr Bracken, because most psychiatrists (unlike you) haven’t got the capacity to work in the way you’re describing. Most haven’t the self-awareness or the disposition, so they will never be even minimally what you hope they will be.

    And, the profession of psychiatry, as a whole, is just too far gone, down the road of ‘brain worship’ (thus, psychopharmacology-worship… and, for some psychiatrists, ECT worship) already; its practitioners have become (almost without exception) individuals who have no measurable interest practicing anything like the hermeneutics that you’re suggesting — nor anything even remotely comparable.

    Psychiatrists are not often also liberal arts majors, Dr Bracken; they’re not lovers of great works of art, in the way you may be (some may collect art, I knew one who did, but he did not appreciate artists in the sense that your are describing); they are mainly folk who are awed by the latest brain science and by the now-standard, digitized color images that are created by brain-scan machines, fMRIs.

    So, what you’re offering, in your encouragements (toward a world of psychiatry that would embrace hermeneutics), is really quite overly-optimistic, I think; it’s your dream/vision of what, I suppose, plenty of psychiatrists could ideally be in some alternate universe.

    They’d be medical specialists who are adept at understanding the products of our life as would a great art historian understand Picasso’s most celebrated paintings! Wonderful…; but remember: in this universe, psychiatrists are (most of them) working directly or indirectly for governments — indeed, for government agencies that are unsurpassed by any other government agencies in their tendency toward bureaucracy.

    In fact, these are agencies guided by laws, which are designed to control individuals’ thoughts, feelings and behaviors… at the expense of sacrificing their civil liberties.

    Psychiatry is, above all else, a key System of Control, in modern/industrialized/secular societies; and, thus, rarely ever do any psychiatrists work entirely on behalf of their “patients” (they can’t).

    Always, psychiatrists are beholden to the dictates of the System of Control, which guides their practices — which means there’s a constant threat of forced ‘treatment’ behind even their kindest offerings.

    The psychiatric “patient” must ultimately bow down to the dictates of a State, which fears ‘deviance’ above all else, and it will always be psychiatrists, first and foremost, who will make sure that every “patient” in the ‘care’ of psychiatry does so…

    To be marked as a psychiatric “patient” is almost always to be viewed (especially, by strangers) as potentially threatening, by society. Thus, no psychiatric “patient” can speak entirely freely about being a psychiatric “patient” …and their lives will inevitably be largely a mystery to their psychiatrists, as the “patient” who somehow ultimately ‘fails’ to ‘properly’ (in the eyes of psychiatry) present a current image of himself/herself that conforms and abides with the psychiatrists’ sense of propriety, will be subject to medical incarceration and forced or coerced brain treatments.

    The “patient” of psychiatry must largely remain in hiding, as compared to others, who are not “patients” of psychiatry… because always are ways of being shafted by society, when one is known as a “patient” of psychiatry; and, there’s some implied coercion, in the psychiatrists’ officially prescribed recommendations, always.

    This is all to say, in most instances, “patients” of psychiatry will not be fully known or understood by anyone — least of all their psychiatrists.

    The stigma of being a “patient” of psychiatry is crippling in a way that most psychiatrists cannot admit to themselves; and, then there’s the stigma of psychiatric labeling…

    Dr Bracken, few psychiatrists can or will ever feel free to fully enter the ‘world’ of their “patients” — especially, not those who are called “seriously mentally ill.”

    Most psychiatrist fear that world terribly.

    The psychiatrist is not a shaman, after all; s/he has not been ‘initiated’ into — has no knowledge of — the ‘underworld’ …that’s so well known by so many “chronic patients” of psychiatry; the shaman (i.e., real shaman) knows how to transcend that realm, overcoming any tendency toward living a life of persisting fears and anxiety, because s/he has face and overcome fear-of-death itself.

    I’m not sure if you can understand the importance of that (probably, you can, but most psychiatrists can’t); most people who can appreciate what I am saying here will know what I mean, as I say: Psychiatrists are mainly bound to be and remain forever inept, at their work, with so-called “psychotic” people… because they have no first-hand, lived experience, no first-hand knowledge, of how to transcend ‘psychosis’ without resort to psychopharmacology.

    And, consider this: The practice of shamanism (which, in modern times, has largely been replaced by psychiatry) was never traditionally a full-time job. The shaman was only a part-time shaman (traditionally); s/he was also a hunter and/or a gatherer — as well as, unusually, an artisan.

    The psychiatrist, of course, is forever dependent upon being a psychiatrist (which typically requires pedaling emotionally and mentally suppressive drugs) to earn a living; and, in all eras and places where psychiatrists have put up a shingle, to earn a living, while they have worked full-time doing so, at most, only partially have they worked for the good of their “patients”; for, they are working to support themselves and their own families firstly, and, then, secondarily, they work for their society and for the families of “patients” who wish for nothing more or less than seeing the so-called “mental illness” of the identified “patient” controlled — which means the “patient” must be subdued — most often, chemically (if not by electric shocks).

    (The “patient” of psychiatry is to be made subservient, to one and all; she is not to be encouraged to live a life of full self-expression, as did Picasso! Goodness, no…)

    So, society allows the psychiatrist to earn his/her living by scheduling periodic fifteen minute sessions, to consult with “patients” on “medication” effects and so-called “side-effects” …adjusting ‘meds’ …as the “patient” slowly succumbs to “medication” induces metabolic disease and brain-shrinkage; and, that is it.

    (I know that describes psychiatric practices here in the U.S. more than anywhere else, including where you live, but…)

    Frankly, precisely because psychiatry has hit such lows here in this country, it is very easy to shun psychiatry altogether.

    So, instead of psychiatry, I suggest the Ways of shamanism and Buddhism and yoga — all without government involvements. (Other psychiatric survivors have come to appreciate religious faiths and spiritual traditions, that work well for them…)

    And, yes, that Way of yours (the hermeneutics that you describe) sounds perfectly good, too; however, much as I can and do appreciate the vision for psychiatry that you’re aiming to encourage, there’s just no way that it will happen on any considerable scale, because psychiatry has always been more or less obsessed with materialist-reductionist theories and labels (called “diagnoses”), and those theories and labels work best for the government control systems.

    I assure you, no society can train professionals to appreciate human life and culture as you appreciate them; and, without a doubt, psychiatry will never adopt a great Way for knowing and appreciating the lives of “patients” in the way that you do…

    Sorry to bust your bubble.

    Respectfully,

    Jonah

    ___________

    P.S. — Much as I appreciate its over all message, I think your post fails to convey the reductionism that’s inherent in psychiatric labels. So, here’s a blog post that I recommend: http://mbramham.blogspot.com/2012/02/people-not-labels-or-categories.html

    • Jonah

      Welcome back. I always appreciate your well thought out and articulated posts at MIA. This also includes your exposure of ECT above in your response to Sinead.

      I do believe some people can be very contradictory in their belief system; sometimes it is baffling but it frequently happens. Healy’s brilliance on his many exposures of Biological Psychiatry and then his terribly contradictory support for ECT. Peter Breggin’s courageous history representing a tiny minority exposing Biological Psychiatry and his horrific support (after 9/11) for extremist right wing radio personality Michael Savage.

