Say What?  Understanding That What We Say—and How We Say It—Changes Lives


In 1963, Lyman Wynne and Margaret Singer introduced the concept of communication deviance (CD) to describe fragmented patterns of interaction that were characterized by vagueness, interrupting, lack of closure, and irrelevant comments.  CD frequently occurs when actions, words, and nonverbal cues regularly contradict each other and are not conducive to direct, clear communication.  As the decades persisted, research increasingly indicated that youth who grew up in families where CD is the norm are more likely to exhibit later psychiatric problems, especially schizophrenic symptoms.  Much of the research also indicated that patterns of CD are largely stable, persisting over time and in different situations.

Around a decade prior, a psychiatrist by the name of Theodore Lidz published a book entitled Schizophrenia and the Family.  Unlike many others of his time, he believed that schizophrenic symptoms were not necessarily the result of an underlying disease, but could be caused by dysfunctional parental behavior.  He noted that significant conflict and high levels of tension were not necessarily the cause of symptoms; in certain families, a pattern of “skewed” communication existed in which odd, often unhealthy patterns of interaction and behaviors were allowed and even supported by one spouse, which resulted in a confusing, distorted environment for the children.

As the findings regarding CD emerged, so did a similar vein of research looking at expressed emotion (EE).  Individuals and families that are high in EE frequently use hostile and critical means in giving feedback, and parents often become emotionally overinvolved in even minor matters.  In combination with CD, it is found that high EE was also associated with worse outcomes in children, especially in the area of psychotic conditions.

All of us as parents engage in these patterns to a certain degree.  We are not always clear and direct with what we say.  Our actions do not always reflect the words we use and gestures we display.  We get angry as sometimes we should.  We yell when it is probably least effective, and interrupt when answers might not be far away.  So as we enter into this discussion, it is critical to understand that the topic I am broaching is not meant as a condemnation of our imperfect nature as parents, but a conscientious examination of how patterns of communication in our homes make such a difference.

Let’s begin with a simple point of reflection.  Think back (and currently) to the ways in which your parents interacted.  As a young child growing up, most of us found ourselves discerning just how we would say and do things when we had kids, and often specifically how we would go about things differently.  My father was (is) a tremendous parent.  But I remember distinctly growing up and thinking that one day when I have children, I wouldn’t walk in from work and yell at them for their shoes being out in the foyer because there were a lot of other things I (he) should be positive about.  You will have to ask my kids how well I am holding to that promise today.

Yet regardless of the promises we may make, we will find that many of the ways that our parents communicated do in fact find their way into our homes decades later.  Generations after generations often speak in much the same ways.  Sometimes it works well; sometimes it does not, especially if the household remains such a tense, confusing place to be.  Again, all of us as parents have a right to be angry at times, and none of us ever remain perfectly clear and consistent.  But if this becomes the mode of operation, then it behooves us to consider whether a change is in order, and just how this can occur.  Otherwise, there is a good likelihood that you will hear your children repeatedly say things to your grandchildren that in your acquired wisdom will make you cringe.

This issue also becomes particularly critical in romantic relationships and marriages.  As I previously wrote in my Partner Bill of Rights (see July 2014), every person in a relationship is deserving of communication that does not undermine, disrespect, invalidate, or otherwise disparage him or her in a devaluing way.  If you truly believe in the Golden Rule, then you inherently believe this.  Just as our children will most likely learn parenting from us first, so they will also learn how to treat their partner, too.  And if being deviant with our communication, and repeatedly hostile and critical is the norm, expect that it very likely will become the standard operating procedure in the next household to follow.  

In taking this a step further, consider how CD and EE relate to what John Gottman calls the “Four Horseman” of marriage, which he considers to be the biggest threat to a couple’s happiness and commitment.  The first horseman is criticism, which should be differentiated from a complaint.  A complaint occurs when a partner voices displeasure with something that has occurred, and almost always begins with an “I” (e.g., “I was frustrated last night when you didn’t clean up while I put the kids to bed like we agreed”).  A criticism (often beginning with a “you”) occurs when a person is purposefully degraded or demeaned (e.g., “You are so disorganized”).  A second horseman is defensiveness, which is not only characterized by a lack of acknowledgement when wrong has occurred, but also a direct attempt to criticize the other partner as a means of reactive blaming.  The third is stonewalling, which is basically characterized by verbal and nonverbal disengagement, or “shutting down.”  This occurs when someone diverts their attention to a mobile device, book, or simply leaves the area when a criticism or complaint is given.  The final horseman (and considered to be the most detrimental) is contempt, which occurs when a partner displays disgust about the other person.  This may occur in the form of eye-rolling, biting sarcasm, mockery, name-calling, or harsh humor.

