Psychiatry and the Pressure to Prescribe

Philip Hickey, PhD
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Hugh Middleton, MD, posted an interesting article on Mad in America on October 1, 2015 called Hey; Don’t Just Shoot the Messenger!   Dr. Middleton is a British psychiatrist who  is a founding member of the Critical Psychiatry Network, and was a co-author of the cardinal paper, Psychiatry beyond the current paradigm. (2012).

Dr. Middleton had attended a conference in London on September 18.  The conference had been organized by the Council for Evidence-based Psychiatry in order to address the topic “The iatrogenic harm caused by the over-prescription of psychiatric medications.”

Dr. Middleton’s paper is essentially his thoughts and reflections on this conference, and he raises some very fundamental points and questions which, in my view, warrant further discussion.  It is not particularly my intention to criticize Dr. Middleton’s paper, but rather to expand on some of the points he has made, and to supply some answers to the questions he has asked.  Here are some quotes from the article, interspersed with my comments and observations.

“Working as a psychiatrist exposes me to people who want medication as much as it does to those who don’t. We can question why and how those who want medication have come to that position, but it is commonly difficult to shift and the result is frequently a prescription with the advice ‘OK. If you want to find out whether meds can help, try this and see how you get on.’  Hardly expert knowledge or advice, but when it happens, most usually it is a response to a situation that would otherwise result in a request for another opinion and another doctor providing the prescription instead.”

I think it is indeed true that many people go to psychiatrists specifically to get drugs.  This is because it is widely known that psychiatrists will prescribe psychiatric drugs readily.  In fact, since about 1980 or so, they really don’t do much of anything else.

Dr. Middleton’s contention that this drug-seeking position is difficult to shift is probably true, but is not the primary issue because in reality most psychiatrists don’t try to challenge or shift that position.  For most psychiatrists, a “patient” returning at regular intervals for “med-checks” and refills is the ideal scenario. Within the psychiatric community, there is, I think, a great deal more concern expressed about non-compliant “patients” than there is about those who adhere faithfully to the prescription and keep coming back for more.

In addition, defending the practice of over-prescribing on the grounds that refusal will simply drive the client to seek his drugs elsewhere strikes me as indefensible.  Essentially it amounts to:  “I must do something that’s ethically and professionally questionable, because if I don’t, somebody else will.”

. . . . .

“Many of the distressing stories we heard at Roehampton were of people who had tried one antidepressant after another in the hope of relief … where was the belief that somehow, somewhere there is a pill that can safely and reliably relieve their distress coming from?”

Actually, it is psychiatry’s standard message, and has been for about the past 30 years:  we’ll try different medications, or combinations of medications, until we find the one that’s right for you: the one that corrects the chemical imbalance in your brain.

In this regard, here are two quotes:  the first from the APA, and the second from the Mayo Clinic:

“Medication: Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, ‘uppers’ or tranquilizers. They are not habit-forming. Generally antidepressant medications have no stimulating effect on people not experiencing depression.

Antidepressants may produce some improvement within the first week or two of use. Full benefits may not be seen for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist can alter the dose of the medication or add or substitute another antidepressant.”  APA What is Depression 2015

“Medication strategies:

If you’ve already tried an antidepressant and it didn’t work, don’t lose hope. You and your doctor simply may not have found the right dose, medication or combination of medications that works for you. Here are some medication options that your doctor may discuss with you:

Give your current medications more time. Antidepressants and other medications for depression typically take four to eight weeks to become fully effective and for side effects to ease up. For some people, it takes even longer.

Increase your dose. Because people respond to medications differently, you may benefit from a higher dose of medication than is usually prescribed. Ask your doctor whether this is an option for you — don’t change your dose on your own.

Switch antidepressants. For a number of people, the first antidepressant tried isn’t effective. You may need to try several before you find one that works for you.

Add another type of antidepressant. Your doctor may prescribe two different classes of antidepressants at the same time. That way they’ll affect a wider range of brain chemicals linked to mood. These chemicals are neurotransmitters that include dopamine, serotonin and norepinephrine.

Add a medication generally used for another condition. Your doctor may prescribe a medication that’s generally used for another mental or physical health disorder, along with an antidepressant. This approach, known as augmentation, may include antipsychotics, mood stabilizers (lithium or anti-seizure medications), anti-anxiety medications, thyroid hormone, beta blockers, stimulants or other drugs.” Mayo Clinic: Depression (major depressive disorder): Treatment-resistant depression 2015

. . . . .

Back to Dr. Middleton’s paper: 

“What was the person who went to the doctor because they were distressed by difficult circumstances actually looking for? They were having difficulty sleeping. The doctor might have prescribed a benzodiazepine sleeping pill, but we are all quite rightly very wary of benzodiazepines, and an SSRI is the more commonly used alternative. This is not because there is confidence it will work, but because that is all the doctor can do under such circumstances, and a prescription is frequently received as a symbolic token of concern and acknowledgment of the recipient’s difficulties.”