      These type of contradictions will certainly raise my suspicions evaluating future positions held by these men, but I will always attempt to evaluate each position they take independently. I will try not to allow my political disagreements to color my scientific evaluations of their body of work.

      BTW, Jonah, please take a moment to review my comment on August 31, 2014 at 3:21PM in Joanna Moncrief’s recent blog on August 26 entitled “The Lessons of Ancient Philosophy.” Towards the end of my comment I address specific comments and questions to you; I am hoping you will respond. Thanks in advance

      Richard

      • “I do believe some people can be very contradictory in their belief system…

        Richard,

        Before I address that point you are making, about contradictions, I must say thanks for the welcome back and for alerting me to your comment under Jonanna Moncrieff’s August 26 blog post. I had not been aware of it, and, now, having read that comment of yours, I must say, I quite appreciate your kind gesture, offering to speak with my dad and vouch for me any time! (That’s really very kind of you, very thoughtful.) You also ask a couple question of me, there. I’ll ponder them just a bit more, then respond with a comment (or maybe an email) later tonight or tomorrow.

        About being contradictory…

        You mention an intention to remain “scientific” in your evaluations. In the context of this discussion, wherein the value of the work of Pat Bracken is being compared to that of the work of David Healy, I think it’s important to recognize, that Healy is a researcher who’s most often claiming to prove himself as a critic of Big Pharma; hence, he strives to develop a special expertise in knowing the downsides (a.k.a., “side-effects”) of psychopharmacology. I believe, in most instances, he’s not going to shun these various pharmaceuticals; he’s in no way ‘anti-psychopharmocolgy,’ nor does he reject the traditional psychiatric ‘diagnoses’ (labels); but, all the time, his running themes suggest that he’s uncovering ‘negative’ effects such drugs. Meanwhile, there is his resounding approval of and support for ECT; and, he runs an ECT clinic; and, whenever presented with claims that ECT is causing lasting damage (enduring “side-effect”), he counters those claims, denying they are valid… while typically insisting they are coming from “patients” who are actually experiencing negative psych ‘med’ effects. He does this quite regularly — never conceding that ECT can create lasting damage.

        To me, he hasn’t the capacity to be objective, and I don’t trust the results of his research. (If you wish, you can see my further comments on this matter, including a couple of links that I recommend, at the bottom of this page.)

        For whatever it may be worth, here I’ll add: I’m on a big ‘focus’ kick lately — aiming to be more focused, in every aspect of my life.

        So, in the interest of staying focused, I’d like to do my best to keep the content of my MIA comments fairly well directed on the context of the discussions being raised by the bloggers and address other commenters who are fairly well staying on topic; your above-mentioned questions to me may be out of context, relative to Dr Moncrieff’s post; hence, I may email you instead of post a comment reply on that page.

        I’ll have to go back to that page, take a moment to read that blog post by Dr Moncrieff… and then decide how to respond. (To whatever extent that I can, I will reply to your questions in a way that utilizes the topics raised by the blogger… that is, if I can find a way to weave the various themes together in a relatively natural way, such that I can leave at least a brief comment reply for you there — at the bottom of that page.)

        Expect a comment reply there or else an email, sometime in the next 24 hrs.

        Respectfully,

        Jonah

  5. Now whether it is coming from the orthodoxy, or from the critics, I have a few problems with these types of arguments, chiefly because I think they serve as a way of ignoring the elephant in the room. The elephant I am speaking of is coercive practices. Certainly biologically reductive explanations conflict with explanations involving a social context. I just don’t think Hermeneutic explanations necessarily spare a person the sort of social condemnation you can get in both cases. The problem is not just that psychiatry in some cases doesn’t grasp that things happen within a social context. The problem is that, given psychiatry’s cozy little relationship with law, that context usually involves abduction, assault, torture, imprisonment and poisoning. You change that context, and you’ve done a great deal of good. A person can’t succeed once put on a one-way track to the garbage bin without an abrupt change in direction. It is the fact that you psychiatrists have to act as thought police and behavior cops that is the real problem. Thought crimes are not crimes, and ditto eccentricity and unorthodox behaviors. I’m still waiting for psychiatrists to recognize there is something wrong with depriving people of their human rights. If you are saying assault masquerading as medical treatment has a future, that’s a sad future, and I hope we can find plenty of people to oppose it.

    • Excellent writing, Frank Blankenship. I wish I were a native English speaker* and could use the wings, forces, perspectives and nuances of linguistic elaborated ideas for the intellectual and philosophical education of our thinking, viewing, assuming as you can. (*in an English lanaguage blog only)

  6. Pat, Obviously psychiatry which is inherently coercive in any possible incarnation is absolutely hazardous to anyones health including you as a practitioner. We need you, all pseudo science aside ,to stop hiding what you don’t know behind terminology’s in an attempt to maintain the coercive authority of a basically Spanish Inquisitional type of criminal plague over humanity. Reinvent yourself find another title maybe Mr. and work for the advancement of people oppressed by psychiatry . Get some education on how not to harm your fellow human being . Yes it takes courage. Fred

  7. I respectfully disagree. I would like to see psychiatry abolished as a profession. If I thought I had a problem with my brain, I’d seek the counsel of a brain expert, a neurologist. If I thought my problem were physical, I’d seek my general practitioner’s counsel. If I felt that my problem were emotional in nature, I’d seek the counsel of friends, family, clergy, or in a worst case scenario, I might even go to a psychologist. I believe that pretty much covers the gamut of potential difficulty. So, that leaves psychiatry as a redundancy that’s completely useless except as causing many of the worlds problems and working as pill pushing shills of the drug companies. To claim that there are a few who don’t let their overblown ego get in the way of doing meaningful work is like claiming that there were a few good people in a Nazi uniform so we should forgive all associated with that hated symbol.

    I’m really disappointed that this forum turned, first of all, into a pop psychology type of read and now it’s providing a forum for “good” psychiatrists to find haven and solace from critique. Unfortunately, I deal every day with the fallout of too many who believed they were “good” because that’s all their ego would admit. Please stop defending your profession and go seek an honest field of endeavor. If you don’t want to waste your education, go on into neurology and help people from that lofty perch.

    Sorry if I’m bitter but I trusted the profession and they got ten years of my life. When I stood up and questioned and challenged, I recovered and escaped the clutches of psychiatry but, it was too late and the damage had been done. I’ve experienced the damage of over ten years worth of psychiatric drugs as they weakened my heart. I have now survived five heart attacks and I’m dying of congestive heart failure. It will kill me but, not today. I was lead down a merry path by the psychiatric profession and will die for swallowing their pills and their hermeneutic attitudes. I didn’t hear a single good reason for this profession to continue to exist for another day.

  8. Medical doctors?
    Why do we need to have *doctors* addressing emotional distress?

    Aren’t there counselor, therapists who can do that?
    Some (including myself) would argue that clergy, peers, friends have a huge role to play.
    As does community involvement, and many other*real life* ‘therapies’.

    But medical doctors?