Again, at any given time, we might find ourselves falling prey to some or all of these horsemen.  But when they become a pattern, the underlying framework speaks of CD and EE.  Instead of directly taking on the issues at hand, these harmful patterns of communication serve to increase the level of emotion, deflect true responsibility, reduce chances of really working through a problem, and ultimately sabotage true opportunities for growth.  Then, the worst part happens.  Our kids watch this unveil itself, and don’t have the brainpower and/or life experience to realize that this is not how it is supposed to be, especially when formation can most occur.  For all that we directly say and do for our kids, I am increasingly convinced that what probably matters just as much is what we say and do around our kids.

If all of this is true, it brings us back to a realization that is not necessarily an easy one, but potentially a hopeful one.  It begins with specific questions, some of which may look like these.  What would I have to do to scream and criticize less? What would I have to do to communicate more clearly and honestly?  What would I have to do to be more positive? What would I have to do to admit when I am wrong or contradicting? The questions might seem infinite, and the answers might seem elusive, but they really all involve a few time-honored principles and behaviors, of which a partial list of suggestions was presented in my series Turning Distress into Joy (see October 2014).   What we all definitely need to make even a little progress (remembering that any progress is still progress) is a meaningful goal, endurance, support, time, and faith.  As parents, we spend years of our lives shuttling kids to practices and events, organizing memorable experiences, and providing for the educational needs.  But just how much time do we really carve out in the daily task of improving ourselves and counteracting negative patterns, which in the end might make more of a difference than anything else?

A few weeks ago, I sat down with a married couple.  The husband had grown up where CD and EE were the norm.  It wasn’t until he got married, and he and his wife ventured into the world of parenthood that he realized just how awful the communication had been.  For years, their marriage strained at the seams as he and his wife struggled with the unwelcomed reality carried over from his youth, and the continued reality of the in-laws that were.  But as the years evolved, and he begun to see that things could be much different, and much better, his focus gradually changed.  He set forth on the rocky, vulnerable road of self-improvement, and it had been (and in some ways, still was) rough even as much had improved.  But as I looked at them as they held hands, and they talked with great hope and passion about their son, I could not help but think how much I admired him (and her) for the journey that they had undertaken.  That for all the astounding things that people do in this world, and all the public accolades that people receive, I am becoming convinced that one of the most amazing, impactful things that occur can be in the ways we choose to speak, when we set forth to change the wrong that has been for the right that lies within.      


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Really interesting and insightful, James. Having just celebrated 30 years being with my partner, I can personally vouch for all the passages we go through in order to have a meeting of the minds and hearts for the purpose of achieving unity and cohesion. That’s hard work!

    What’s most interesting to me is how we do carry over what we learned in our families, and when people come together, internalized family cultures come together. Whether they merge harmoniously or discordant is going to depend on how willing each person is to own vs. project the discomfort of those differences. Personally, I think that’s really valuable awareness which can make or break a relationships and communities.

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  2. I agree with much of what you say, and would like to point out that it nicely describes some of the problems with psychiatry. Some, and it now seems many, psychiatric / psychological practitioners criticize and defame their patients to their families (“You are bipolar”). When the person disagrees, and says she’s certain the problem has to do with adverse reactions to drugs prescribed by her doctor (not one of my doctors knew a synthetic opioid or a “safe smoking cessation med” / antidepressant could cause odd thoughts), the psychiatrist gets defensive, blames everything other than the pharmacutical drugs, and claims the person has no “insight into their illness.” Then the psychiatrist stonewalls by massively tranquilizing and poisoning the person, in my case by creating psychosis via anticholinergic intoxication syndrome. And this, of course, results in contempt for the psychiatric industry. I hope some day the psychiatric and medical industry will stop covering up their easily recognized iatrogenesis and child abuse for the religions in this way, it’s wrong.

