“Understanding Psychosis and Schizophrenia” Report a “Cruel Hoax”?

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In Mind the Brain, psychologist James Coyne accuses the authors of the British Psychological Society’s “Understanding Psychosis and Schizophrenia” report of misrepresenting research. Coyne calls the report “a cruel hoax perpetrated against more typical severely disturbed mental health service users, their family, and policymakers.”

“Understanding Psychosis and Schizophrenia” and mental health service users (Mind the Brain, PLOS Blogs, February 26, 2015)

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16 COMMENTS

  1. I think the most significant statement in this article is the sentence wherein the authors talk about the “most significant stakeholders.” I notice that the clients/victims of psychiatry are not on this list.

    But the authors have no hesitation in claiming to speak for these very people, that include me.

    I think this is the essence of articles like this. E. Fuller Torrey does this as well.

      • “exploiting service users, pitting more highly functioning ones against those who are functioning less well and their families who have to deal with them when they cannot take care of themselves.”
        That one is also lovely. You see, we are now against people who are not “well functioning” as we do. Nice putting words into our mouths.

    • Yeah. We are the crazies who have to be treated like toddlers when it comes to decision making and like “terrorists” Guantanamo-style when it comes to personal liberty and dignity. I bet these are the same type of people who will then offer you some cake:

      https://www.madinamerica.com/2015/03/ways-lessen-violation-people-feel-psychiatric-hospitalizations/

      Are these people evil? Or how did they manage to get through school with that level of comprehension?

    • This one is also great:
      “A number reported difficulties deciding whether the “voices” that some veterans describe represented schizophrenia or vivid re-experiencing symptoms consistent with posttraumatic stress syndrome, for which exposure therapy is indicated.
      The authors of Understanding Psychosis express a clear disdain for making diagnostic distinctions. But, it is important for clinicians to decide about the nature of clients’ distress in order to decide how to treat it.”

      In other words: whether to give them an anti-psychotic for schizophrenia or give them the very same anti-psychotic for PTSD. Yeah, these are very crucial diagnostic decisions. How many people with so-called PTSD get exposure therapy? Plus 99% of all their so-called differential diagnoses are essentially PTSDs.

      • After my brief reactive psychosis(thank you), that was like a long waking night terror with the flashback memory of a decapitating Soviet strike and the horror of it in real time; I did some searches and found studies being done on combat veterans and victims of political torture living in asylum that addressed the possibility of PTSD with psychosis. Of course, ever clinging to the fairy tales of eugenic and fraudulent twin studies, they used combat veterans with PTSD and a diagnosis of a psychotic disorder as “controls” as if many or most of those veterans might not be suffering from PTSD-P and have been misdiagnosed with schizophrenia or bipolar disorder.

        That was very early in 2011. Now there are articles on PTSD-P all over the web on “reputable” medical sites, with no acknowledgement that this diagnosis is new. This general lack of acknowledgment ignores people who have been diagnosed with psychosis and PTSD erroneously before the category was created. Most professionals lack a sense of the history of their field necessary to put new developments into an historical context, no matter how recent the history, but psychiatry is, in my opinion, one of the worst offenders. This makes labels too permanent and gives the individual who diagnoses entirely too much power and influence in a person’s life, legally, socially, and personally.

        I think it takes a lot of energy and effort to make the fact that a person can experience such profound and unmanageable (if not ineffable) pain that they break down. It’s one of the most universal human realities I can think of, and it used to be understood by most people who suffer great and/or chronic stress. Yeah, I’m hanging by a thread too, and I hope I don’t break, take it easy, get well. is a healthy response to someone who has cracked. Hanging a label on them and telling them they are forever broken and ignoring the reality and value of their suffering after one psychotic episode or more than one in ten year intervals, or the like, is preposterous.

        The system needs to be changed to allow treatment and payment for treatment without binding labels.

      • The antipsychotics may help people suffering from psychosis.

        But the antipsychotics / neuroleptics also can cause psychosis in people who are not previously psychotic. From drugs.com:

        “… neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

        So giving the neuroleptics to soldiers to help them sleep, or for PTSD, or whatever else they’re being prescribed for these days is unwise.

        The neuroleptics do cause people who are inappropriately put on them to get “voices” and hallucinations and psychosis and all the other symptoms of schizophrenia.

        • From Dr Peter Gotzsche: “The fact that psychotropic drugs in the long run create the diseases they have a short-term effect on has been brought up again and again over the last 30– 40 years, but every time, no matter how strong the new evidence, leading psychiatrists have brushed it under the carpet”

  2. This is a most curious post by James Coyne, because it bears no relation to the facts of the report at all.
    Rather than excluding/silencing/marginalising/disrespecting service users/survivors, the report was co-authored with them.
    Rather than solely representing narrow clinical psychology self-interests, the report has been publically supported by several of the most senior psychiatrists in the UK, by the two leading UK Mental Health charities, and by many other professional, service user and carer representatives and many others. It is fortunate that these alleged narrow interests seem to coincide with theirs as well….!
    Rather than ignoring severe ‘psychosis’, the report draws from the expertise of several authors who have experienced, and documented, psychotic states at the far extremes of human suffering.
    Rather than being racist, the report argues that psychosis should be understood within its personal, relational, social, spiritual and cultural context….. as opposed to the medical model that Coyne supports, and the ample evidence of racism in theory and practice based on traditional concepts of ‘schizophrenia’.