    I can see their role in looking for underlying causes of what is mis-labeled as “mental illness”:

    http://psychoticdisorders.wordpress.com/bmj-best-practice-assessment-of-psychosis/

    But psychiatrists are not needed to do so.
    In fact, their bias toward “mental illnesses” only causes more harm than good.

    The *overwhelming* majority of psychiatrists are *utterly* useless, IMO.
    Especially in dealing with severe emotional distress.
    Or a very *real* underlying medical condition.

    They don’t have the training that many others have.
    It’s much safer to seek help elsewhere.

    We make this stuff so complicated.
    It’s not.

    Duane

    • We talk quite a bit about forced treatment on this site.

      I think that any psychiatrist who locks someone up or prescribes psychiatric drugs by force, without *first* ruling out such things as: traumatic brain injury; use of illicit drugs; prescription, otc drug interaction; sleep deprivation, and others… as a bare minimum, should be taken to civil court, where the person harmed can take away their vacation property, luxury automobiles, jewelry, and empty their bank account of expendable income.

      That outta put a stop to a lot of this stuff. I guess that makes me ‘critical’ of psychiatry.

      Duane

  9. I believe that the future of psychiatry is a feature in history textbooks. Children will learn about it as a historical aberration, an oddity, along with human sacrifice, witch hunting, slavery and women not having the right to vote.

    Eventually people will have to have the concept of mental illness explained to them as a concept that primitive people used for a social purpose. Eventually it might even be forgotten about completely. Christianity only survives or survived in tact for 2000 years because the bible was written in a language people couldn’t understand for 1400 yrs. Ideas that are junk are going to be discarded by society at large much much faster from now on.

    Critical psychiatry is really just part of the death rattle of psychiatry…. a rattle that will only get louder…. the edifice is weaker than it looks.

    • Poetic Justice !!
      Very well ARTICULATED 🙂

      ALL of the comments I have read to this point address the error in Dr. Bracken’s premise:

      “… I maintain that a good deal of psychiatry as practised now is helpful and that many psychiatrists manage to play a positive and therapeutic role in the lives of their patients.”

      and explain the error in his conclusion:

      “I believe that psychiatry has a future.”

      Dr Bracken’s views are interesting and his philosophy refreshing, but am curious as to how he could fail to call for indictments against psychiatry after giving such a comprehensive account of his profession’s *crisis*.

      What do you call a scam that yields obscene profits and harms it’s ‘victims’??

      Yes, we know there never was any real science, much less medical knowledge to give credence to the current psychiatric paradigm –of **care**. So, before we proceed to envisioning a future for psychiatry, I think we need to prosecute the crimes psychiatrist’s have committed, seeking restitution from corrupted MDs and pharmaceutical company tycoons– equally 🙂

      Then we have the funds to support the myriad activities that nourish our souls.

      Justice goes a long way toward reviving the hopes of humanity.

  10. Dr. Bracken,
    A wise friend once described Pat Bracken to me as “fantastic, the very ideal of a psychiatrist.” 😉 I agree!
    Thank you so much for the great work you are doing, especially in exhorting other psychiatrists to recognize the shortcomings (and I would add, the grave dangers,) of biopsychiatric reductionism. Bravo, sir!
    I hope you will continue to promote the message that “the neurobiological project in psychiatry finds its limit in the simple and often repeated fact: MENTAL DISORDERS ARE PROBLEMS OF PERSONS, NOT OF BRAINS.” Not everyone will embrace your message, of course, but some will. Courage!
    Thanks again for all you do.
    By the way, I LOVED the Picasso analogy. Nicely done!

  11. Dr.Bracken,

    Thank you for the thoughtful paper presented.Unfortunately, it can be construed by many (including myself) as promoting what you are attempting to debunk.

    As a practicing clinical psychiatrist who has taught neuroscience for over 20 years, is a trained psychoanalyst, has seen thousands of patients,and is a defendant of those who ridicule the field-I find your paper to be yet another that moves us and patients-nowhere.

    The paper is to my thinking, yet another fancy form of pseudoscience.Nothing more, or less.I believe your intentions are good, but significantly misdirected.

    Until there is a model of the brain/mind, nobody has the right to say which is the right direction.It could be do nothing at times like Lacan, or a lobotomy or insulin shock.The point of science is to remove mythology.This paper does the reverse:it dresses it up.

    Focus on meaning,values,relationships? Lets do what Einstein called a thinking experiment.Remove biology from the brain-and which of those three remain? None.Problems of persons ,not brains.Repeat the same experiment.As is in the worst of neuroscience, your paper ends with-words, not solutions.As Freud wrote in his “Project”-until his and others theories stand the scrutiny of science,they are just concepts at best, and mythology at worst.

    I suggest after you have read 15000 or so papers in neuroscience, and have mastered the concepts proffered (unlikely)which cares less about whether someone gets pills or talk therapy, then you reconsider what you wrote.My patients and students thank me because I do not discuss hermeneutics with them, but rather we have about how the brain works, how dualism is destructive, and what sort of things we can to to improve peoples lives.

    That said, while strongly disagreeing with your perspective as backward looking, I appreciate the heart and effort put forth.

    Dr.Goldstien

    • Dr Goldstein,

      The blockbuster neuroscience discovery of the trauma reactive brain response– and the underpinnings of cognitive development pretty much blew away the best explanations psychiatrist’s were offering for the signs/symptoms of mental and emotional duress.

      The trauma reactive brain response explains ALL signs/symptoms that have been categorized as mental illness and the major thought disorders.

      Anxiety and sleep deprivation are the greatest impediments to cognitive function, causing misinterpretation of sensory input– and the ‘delusional narrative’ that is labeled, psychosis.

      In the more than 10 years that I have devoted to professional development in alternative and complementary therapies– ALL considered interventions for “trauma informed care”, I have become convinced, via the success rate of these interventions as opposed to ANY form of psychiatric treatment, that ‘improving people’s lives’ is ONLY possible thru the application of these modalities. Why? Because the human connection that exists in this form of therapy, the education that is imparted in this venue is empowering and affirming of the inherent power we each posses to heal ourselves and each other.

      I like that cool PET scans and solid neuroscience back up the experience– that something REAL is happening and changing within the brain– BUT the translation of this knowledge into practice is a creative, artistic expression of human potential, not likely to be taught in medical school.

      I love the validation I feel from the neuroscience discoveries in both cognitive development and anxiety/trauma responses– We don’t live in a society that accepts and appreciates a positive treatment outcome that does not have a ‘science’ stamp of approval.

      AND..

      We don’t live in a society that promotes and supports alternative and complimentary medicine as viable options for the average health care consumer, who cannot pay out of pocket for what her health insurance will not cover.

      YET– since neuroscience has contributed solid evidence for NON- medical therapies to improve people’s lives– why aren’t neuroscientists leading the way toward adopting the holistic model ?

      WHO knows better than you, how futile and potentially harmful ALL current psychiatric treatment actually is??

  12. Dr. Bracken,

    “A reductionist approach to art appreciation would involve the unlikely idea we could reach the meaning of a painting through the chemical analysis of the various pigments involved.” This is a wonderful parallel to the awe inspiring lack of logic and insight of today’s reductionist psychiatric approach. As a fine artist, with an Artist Interrupted story, I greatly appreciate the creative analogy. I hope you don’t mind if I quote you.