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      • B, I choose not to use the word psychopath to describe a person. First of all, I’m not a “doctor.” Secondly, “psychopath” is just another harmful diagnosis like the rest. There are people who commit crimes and those that tend not to. There are those wrongly accused and those whose lives are ruined because of a very petty crime or one done in youth. I feel the same about “sex offender.” They are the tiny percentage that got caught. Just like my particular “crime” was going to see a therapist many years ago.

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  3. Good article James. You see these types of perceptions and misperceptions expressed through speech and carried over through “transference” (of feelings about parents toward new partners or relationships) all the time. Transference is a basic concept of psychoanalytic/psychodynamic thinking. The negative forms often get expressed in the contentious discussions between psychiatry and antipsychiatry forces on this and other sites. I am sure I do it myself some of the time; in fact, I can see that I do afterwards, but I cannot control it at the time! But I’m trying to do better.

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      • I was thinking very generally about how contempt and inability to see the other side’s viewpoint sometimes creates polarization of viewpoints into extreme pro or anti-psychiatry positions.

        On the other hand psychiatrists’ lies about pseudo diagnoses and neuroleptics to treat them really do suck, and at a certain point there is no negotiating with the blind, ignorant idiots who repeat those lies… just like there’s no negotiating with the blind, ignorant maniacs in ISIS or North Korea.

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        • I’m wondering what you would consider an “extreme anti-psychiatry position,” and also how you would know that said position might be – because of transference – created from an inability to understand a pro-psychiatry point of view, as opposed to, say, a person’s lived experience of abuse by psychiatry and/or the fact that psychiatry is an illegitimate medical specialty.

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          • Ok, a few examples of extreme anti-psychiatry positions would be:
            1) Medication is always harmful and should never be used.
            2) Psychiatrists are malevolent sociopaths who want to harm patients.
            3) The DSM should be abolished.

            I mostly agree with statement #1 – usually medications do end up doing harm, and they should very rarely be used. But occasionally they can be useful under very brief, controlled, monitored use. In practical terms though, we’d be much better off if no medication were ever used compared to the flood of medication used today.

            As for statement #2, a few psychiatrists are monsters. A much larger number are ignorant, ineffectual, well-intended quacks who understand very little about how to help a person psychodynamically / relationally. This majority ends up doing much harm through communication of the false disease model and through foisting heavy meds on their clients. And lastly there are another minority of better psychiatrists who do mainly psychotherapy and rarely medicate. Some of them are on this site. In reality, these groups are part of a spectrum.

            I don’t think #3 is so extreme 🙂 I strongly advocate the abolition of the DSM and the destruction of all the fake diagnoses contained therein.

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          • BPD —
            You have a somewhat incomplete understanding of what anti-psychiatry means. Some of these misunderstandings are deliberately fostered by the other side. To wit:

            #1 As has been discussed before, “medication” is neither good nor bad; it is, as relates to psychiatry, non-existent. There may be infinite chemicals that alter the brain’s function, but since there is no disease involved except, at best, on a metaphorical level, none of these chemicals can be considered medications. Whether they “should” be used, given that at the current time they are being manufactured, is an individual choice, as with cocaine. But none of this has anything to do with medicine.

            #2 The anti-psychiatry movement is against the fraudulent “profession” of psychiatry, not individuals who practice it. Some of them may be malevolent monsters. No doubt some podiatrists are too. But what we are primarily fighting is the mindset which allows for mass mystification to embrace the idea that there can literally be “mental” diseases which can be treated by physicians, and the myriad abuses which spring from acceptance of such illogic. Incidentally, sociopathy is a form of “mental illness,” so of course we don’t consider evil shrinks to be sociopaths — that would absolve them of responsibility for their actions.

            #3 Why did you list abolishing the DSM as “extreme” then refute yourself?? Anyway, the DSM is a list of non-existent “mental” diseases; why would abolishing it be any more extreme than consigning to history, say, the Malleus Malificarum?

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          • Hi Oldhead,
            Thanks for this explanation. I have not read a lot about anti-psychiatry per se, so you are right that my understanding may be incomplete. I basically agree with everything you said/explained, however.

            I still feel that identifying as “anti” psychiatry is not something I want to make my primary identity, even if I do share its beliefs. I want something positive that conceptualizes life problems in terms of relationships/emotional development/environmental causes. I don’t know if there is a label for that.

            As for #3, that was my attempt at a joke, but it doesn’t come over well on an internet forum.