    And so on and so on. I suspect the real threat comes from the report’s very reasonableness. It quite clearly isn’t imposing any simple or single model, and quite clearly has appeal across professional and service user groups. Even more threateningly, it argues strongly for a choice of models and interventions. By that it means a real choice: to use diagnosis and medication if that is found helpful, but also to choose non-medical understandings and interventions. Of course that is exactly what is NOT on offer at present, whatever the rhetoric about empowerment, and however damaging the evidence about the lack of support for diagnostic categories, the potential harm of medications and so on.
    The potent mixture of strong support accompanied by strong backlash indicates the importance of these issues…. and the threat that is posed by the report’s humane and evidence-based recommendations. We live in exciting times!

    • With respect, understanding psychosis within in personal, relational, social, spiritual and cultural context does not necessarily mean being non/anti-racist.

      But, more importantly, I am baffled why you, a co-author, would completely ignore the fact that the report failed entirely in engaging meaningfully with the “ample evidence of racism” you point out. Crucially, the process perpetuated institutional racism in the context of knowledge production by completely ignoring and excluding the expertise and knowledge within UK’s minority ethnic communities – professionals and user/survivors. These issues were pointed out in an open letter to the editor of the report and in articles on this website and in Mental Health Today.

      The editor and some of your colleagues have publicly acknowledged these shortcomings and issued an apology. Your own organisation is currently working out ways to remedy the racism inherent in the report with those of us who have raised the issue and been in conversation with your colleagues.

      Here is the ‘statement of apology’ issued by your colleagues, in case you have not seen it.

      Statement regarding the DCP’s report ‘Understanding Psychosis and Schizophrenia ’:
      The report ‘Understanding Psychosis and Schizophrenia’ has generally been very well received since its free publication. However, a number of people have expressed concern that it inadequately covered racism (both as a causal factor and in mental health services), that some of the language used in relation to race and mental health was dated and patronising and that black people were not represented in the author group.
      The editor and some of the authors recently met some of those who had voiced these criticisms in order to discuss the concerns. The points raised, outlined above were conceded fully by the authors present. We personally apologised for these serious significant oversights and undertook to work with those present to propose amendments to the relevant sections of the report. Those expressing concerns offered a constructive way forward whereby they offered to participate in this process, an offer which we gladly accepted. We feel that these constructive suggestions will make the report stronger and likely to be more helpful to people from black and minority ethnic backgrounds. We will we will strive to ensure that the lessons learned through this process are shared with the DCP and the BPS so professional psychologists will be enabled to more fully address the challenges of racism.
      Anne Cooke Editor
      David Harper Co-author
      Peter Kinderman Co-author
      David Pilgrim Co-author
      30th January 2015

      It would be more honest to acknowledge these faults rather than continuing to pretend they aren’t there.

  3. Looking past James Coyne’s aggressively sensationalist language (‘cruel hoax’), his contention that it is “more typical” for individuals who experience psychosis to be “severely disturbed” is quite shocking in it’s potential to stigmatise, but also shockingly incorrect. Referring to the UK’s Royal College of Psychiatrists online information* about schizophrenia for example, we see that:

    “Many people with schizophrenia now never have to go into hospital and are able to settle down, work and have lasting relationships. For every 5 people with schizophrenia:

    1 will get better within five years of their first obvious symptoms
    3 will get better, but will have times when they get worse again
    1 will have troublesome symptoms for long periods of time.”

    Similarly, referring to a recent ten-year follow-up study** of 557 individuals with psychosis, we see that:

    “Sustained periods of symptom remission are usual following first presentation to mental health services for psychosis, including for those with a non-affective disorder; almost half recover.”

    It is unclear why Coyne has chosen to ignore current understanding about recovery from psychosis or schizophrenia, but it is clearly unhelpful to those with these experiences that he has.

    * http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/schizophrenia.aspx
    ** http://www.kcl.ac.uk/ioppn/news/specialist-seminars/journal-club/2015-03-11-Reappraising-the-long-term.pdf

    • I’ve tried psychiatry (reluctantly at the time), and for me it didn’t work. But Psychology did provide good long term solutions.

      My Diagnosis and Prognosis at the end of my time with psychiatry were as bad as they could be.

      The psychologist that pointed me in the right direction told me that all sufferers could recover, and from my own experience, I can’t see why not.

  4. Instead of ignoring serious psychosis, that report draws from the knowledge of a couple of authors who have experienced, and documented, psychotic episodes at the far degrees of human agony. Instead of being racist, the report argues that psychosis should be understood within its personal, relational, social, spiritual and cultural context…as opposed to the medical model that Coyne supports, and the ample evidence of racism in theory and practice based on traditional concepts of ‘schizophrenia’.

    I’ve seen schizophrenics recover fully so recovery is definitely possible. Personally, I came across the mental health recovery writings of Will Jiang, who experienced the same. His autobiography, “A Schizophrenic Will: A Story of Madness, A Story of Hope” is quite inspriational, just as his book, “Guide to Natural Mental Health: Anxiety, Bipolar, Depression, Schizophrenia, and Digital Addiction: Nutrition and Complementary Therapies”. I found his author page located at http://www.mentalhealthbooks.net And, as it turns out, he’s a seasoned designer who didnt let his condition take away everything he loved to do. I believe this is his web design firm where he earns his living from: http://www.newyorkwebdesign.nyc 80% of schizophrenics are unemployed and it is quite hard to believe that this man suffered from schizophrenia.

    • I don’t go in for “schizophrenia” myself, because it lays claim to a sinister illness. In my experience what works for anxiety also works for “schizophrenia”.

      I had my work cut out for me with this, as when I withdrew from “anti psychotics” I had to deal with the super sensitivity syndrome,
      and I still say it’s about anxiety.

      And for me, medication is not medication it’s tranquilliser (though unpleasant at that).

      IMO “Schizophrenia” is a means of hijacking a young and vulnerable person and stealing off them.

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