    I absolutely agree mainstream psychiatry today is stuck in the completely materialistic modern level of consciousness, and do hope they can transcend to the post modern level of consciousness, and even graduate to the intuitive level of consciousness some day soon, too. As a woman who moved from the modern level of consciousness to the post modern level in 1992 or so. Then had the misfortune of being subjected to the modernist psychiatric industry in 2001, I must confess I found psychiatry to be so incredibly backwards, it was impossible to even communicate with those within that, IMHO, insanely disrespectful and delusional industry. I’m glad at least some psychiatrists are starting to wake up and evolve. Welcome.

    As to a hermeneutic shift in psychiatry, it strikes me that’s the societal function psychology is already supposedly filling. Although, as a person who ended up suffering from “psychosis” and “voices” from the psychiatric drugs, I will say the story resulting from these terrifying side and withdrawal effects did end up making logical sense in my life. The drug induced “voices” were the “voices” of the people whose lies (documented in my medical records) to a psychologist were used to get me misdiagnosed and drugged initially. And since my drug withdrawal induced “psychosis” actually took the form of an awakening to the story of my dreams, and as it turns out the inspiration for my artwork comes from the story of my dreams. Living through that “manic psychosis” did allow me to understand the meaning behind work I had done decades earlier, which is a good thing. But my point is that when a person suffers from “psychosis” or “voices,” these are completely relevant to the life of person. Ignoring them is absurd, ignorant, and apathetic.

    I enjoyed reading all the intelligent and well thought out comments of others, as well.

    • Oh, one more comment. I am grateful for your article recommending that forced treatment rights be taken away from the psychiatric industry. In my case, I was put on psych drugs because my PCP was paranoid of a malpractice suit due to the fact her husband had been the “attending physician” at a “bad fix” on orthopedic surgery. And an ex-pastor wanted to cover up the medical evidence of the sexual abuse of my child. My subsequent pastor was kind enough to confess that psychiatry has always been in the business of covering up sexual abuse of children and easily recognized iatrogenesis – he called this the “dirty little secret of the two original educated professions.”

      My point, however, is that there is no question whatsoever in my mind that the psychiatric industry absolutely does abuse their right to force treat people, and for appallingly unethical reasons. And one does largely lose all respect for, and trust in, the medical industry when one is subjected to forced treatment because of this “dirty little secret” of the medical community and paternalistic religions.

  13. Jonah,

    I have two very specific reasons for disregarding your well articulated aversion to Dr. Healy.

    1.) I have read– cover to cover– 3 of Dr. Healy’s books : “Mania”- history of Bipolar disorder; “Let Them Eat Prozac” and “Pharmageddon”. Theses are the best sources of information and historical background for mental health professionals who actually notice how much worse the outcomes have become SINCE the advent of the ‘magic bullet’ biomedical model for psychiatry.

    2) I have been working exclusively on inpatient. acute- child/adolescent, young adult, and older adult units for over 20 years. My proximity to ECT has been limited to the testimony of adult patients who seek it–and request it — either first time, or repeat ECT — I have never encountered the patient who claimed to be ‘damaged’, but have witnessed improvements in severely depressed and distressed patients who requested ECT. I have had no exposure to any sort of coercive/forced ECT on anyone. While I do not discount the experiences that have led many to be adamantly opposed to ECT, I cannot find cause to vilify Dr. Healy for supporting the use of ECT, as he has never promoted forced ECT– . I also see nothing to validate the accusations by Dr. Breggin et al, who suggest that Dr. Healy is ‘attacking pharmaceutical companies’ as a means to garner more patients for ECT; that his motivation is financial gain. This is beyond absurd to me.

    I appreciate your not attacking me, personally, or negating any valid points I may have made because I shared what I respect and admire about Dr. Healy. He is taking to task the key players who are indisputably destroying the lives of innocent, vulnerable people. I see no other psychiatrist who has the credentials, courage and tenacity that Dr. Healy has focused on what most commenters on MIA agree is the biggest threat to our ‘very lives’. I certainly have no intention of dedicating any of my time and energy toward finding a reason to vilify him.

    Based on all I have learned from developing my practice and providing therapies that alleviate suffering and empower people, I would never refer anyone to a psychiatrist, much less seek one out for my own issues. 🙂

    Respectfully,
    Sinead

    • Sinead,

      Thank you very much for clearly articulated comment reply. Imo, you and I are basically in agreement about much of what we’re discussing, especially as you say, at last, “I would never refer anyone to a psychiatrist, much less seek one out for my own issues.” However, it’s true that you (and I, too) will, at times, refer certain individuals to certain writings of certain psychiatrists…

      In fact, I don’t fault you at all for your recommending those books by Healy, which you’ve found so useful for the way in which they confirm your observations as a professional; you should recommend them, as they are illuminating, in your view. And, I want to emphasize this (before going further): The sense I get from reading your comments (including your comment on October 4, 2014 at 3:30 pm, to Dr Goldstein), is that you are surely doing your clients immense good, in your ways of working with them. In fact, I suspect you do enormous good in your work.

      Only, we do disagree about Healy’s ultimate legacy — particularly when it comes to the effects of his being a ‘schock-doc’; and (to be perfectly frank), from what you’re saying, I think you are uninformed about the true nature of ECT.

      From what you’re saying, I gather you’ve not ever been exposed to anyone who, to your knowledge, has spoken of being harmed by ECT.

      Yet, I presume you must realize, there are many people who say that they’ve been seriously harmed by ECT. (Surely, you must realize that’s true, I image.)

      (Actually, I am aware that you’ve spoken with one victim of forced ECT — at least, via comments on this website; but, from what you’re saying, I conclude you never discussed his experiences of ECT with him.)

      Also, you may or may not realize: there are quite a few individuals who’ve committed suicide not long after receiving ECT; I can think of a couple of them who were well-known ‘celebrities’ in the world of literature. They may or may not have complained of ECT’s effects, but (I believe, without a doubt) the effects of ECT do, at times, drive psychiatric “patients” to committing suicide.

      But, on the other hand, many people have been positively helped (even ‘saved’) by ECT, according to their own reports.

      This is what makes the procedure so controversial, that: there are such mixed reviews.

      Many say they’ve been greatly helped by ECT, but many people who’ve received ECT feel they’ve been harmed terribly by it, and I deeply believe many have indeed been harmed by it, quite…

      By this point, I myself have only had conversations with a relatively small number of such individuals, and their personal stories, of having been harmed by ECT, are, to my mind, entirely convincing.

      ECT-providers (‘shock-docs’) are, generally speaking, notorious for flatly denying the existence of any such harm.

      Healy is one such a doctor.

      In Healy’s view, it is psychopharmacology alone that can and does often wind up causing considerable harm to “patients” of psychiatry. (However, note: Healy finds some applications of psychopharmacology to be quite useful — and does sometimes recommend its forced application.)

      I think Healy’s calls for genuinely careful/minimal/judicious use of psychopharmacology should not to be dismissed (they are valuable recommendation, because they are harm-reducing recommendations) except at the point that he’ll recommend involuntarily received (i.e., forced) applications…

      All of psychiatry’s forced use of psychopharmacology is wrong. (I am totally opposed to any and all forced brain ‘treatments’ that are ‘prescribed’ for so-called “mental illness.”)