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          • For a person who believes in depriving mental patients of their liberty, it is certainly not too extreme a position for you to take when it comes to supporting other forms of therapeutic state sanctioned violence. Among the state sanctioned violence you support, hey, why not have a field day supporting and promoting widespread chemical lobotomies, psychiatric oppression, the “mental illness” brainwashing that goes along with it, and the propagation of fictitious diseases. It is all of a piece that goes together, isn’t it?

            I, on the other hand, think it is very important to recognize the humanity of human beings, even those human beings the mass of humanity would throw away. We have a word for this recognition, rights. Human, civil and legal, and sometimes even unwritten, rights. Rights are a thing patients who aren’t recognized as human beings don’t have. If I remember correctly, among those rights are the right to life, liberty, and the pursuit of happiness (or, sometimes, property). Also, there is the little matter of equality, something you don’t get if people are to be deprived of those rights.

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  4. I like the way you spelled out the different types of miscommunication. I came from a good family, not a perfect one but what family is? Shrinkage annihilated my family, eroded it down to arguments over money, and distrust. So I ended up designated scapegoat. Someone else, you are right on about the way so many shrinks communicate and others working in facilities. I’ve been subject to jeering, finger-pointing (“You are a liar!” the doctor said, pointing his finger. “Liar!” he said, over and over), walking out on me before I finish a sentence, eye-rolling, pretending they don’t hear, constantly looking at pager, cell phone, or watch, taking casual calls on time I paid for, saying, “are you finished now?” when I just started two words ago, denial “We can’t see your Tardive Dyskinesia, so it must not exist.” ….”You claim you gained over 100 pounds on that pill? Why don’t you just accept your weight and live like that?” “It doesn’t matter. Your quality of life is poor so why do you need to live those extra 25 years?” “It doesn’t matter that there was a death in your family last week. How are your meds doing? That’s far more important.” “I don’t believe you even have a college degree. You are delusional and incapable of college.” The worst was the eye-rolling I’d say, or verbal manifestations of it.

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  5. BPDTrans, I am thinking we need to get away from the idea that we are in camps based on just how anti we are. It divides us. We all want change. And we all come from different backgrounds, different experiences, different human qualities, different abilities and different strengths and weaknesses. A lot of criticism that I hear personally is the negative overtone of anti. I believe that since I am a writer, I can improve and use more positive language. Changing one’s language changes the way one thinks. For instance, “If we can’t stop shock, thousands of lives will be ruined.” Or, more positively but saying the same thing, “Imagine if we could stop shock, it would save so many people.” I have found that if I try to change my language more toward the positive, actually rather consciously at first, people aren’t so turned off. I can say the exact same stuff, make the same pro-human rights statement without sounding condemning. I think this would help my ability to make and keep friends as well.

    I also feel that we need to set a good example for those still in the System and those “questioning.” That is, to live well and show that we are stronger now without shrinkage. At the same time, every human out there, whether labeled or not, is a “work in progress.” A few days ago, I vowed to speak slower. Oddly, I usually spoke at a slow to moderate pace and never rushed. Suddenly, all that changed and I speak so fast some cannot follow me. Many find it annoying. I learned that this is from trauma and it’s a common sign.

    I can work directly on the trauma, which is probably not wise if I do it alone, or I can do it backwards. I just figured this out a few days ago. My new theory. Tell me if it holds water: If I consciously and deliberately speak slower. and any time I find myself speaking too rapidly, stop myself, this discipline will in fact work backwards. The body’s habit to be on alert (which apparently is in one’s endocrine system) will in fact relax.

    I had a theory a couple of years ago that the same would work for eating disorders. I’ve never even developed this one. Many people I met in treatment spoke at barely a whisper. In fact, it was somewhat annoying but I tried to be polite. I realized later on that if only I could encourage a person to speak louder, at a more audible volume, the person might gain more confidence. That’s backwards from the thinking that one should have endless hours of therapy and then the whispering will stop.

    I once took voice lessons from one of the most amazing voice teachers ever, Frank Baker. I was so lucky to have known Frank. He would help his students discover the potential they already had. He also worked backwards, as I described. For that reason, I saw rank beginners who had never sung a note suddenly fill the room with sound.