      And, I believe Healy’s pat denials of the harms caused by ECT (whether it’s conscious or unconscious denial, I really don’t know) are inexcusable.

      There is no doubt in my mind about this: harms that ECT (not infrequently) causes can be personally devastating…

      Indeed, all the more devastating for those who are harmed by ECT, is this fact, that ECT providers will not acknowledge it ECT can cause harm…

      This denial on the part of ECT providers leads countless vulnerable souls to accept the recommendation that they should receive ECT.

      Afterward, if/when they feel harmed by it, they find themselves in a no-man’s-land, haunted by a deep sense of being personally damaged… and enduring the experience of being rebuffed by their doctors, once they complain about such effects; to be left with a long-enduring sense of having been ‘taken’ is then virtually guaranteed.

      ECT providers (such as Healy) are uniform in their responses to claims of harm being done by ECT; once that very real harm that can be done by ECT becomes an issue, they become defensive if not ‘just’ stone-faced.

      So, yes…

      Healy’s standard line, to those who insist they’ve been damaged by ECT, is that (here I paraphrase): there are no negative/lasting effects of modern-day ECT treatments; any seemingly negative effects will pass after six weeks’ time, and any other negative effects that (to the “patient”) seem to last longer, are not really ECT effects.

      Consistently, Healy insists that such “patients” are mis-attributing enduring effects of harm that was actually done by psychopharmacology, to ECT. (And, of course, ostensibly, he’s referring there to drug ‘treatment’ that “patients” had been prescribed by previous doctors… who were not properly versed in how to judiciously prescribe ‘meds’ as is he.)

      I’ve seen Healy engage in such automatically defensive conversations online.

      Frankly, because Healy is so totally dedicated to denying the cause and effect relationships that potentially discomfiting ECT “patients” report to him (here I’m referring to causes and effect regarding how they’ve, indeed, quite likely been harmed by ECT), I do not find Healy to be a credible researcher.

      He accepts countless complaints about psychopharmacology effects, as valid — but invalidates complaints about ECT effects (most especially, long-term ECT effects).

      More than anything, its that aspect of his professional practices, which leads me to compare him to Pat Bracken in a way that is quite unfavorable. (I.e., in my way of comparing the two, Bracken is the better man and the more efficacious professional, by far. Of course, being that I don’t know either of these men personally, I can’t claim to be any kind of ‘ultimate judge’ of their work, but…)

      My sense from what little I do know of them, through my exposure to their writings and talks online, is that Bracken, as a psychiatric ‘therapist’ …will always be superior to Healy, because Bracken (as far as can tell from reading his writings) is the rare psychiatrist who will be genuinely careful to listen to his “patients” — and will not dismiss the observations of his “patients” to defend his own interests and positions.

      I strongly suggest taking time to carefully study the offerings at both of the following two links:

      “Book Review: Shock Therapy by David Healy, Edward Shorter (and Max Fink)”
      http://www.ect.org/?p=796

      “Linda Andre’s New Book, “Doctors of Deception: What They Don’t Want You to Know About Shock Treatment,” Just Out From Rutgers University Press!”
      http://www.ect.org/?p=803

      That first link offers a very thorough analysis of Healy and Shorter’s book on the history of ECT, which I mentioned in my first comment to you, above. (I have read most of that book, and I think it’s a disgrace, as it is such a one-sided take — pro-ECT all the way.)

      That 2nd link refers to a book that is widely considered excellent, by survivors of bad ECT experiences. As you have never exposed yourself to anyone who (to your knowledge) had a bad experience with ECT, I strongly recommend your taking some time to read carefully through the comments of that 2nd link.

      Again, Sinead, thanks much for your very clear reply.

      Respectfully,

      Jonah

      • Jonah,

        I am not advocating for ANY *psychiatric treatment*. I am on the same page with the ONE victim of forced ECT that you somehow know I have talked to —

        I had the good fortune to meet and hang out with this amazing individual this past Spring. I learned so much from him– hope that if he is reading this he won’t mind my sharing that I refer to him as either my ‘big’ or ‘little’ brother– depending on who seems to be winning the argument 🙂 But it is never ECT we are arguing about. I think it is barbaric, inhumane. So, yes, I know one victim of forced ECT and have had ONE opportunity to strongly oppose it as a ‘treatment’. Just once.
        A young man in his 30’s on an inpatient unit told me he was considering ECT, since ‘nothing had helped him’. My lecture/ response to him– against ECT was longer than your post – He said he was desperate, then asked me if I thought he looked like someone afraid to take risks. So– I pulled the following response outta nowhere– as I was feeling desperate, too.

        I asked him:” Would you wrap your head in tin foil and sit out on your roof during a thunderstorm?”
        He laughed. “Of course not– that’s stupid,”
        “And that’s my best argument against ECT. It’s THAT stupid” , resting my case.
        That intervention happened years before I encountered MIA and the anti-ECT testimonials and references to web sites, books, articles.

        I think that being against ECT is a natural response, but there are many medical and surgical treatments that make me queasy, or cringe. I would never undergo chemo therapy, for instance. I actually believe that I understand why IT is stupid. Traditional Chinese medicine, acupuncture/herbs, Qi-gong, aromatherapy, nutrition– (paleo is the way to go), Reiki—– etc. are ways to stimulate our own healing response– they are peaceful therapies that honor the spiritual aspect of our mysterious natures–. I think we are spiritual, not mechanical beings.

        BUT– my comments on this post were directed at the topic raised by the author, Dr. Pat Bracken, a ‘critical psychiatrist’– who believes psychiatry has a future.

        I see your points about the therapeutic value in Dr. Bracken’s approach to ‘patients’. BUT, I am not pitting him against Dr. Healy on therapeutic technique, wit, wisdom or even humor (they are both Irishmen)– as I am determined to illustrate that the ONLY issue facing *psychiatry* is the bogus bag of BS that PsychiaTRISTS have let slide — and continue to side step– even as CHILDREN are dying from the adverse effects of drugs that have NEVER been proven to be SAFE, much less , therapeutic. Very few psychiatrist’s are raising the significance of this issue– while some psychiatrist(s) will roll out their own take on the NEXT new frontier for psychiatry. Pleez– clean up THIS mess before you take out any more toys. [is what I’m driving at]

        I have zero tolerance for medical doctors, especially psychiatrists themselves, ignoring the carnage of the last NEW frontier. And strictly speaking it is incumbent upon every single psychiatrist who is currently seeing patients to address this very crucial matter.
        WHY??
        [because] It’s their freaking job to care that there is NO science and no reliable ‘clinical trial data’ to support what they cannot seem to STOP doing to children, adolescents, young adults and even the elderly!! Cradle to the grave — morphing into pre-natal–in-utero — from the moment of conception—

        EVEN the psychiatrist’s who are boldly going where psychiatry may have been long ago– listening to patients and actually engaging them; even the warm fuzzy psychiatrist’s have a DUTY– to address the life threatening *paradigm* that is currently called, biomedical psychiatry. Morality and ethics go with the license.

        Dr. David Healy’s career is on the chopping block again for his brazen outspoken criticism of HIS OWN PROFESSION ! Rest assured he is currently not seeing patients or ordering ECT– and hopefully, he isn’t planning to wrap his head in tin foil and sit atop his roof in a thunderstorm–

        [because] WE NEED HIM !
        He has all the ammunition.
        He knows where ‘all the duck babies are buried” (line from the movie, “The House of Yes”/ Parker Posey).
        He is an expert- psychopharmacology and data medicine, a brilliant medical historian–
        AND HE HAS THE GUTS TO CHALLENGE THE BIG TIME CRIMINALS.

        So-, Jonah, I’m okay if you want to- refer everyone in the UK to Dr. Bracken– BUT, please consider what is at stake for everyone not lucky enough to choose their ‘poison’.

        Warm regards,
        Sinead

        • Sinead,

          Thanks much for your further response.

          I sincerely appreciate your sharing those recollections of having talked that ‘patient’ out of accepting ECT; it’s a wonderful story, which strongly suggests you’ve long felt (rightly) that ECT is potentially quite dangerous.

          But, about your saying “I am on the same page with the ONE victim of forced ECT that you somehow know I have talked to,” …I’m scratching my head.

          I don’t get why you say that, Sinead.

          After all, there should be no sense of mystery about how I know this, as I already told you: “I am aware that you’ve spoken with one victim of forced ECT — at least, via comments on this website.”

          Of course, that simply meant, I can recall seeing your exchange of comments under his blog post, in late December, as I was also posting comments on that page too, at that time. (In fact, I recall you’d offered some very informative comments in regards to issues surrounding the topic of that post.)

          You describe yourself as being on the same page as that MIA blogger…

          However, I can’t help but wonder: are you really entirely on the same page with him when it comes to ECT generally? …because he’s worked to abolish its use in California; and, meanwhile, you say “I think that being against ECT is a natural response, but there are many medical and surgical treatments that make me queasy, or cringe…”

          Maybe I’m misinterpreting you, but your saying that suggests to my mind that you are probably not on the same page with ECT abolitionists. (Note: I do count myself amongst such folk, as I believe ECT is such an ultimately dangerous crap shoot, no one should be licensed to administer it.)

          And, frankly, I don’t get your wild (shouting, all-caps) enthusiasm for Healy and your insistence that he’s an indispensable ally.

          To me, as far as his professional practices go (from what I can tell, by way of my online study of them): but for the fact that he enjoys jousting with Big Pharma and its minion, he seems a fairly conventional psychiatrist, in most ways.

          He’s a fairly classic, modern ‘biopsychiatrist’ — promoting his own genetic theories of “mental illness” …whilst believing “schizophrenia” is a perfectly legitimate/valid diagnosis (a real disease) that shall inevitably require periods of psychiatric drugging as well as shal, in some instances, positively call for electro-shock/ECT.

          (He also suggests drugs and/or ECT for ‘mania’.)

          All the while, he paints himself as a long-suffering “heretic,” opposed to Big Pharma; and, he is one, certainly, as compared to psychiatrists who never question Big Pharma; but, he paints himself the Lone Ranger (battling Big Pharma), even as he’s standing on the shoulders of those who came before him (e.g., Peter Breggin).

          After reading this last comment of yours, I watched Healy speaking in the video he posted on his latest MIA blog post, and I think it’s sad; he’s appearing there a bit of a shambles, way overplaying his ‘victim’ card.

          (To one extent or another, he’s been doing that for years. I suppose he gains sympathy from his fans that way?)

          To the extent that he really is a heretic, he’s not the ultimate heretic amongst psychiatrists — not at all. Breggin is far more ‘heretic’ than Healy… being that Breggin began his fight with Big Pharma long before Healy (of course, being that Healy is younger than Breggin, that’s not Healy’s fault), and, more to the point: Breggin altogether opposes the use of psych ‘meds’ and totally opposes ECT and encourages the complete rejection of psych labeling to boot!

          (Probably, it goes without saying, Szasz was the ultimate ‘heretic’ amongst psychiatrists — because he was the first psychiatrist to completely reject the medical model, and he totally opposed psychiatric coercion.)

          Finally, you indicate that Healy’s no longer ordering ECT, and I don’t know why you say that… (Have you any documentation, in those regards, or is that speculation? maybe wishful thinking?)

          Surely, your heart is in the right place, Sinead, that’s more than obvious, as it seems to me that you know ECT should be abolished, but you’re painting Healy as some kind of Savior nonetheless, because you view him a Giant in the fight against Big Pharma; I don’t view him as such; indeed, I view him as a perp of classic psychiatric abuse (note: you say, at last “please consider what is at stake for everyone not lucky enough to choose their ‘poison’” so, again, I point out: Healy argues that forced psychiatric drugging is, at times, necessary).

          I think Bracken is moving in the right direction (and I think you do not realize, he is far and away less of a ‘biopsychiatrist’ than is Healy); Healy supports and upholds the medical model (Bracken not so much); and, Bracken is, for my money, a far better communicator.

          But, that’s just my personal opinion.

          I have carefully read both of his papers that are posted above. The first one reflects a pipe dream, I think; the second one is more compelling.

          But, please understand: Bracken is no hero, in my view, nor is any other psychiatrist — i.e., not Breggin (who once was a hero in my eyes) nor even Szasz.

          It seems to me you are indicating that Healy is a hero in your eyes? (I could be wrong about that, I may be misinterpreting your final, all-caps expressions, but if he is a hero of yours, that’s fine, go with it…

          From the unmistakeable passion of your expressions, with respect to your concerns regarding the tragic impact of psych ‘meds’ on our society, I do feel your heart is in exactly the right place, and however you view Healy is fine with me.

          I was just addressing you (in my first comment to you) with a mind to hopefully elevate the ‘moral’ status of Bracken, in your eyes somewhat (and, indeed, elevate him over Healy), because, much as I do agree with your concerns, my own first concerns regard use of coercion and force, in the ‘treatment’ of so-called “mental patients”; and, yes, I find it a travesty that Healy, a psychiatrist who makes it a point to solicit and to consider as quite legitimate countless complaints about ‘med’ effects, is someone who refuses to acknowledge any and all complaints that lasting damage is being caused by his own ‘treatment’ specialty, ECT.

          I will let this convo rest now… fully respecting your right to view Healy and his contributions to this movement however you wish.

          Be Well Always…

          Respectfully,

          Jonah

          • Jonah–

            So far as I know, the MIA blogger that I have met face to face– is NOT currently focused on getting ECT banned. My saying I am on the same page as this really amazing guy ,was re: our shared revulsion for ECT.

            Am commenting in detail on David Healy’s blog– realize you probably are not aware of the latest in his series of his exposing what is rotten in Denmark — just happens to be spot on with my latest adventures — and why I commented about his practice being ‘on hold’ right now. Check it out if you like– will not take up space here on more ‘off topic’ commentary–

            I think that when psychiatrists start taking seriously the ludicrous standing they actually have in the medical profession– and when it is common public knowledge that they need to ALL be de-frocked, so to speak– ECT will be assigned it’s rightful place in the history books–

            I am talking big picture– while you are focused on details– we aren’t even having the same conversation—

            I take some issue with the inferences you make about my assessment skills –

            we aren’t sitting in the same place, you know.–?