    The Movement is getting larger in terms of numbers of people, which is why we bicker. My thinking on that is that we need to split up. Not as enemies, but working side by side. So we could have the legal folks, maybe several differently focused legal groups, and artists, and performing artists, reformed shrinks, journalists, etc. Or some who wish to focus on a particular challenge particular to survivors, such as Tardive Dyskinesia. Or how we communicate, as in this article. I am thinking that smaller groups are easier to self-manage. Democracy isn’t possible with a group so large so many get swept aside in the flurry. Like an army has troops, which are more manageable, that all work together to fight for justice or independence or whatever.

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    • Thanks for sharing all of this and I largely agree. Your theory about speaking louder is probably correct.

      Although people might say that I am anti-psychiatry, I don’t identify as an anti psychiatry person. To do so would be giving psychiatry too much importance.

      I think of myself as pro-emotional wellbeing, pro-healing, and pro-conceptualizing-human distress-as-trauma/deprivation based. Also, I try to understand human development and emotional problems through my favorite paradigm, object relations / psychoanalytic-psychodynamic theory. For me, the focus on medications, diagnoses, and biological/genetic explanations of life problems is a waste of time. Too much time is spent refuting these dead, static myths rather than building newer more hopeful paradigms.

      Wherever possible people need to extricate themselves from and let go of the traditional psychiatry paradigm. Most healthy people don’t experience or conceptualize life through this reductionistic false ideology… it only has a strong hold over the unfortunate people who get stuck in the maze of diagnoses, medications, and brain illness lies, and the psychiatrists and allied mental health workers who profit from spreading these lies. Once you’re out of that world, in my opinion it’s not healthy to keep focusing on the “bad”, i.e. reductionist biological psychiatry.

      On the other hand I do continue to make myself refute psychiatrists and speak out strongly against ridiculous pseudo-diagnoses, overmedication, and biological-genetic reductionism… on this site and some others online. This is because I want people to see another strong voice of someone who once believed these lies but was able to free their mind. Many people labeled “borderline” or “schizophrenic” who believe in their “illnesses” are amazed to see people saying that most psychiatrists are ignorant quacks, that the diagnoses don’t represent real illnesses, that medications are unnecessary, that healing from problems mislabeled in this way is very possible, and so on. So it sets a good example to speak out strongly against the charlatans. I want others to think that they can think this way too.

      On the other hand, I sometimes get a bit jaded by it all. Fortunately, my day job has nothing to do with psychiatry and involves working with children in education in a very alive and engaging way. At one point, I had considered becoming a therapist, but I have now decided that I cannot do that. Psychiatry caused enough damage to me already and I do not want to become involved in the American system of mental health care provision where I would inevitably come into contact with brainwashed charlatans who cannot open their eyes and see beyond diagnoses and medications. So I’ve sadly decided that although my experience could be useful to others, I am not going to be able to work within the mental health system. I just want my life to be as free from psychiatry and its lies as possible going forward.

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    • Just as with antifascism, I have no problem being anti so long as that anti is antipsychiatry. I see that anti as a very positive thing all the way around. Psychiatry, in league with Big Pharma, kills, and on a daily basis, too. Reversing the damage done by psychiatry is a lot like reversing global warming. Colluding with the criminals behind this mess is not going to clean it up.

      The “mental health” propaganda would have folks believe that 1 in 4 people in the USA has a “mental illness”. Were we to have a mental patient majority in this country I don’t think that would represent a great improvement by any means. Of course, increasing the numbers of people psychiatrized would increase the numbers of people said to be in some kind of movement. Increasing the numbers of people who actively oppose psychiatry, whether as victims or as outside observers, now there you have a worthwhile goal to strive for.

      I still think the goal should be mental patients’ liberation, that is, liberation of people from the role of mental patient. As psychiatry doesn’t seem to support mental patients’ liberation, I feel I must oppose psychiatry. The artificial invalid movement, the “sickness” movement, the “mental illness” brainwashing movement, the “mental health service consumer” movement, just doesn’t appeal to me that much. I’d prefer to see people get out of the system, and away from the harm.

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    • The Movement is getting larger in terms of numbers of people, which is why we bicker. My thinking on that is that we need to split up. Not as enemies, but working side by side. So we could have the legal folks, maybe several differently focused legal groups, and artists, and performing artists, reformed shrinks, journalists, etc… I am thinking that smaller groups are easier to self-manage. Democracy isn’t possible with a group so large so many get swept aside in the flurry.