            Makes sense we might be standing for different issues—-

            I stand on my own practice– not looking for heroes or banners to wave. After spending 40 years in nursing- my whole adult life- I trust my judgement and instincts regarding credible sources of valuable information.

            Will leave this comment thread reiterating my only reason for joining the discussion.

            Unless psychiatrists are engaged in holding their peers/colleagues accountable for the standards ALL doctors are expected to have BEFORE tinkering with our lives– and charging outrageous fees– THEN, the future of psychiatry [and ECT] are moot points!

            Ciao!
            Sinead

          • Right. Doctors of other medical specialties work really hard to keep people from having seizures since they say that said seizures are harmful to the individual’s brain.

            But then you have the specialty of psychiatry that believes that they have the right to INDUCE seizures in the brains of people labeled as “mentally ill” or severely “depressed” or whatever.

            Makes a whole lot of sense, doesn’t it? But they get away with it because people who are supposedly “mentally ill” don’t count so it’s okay to do barbaric things to them that they wouldn’t be able to get away with concerning any other group of people. I also find it interesting that ect has always been given more to women than to men. Wonder what’s going on there?

    • I am almost struck dumb with amazement at what I am reading in some of these posts.
      Yes, psychiatry is dangerous. Yes, trauma underpins many mental illnesses and thought disorders. Yes, alternative and complementary therapies are more successful than ANY form of psychiatric “treatment”.
      However, to say you have “witnessed” so-called “improvements” in people “requesting” ECT and have had “no exposure to any sort of coercive/enforced ECT” stuns me. Perhaps you need to read Bonnie Burstow’s article on “Problematizing the Problematic” which discusses why “consent” to ECT is not possible, ever. Since the “real” risks do not appear on the “informed” consent ( brain damage, reduced IQ, emotional blunting, severe emotional trauma, inability to learn new info, loss of years of memories, obliteration of a sense of self, identity) no one can truly consent.
      How many clueless doctors and nurses mistake giddiness and euphoria (signs of brain damage) as “improvements”?? How many look at the vacant, stunned victim of this assault who seems to be crying less, bitching and complaining less, and think:” hm, his frontal lobes are so damaged he cannot articulate what is distressing him or the brain injury has made him momentarily “forget”‘?? Lots of insight there. AND the addled patient won’t really become aware of the losses, gaps, deficits, till a few weeks later at home, as brain damage marginally heals.
      So, kudos to Healy for being the hero exposing the dangers of psychiatric drugs and taking to task those who would injure and harm the weak and vulnerable??
      Hypocrite. I have read his promotions of ECT, have watched video of him placing blame on the “drugs” causing ECT damage and memory loss. Defensive of his baby, his “penicillin”. The scientific journal articles and survivor testimonies pile up, but he is sticking his fingers in his ears, lending credibility to a bogus “medical treatment” that is, in my opinion, at least as if not more dangerous and damaging than neurotoxic drug “treatment”.
      So, he doesn’t deserve to be “vilified” ? So he can “support” brain damaging ECT (usually practiced on vulnerable women, young and old) AS LONG as he doesn’t
      PROMOTE “forced” ECT??? Seriously?? So, this man, who has clout, high visibility, and the admiration of many uncritical individuals, is, through his statements encouraging and perpetuating the myth of ECT as useful and as such influencing the decision-making of sick people and their families seeking “cures”. And that is acceptable? So, I guess it follows that you would not vilify him for “supporting” lobotomies that cause brain damage AS LONG as he wasn’t promoting “forced” lobotomies. It would be fine for him to support “baseball bats to the head” as long as they weren’t “forced” and the patient had signed up for them?

      All the exhaustive work Healy has done in revealing the dangers of psychiatric drugs and practices is negated by his deafening silence regarding the damage inflicted by ECT, and his trumpeting of this human rights abuse/assault as a “treatment”. This means he has zero credibility as a doctor, a researcher, and a human being as far as I am concerned.

      Yes, I am that harsh. If you refuse to do the right and moral thing, you are lacking in morality and decency and contributing to the destruction of the lives of the vulnerable and innocent. He is driving the train and he KNOWS it is going to Auschwitz/ brain damage central.

  14. Dear Dr Bracken
    My experience is that the Talking Treatments work very well for ‘Severe Diagnoses’, and that its the Psychiatric drugs that cause ‘The Long Term Mental Illness’ (through withdrawal syndromes).

    I ended up in a Psychiatric Unit about 30 years ago following an unsucessful attempt to withdraw from long acting depot medication. The medication had been causing disabling side effects , and I was dependant on state disability benefit for the years that I consumed this drug.

    While I was in the ‘Unit’ I got talking to a psychologist. He told me that everybody in there could make complete Recovery with the help of psychology, and without psychiatric drugs.

    I did eventually withdraw from the depot injection, through careful tapering with oral medication. I was able to come off State disability benefit because of this, and return to gainful employment. The Talking Treatments helped me to identify how my anxiety process worked; and how to do something about it. I have remained well since.

    On my first contact with Psychiatry I had refused medication and asked for Psychotherapy. But I was not allowed this option and injected with strong drugs instead. This was at World Renowned Psychiatric Research Hospital – The Maudsley, London.

  15. What I like about Pat Bracken is that he challenges conventional psychiatry from within the institution. We need allies within the institutions.

    But I think what he is offering people in distress could be offered by other professions: counsellors, social workers, psychologists etc etc.

  16. Gratitude for all the thoughtful and philosophically / intellectually clear, nuanced, tensioned (dialectically reflective) comments and arguments provided by many commenters.

    Most (of us, survivors) keep a clear focus in asking: What is this psychiatric medical expertise that now calls for neo-graecist hermeneutics? What is this new disguise psychiatrists use to position themselves as experts in making meaning of an individuals distress, magically, ehm, hermeneutically re-inserted in social (con)texts so that it needs ‘medically trained’ psychiatric experts to bring hermeneutics higher knowledge to the poor(ly) educated ‘distressed or confused”patient’.

    ‘Our patients’, that what this is about. Make us uneducated sods believe in another magic of medically enhanced ‘art of interpretation’ to help the wildly agitated or confused, suffering mentally ill. The ‘introuvable’ ‘mental illness’, the trick that provides the power to all the oppressive psy systems dogmatic and treatment abuse – now elevated to patriarchical hermeneutics like with the christian missionaries?

    Would they refer to Socratic dialogues, very subversive and dialectic, of a man who did not elevate himself about the youth he was dialoging and co-thinking with, what a danger in the consequences in taking an equal standpoint with one’s partners in dialogue. Ah, but mental patients, they are to confused, to disturbed, they need hermeneutical guidance. Do they?

    Weren’t there the Our Bounty project where SMI labelled people were most apt at chatting with and listening to their equals, most being homeless people – to the huge surprise of the mh professionals these people were most humanely street smart and soci_able in social groups specific and nuanced lives’ rites and realities (academically purified to con-texts).