      I like a lot of what you say. I have mixed feelings about the above. I agree that smaller groups of people could work as task forces on different aspects of the struggle. At the same time we need some central coordination, and a manifesto which unites the various sub-strata of the movement under a basic set of positions and demands so we aren’t always arguing about this, and so we can’t be played off against one another.

      I am highly concerned that this process must take place democratically. This is why some of us pushed for the creation of the “Organizing” forum, i.e. so lots of anti-psych folks could participate in the creation of such a manifesto/position paper, rather than waiting for self-appointed “vanguard” groups to do this in our name. Unfortunately not enough people have joined in this, and I do believe that some may have felt driven away for not being “radical” enough, even though no one may have intended for them to react that way. At any rate, larger numbers of participants would hopefully create a scenario where people would feel comfortable participating no matter what form their anti-psychiatry sentiment currently takes. And we might eventually come up with a statement of unity that would leave us feeling empowered and proud of our contributions.

      The movement is growing in terms of passion and consciousness, but we have much further to go before we become the sort of movement that achieves concrete victories and real changes. But even if we are still mainly a movement in spirit, I agree that it is growing.

      BTW (to BPD) “anti-psychiatry” is no more “negative” than “anti-war.” And I think the reaction of the “MH” establishment to the term is indicative of its power.

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  6. Hi, I love what everyone has said. We are all saying the same thing so I am sitting here laughing. We are all different and we have different ways of expressing ourselves. I can only conclude that what we are expressing is TRUTH, not opinion. I know those still believing the lies of psychiatry often say, “That’s your opinion, which I respect but I disagree and think psychiatry is valid.” Then I have heard some go on and on criticizing me in a rather attacking manner, even online diagnosing me with various mental defects. Most likely, most psychiatrists did not, during their schooling, tell themselves, “I want to kill people and get away with it,” especially if they had not even started their psych rotation. Much as I am darned pissed at my own former psychiatrist, I remember when I started with her in 2001. She appeared to be about 16, and had a far more energetic and positive approach than she did 12 years later when she was threatening me in her office regularly. What changed? I can only imagine the dogma of psychiatry, with its money-driven lies and inconsistencies, eroded her innate moral sense. While I was a patient I believed those lies. To unbrainwash myself took incredible effort and I am still in that process. Can you imagine just how hard it could be to shake off the brainwashing if continuing to practice your own profession is dependent on your staying brainwashed?

    Having a turnaround of one’s whole belief system and realizing the truth is liberating on one hand, but it is no guarantee that the journey will be easy. One grieves losing the lies since they held all those false promises to which we once blindly clung. Our own degree of comfort with our life situation is now up to us, and no longer forced on us.

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  7. I personally believe all humans have three basic rights that are innate to being human. These are respect, dignity, and privacy. I see every person, regardless of citizenship or nationality, as being born with such rights. Privacy: I own my body. Dignity: Allow me to make my own decisions, whether I am perceived capable or not. Respect: Treat me age-appropriately and honor me as I am, a person who throughout life changes and grows. Honor my abilities and honor my flaws. I am credible, period. I am the only expert on my own experience.

    Applying common sense to these ideas leads to any other aspect of human rights. To respect a person means you honor their words. You don’t trespass on another’s body or property without permission. You don’t imprison nor enslave anyone, nor deceive, nor force, nor coerce (which is a form of deception), no steal, and you don’t infringe on the person’s right to obtain or seek out information, nor on a person’s efforts to educate and enlighten him/herself. Don’t negatively judge a person based on assumption or the word of another. Does that adequately deem psychiatry as almost totally inhumane?

    I say almost. The psychiatrist walks up to a suffering, tired, poor, hungry street boy and reaches out his hand. That sounds okay to me, the sliver of humanity left in the profession. After that, the shrink says, “You can trust me. I’m a psychiatrist.” There’s the first lie. After that, all downhill.

    So the poor, tired, hungry boy looks up, having heard a soft and melodious voice. The boy sees an impeccable beard, not one hair out of place, teeth that are worth thousands in dental maintenance. The boy smells perfectly applied aftershave oozing from this adult figure, whose shadow is now cast in such a way as to obstruct all surrounding light. The boy gazes into the eyes of this stranger, which are turned downward, pinpointed on the boy. The psychiatrist mutters the word “Bulls-eye.” Ten years later, the boy tells himself he should have known better.

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