    Also, I assume, they were in no need of ‘hermeneutics from sophisticated doctors’ who could not make sense of daily realities as marks of the odeurs and ritualistic, very clever talk of people living in abject poverty in the streets. I much prefer social street workers and peers to ‘walk the walk’, know the ironies in seeming atrocies, who daily partake in the accentuated philosophy and silences of those in abject, oppressed or otherwise abused social-margin situations.

    The academic psychiatric beauty talk, needing little understandable philosophical references as authoratative footnotes, seems an exercise of well meaning, nevertheless ‘distant, directive, discursive’ manoevre.

    Not a single reference to the collective endeavours of lived, negotiated, warmhearted, inspired meetings of survivor peers, the wisdom of Deegan’s journey of a heartless heart, the radical democratic stance and collective practice of Judi Chamberlin’s On Our Own, the writings of a small German group of people with experience of extremely widened mindworlds who support each other without no professional intervention, the diverse, kind, intelligent and holistic practices in the West Mass Rec Learning Community, the importance of wamth, humour, heart and everyday practical support as reported from several African survivor organisations, the absolutely honest works of Shery Mead to claim back our extreme feelings, thoughts and troubles from the debilitating and alienating discurse of medical psychiatry, and many many many more.

    So that we stay patients in need of the dubious expertise of hermeneutically, verbosity affluent, necessary medically trained doctors who want to maintain psychiatry – even when abandoning the powerful concepts of diagnoses and mental illnessess and their myth of neurological causation. So that they keep the authoritarian power over the oppressed , now sophistically as well as biochemically controlled ‘poor patients’.

    Ethical and epistemological honesty, practical and social honesty – as a consequence of the interplay of moral, cultural, economic, social and intra-group oppressions and abuses found with people in extreme reactions to unbearable challenges and injustices – would lead to a clear standpoint: medical psychiatry and its harmful treatments were wrong.

    Who did ask for hermeneutically enhanced post-inquisition for a more sopisticated control of witches and perverse homosexuals, who did ask for post-colonialism build on the disappropriation of indigeneous people’s properties, lands, cultures, rights – the oppressors who were the winners and power holders.

    Why should psychiatric survivors wish to allie themselves with the maintainance of expertise of distant and rational academic doctors and their glass-class-castle philosophies and now ‘hermeneutics’ propaganda – lacking real critical engagement and the humble courage of fighting for better rights and opportunities together, hand in hand, with the abused, abjected and patientized.

    Hoping for new perspectives from survivors and some real allies – as Jan Wallcraft and Kim Hoppers to be published work on capabilities as rights and social practices. Knowing there are courageous survivor advocates, activists, researchers, educators, film makers and allies who engage in learning, supporting, working together in the midst of shameless and crying inustices and violent abuses of all sorts, unafraid of being engaged in social movements – because in reality there are no contexts, there are multi over- and multi-empowered social groups, practices, values and missions of liberation from and fight against inustices.

    Hermeneutics are artificial and bougeois intellectial exercises of the past two centuries, dominated and academically entertained by male and totally unengaged, individualistic philosophers and writers in their peer reviewed contexts.

    P&H – None of our, survivors and trustworthy, equality practising allies, critically engaged work, morally positioned in the oppressed patientized sub-classes, but hopefully more and more rich of warmhearted and tensioned solidarity to empower an ongoing ‘patient liberation movement’ from psychiatric oppression, social abjection, societal and moral injustices. To advocate for better housing, better education, healing from abuse and oppression with peers who have been there (and somehow do not need hermeneutics), to advocate for a glocally respected diversity of equalities and capabilities.

  17. Hi! My name is Mylene, and I have some thoughts I’d like to express about what I’ve read thus far of the article by Dr. Bracken. I didn’t read the whole article, basically just the introduction, because I have an issue with concentrating on extensive reading materials. I read some comments, also.

    I do think that the profession of psychiatry is still necessary so that psychiatrists, who have the training and knowledge, to help people withdraw safely from psyciatric medication, can do so. Part of the reason I haven’t is the complicated process of “tapering off”. I’m on all prescribed meds now, and have been for over 15 years and I just don’t have the ability to do it by myself. It seems to me that in today’s world, if all the people suddenly realized that we made big mistakes in our treatment of the mentally ill, myself included in the latter, that we would still need trained professionals to clean up the mess the psychiatric profession has made. At least that would be an extremely helpful and valuable service to me in my life.

    Also, Dr. Bracken made a good point about the somatic differences associated with so-called “‘abnormal’ mental states/conditions” (not the words he used) and how a profession which has both medical and psychological training could be beneficial to those who are affected by somatic symptoms, as well as psychological/mental symptoms.

    They could also be helpful in re-educating the public by exposing themselves for what they have been, perpetually deceiving and lying the public and sometimes themselves and each other about the pharmaceuticals they push on us, while telling us we need lots of drugs in order to live a “more normal life and function in society”. They could be part of the process of our healing and journey toward health and worldly fulfillment rather than what they have been, which for now is still part our problems.

    I don’t think this society is anywhere near making even that much of a breakthrough in its mental attitude towards the mentally ill; and changes of this nature don’t seem to happen instantaneously, to say the least. Social changes are notoriously slow, from what I understand. Although the times are changing, there are still too many conservative politicians, conservative voters, and too deeply and extremely conservative of both types to be dead set on a world of no psychiatrists to happen at the snap of a finger. Right now is what it is, we are not even close to that, and I have great respect for anyone who wants to bring positive change closer to this current reality.

    I would also like to add that I don’t care what exists as long as no one is forced to be subjected to it. However, knowing what I know now is possible for psyciatry to have ac tuallly become, and the ignorance so prevalent in so–called “free” society, I would prefer to be forcibly subjected to kindness than cruelty, if I was only given those two choices with regard to my “treatment”. I want to think that Our Story is inching closer to freedom for all rather than extinction for all. Unfortunately, I think those are the only two options at this time.

    I’ve been rambling, but in conclusion I’m going to say that Dr. Bracken seems to be working to bring people closer to freedom rather than to certain destruction, and I felt motivated to respond basically more to some of the comments than the article itself.

  18. Dr. Bracken, bravo for entering the MIA den of lions! But:-

    “However, interpretation and ‘making sense’ of the personal struggles of our patients are to psychiatry what operating skills and techniques are to the surgeon.”

    Not quite, since such interpretation and sense-making are skills possessed in varying degree by most people much of the time, and which predate psychiatry by thousands of years. Like ALL people, I often make, accept, trust and act on interpretations of my and other’s personal struggles. But I’ve never performed surgery on anyone and when I needed kidney surgery a decade ago the only person willing to do it was a urologist, for some reason…

    More seriously, may I suggest your vocation and experience as a therapist are more vital than your training as a psychiatrist. I do value the profession of psychology. And I do think psychiatry can be useful to the extent that it combines psychology and medicine, as mind and body ARE obviously related, a fact denied by dogmatists (some on MIA) who often hate the ENTIRE medical profession. But a combination of psychology and the law, or psychology and accountancy, or psychology and sociology, etc, could be just as useful.

    Incidentally, if the tub were full of ELECTRIC eels, was that how ECT was invented?