Actually, that is very emphatically not all that a physician can do under these circumstances.  A physician in these circumstances can (and, I suggest, should) conduct an examination to determine if the sleeplessness might be the result of an actual illness.  If, in the unlikely event that a genuine pathology is identified, the physician should either treat that pathology, or refer the patient to someone who can. But if no pathology is found, which would almost always be the case, the physician should inform the client that his sleeplessness is not a medical matter, and is therefore outside the scope of a physician’s practice.  The physician might also provide the person with a list of potentially helpful community resources.  Such a list might contain psychiatric survivor groups, life coaches, gymnasiums, nutritionists, counselors, etc…

Dr. Middleton’s contention that “…a prescription is frequently received as a symbolic token of concern and acknowledgment of the recipient’s difficulties” is probably true in some cases, but it is also somewhat condescending and patronizing and does not constitute a justification for the prescribing of drugs that Dr. Middleton himself concedes are  “…of such dubious value…”, and that entail  “…so obvious a set of adverse effects…”

. . . . . . . . . . . . . . . . 

“I am sure practitioners reading this will recognise the cycle and the deeper and deeper holes they and their clientele can get into as it goes round and round, but what starts it? Why did that person go to the doctor when they were distressed by difficult circumstances?”

Here again, I think the answer to Dr. Middleton’s questions are clear.  Why do people consult psychiatrists when they are distressed by difficult circumstances?  Because for the past forty years psychiatry, ably abetted by the pharmaceutical industry, has used every opportunity and every means at their disposal to promote the hoax that distress (regardless of its source) constitutes an illness!  Since DSM-III (1980), any “…clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is typically associated with…a painful symptom (distress)…” (DSM-III, p 6) is an illness, and psychiatry has incorporated this medical travesty into its daily business without any indication of compunction or misgiving.

Dr. Middleton goes on to ask:

“How can our institutions mark and respond to the fact that someone might have become overwhelmed and incapacitated by life’s challenges without having to identify them as ‘ill’?”

And here again, the answer is clear.  Our social, political, and community institutions cannot respond effectively and appropriately to individuals experiencing distress until the medical hoax has been exposed and ousted.  And the greatest obstacle to this exposure and ousting is psychiatry itself, whose response to the recent waves of criticism has been ever deeper entrenchment and ever more vehement insistence that their concepts are valid, and that their “treatments” are safe and efficacious.

No substantive progress is possible in the direction advocated by Dr. Middleton until psychiatry’s hoax is universally discredited and abandoned.

. . . . .

At this point Dr. Middleton moves, with enormous professional courage, to an even more fundamental issue:

“Put very bluntly, a lot of psychiatric prescriptions are issued (not only to detained patients) because a negotiation has been conducted between the prescriber, the patient and the patient’s associates resulting in ‘agreement’ that the patient should take something to quieten them down.”

Note that Dr. Middleton has not written that the individuals should take something to “treat their illnesses” or to “medicate their psychoses.”  The phrase he used is:  “to quieten them down.”  And in this regard, I think he is being entirely accurate and candid.

But his accuracy and candor inevitably compel us to ask, and indeed Dr. Middleton himself asks, a very important question: why do we need to maintain the pretense that the individual has an illness, and that psychiatrists are the medical specialists who treat this illness, just to quieten someone down?  And we also need to address the entailed question:  why is it that the people whom psychiatry “quietens down,” are denied the rights and due process that have become an integral aspect of “quietening people down” in non-psychiatric contexts?

And here again, the answers are clear:  because psychiatry self-servingly and strenuously resists changes to the status quo in this area, and, at least here in the US, is avidly promoting legislation to expand its power, influence, and scope.

And, of course, the truly important question:  is this person, whom psychiatry deems to be in need of quietening down, actually expressing a genuine and important grievance in the only way that he or she knows how? never even gets asked.  Psychiatry, with its routine dismissal of people’s concerns as symptoms of illnesses, is the very epitome of disrespect.

The status quo is not the result of some blind or random historical processes.  Rather, it is the direct product of psychiatry’s insatiable lust for prestige and recognition, harnessed to pharma’s equally insatiable lust for profits.

. . . . .

“It isn’t nice, but very often psychiatrists find themselves powerless conduits of such forces [expectations of social order], and understanding what they do and why has to include a recognition of this. We have been drugging and incarcerating inconvenient people for centuries and although this must change, wider expectations remain and they are deeply embedded in our understanding of how an ordered society should conduct itself. Of course we have to shout as loudly as we can in criticism of those who cynically exploit the opportunities this provides, but we also have to address the core issues themselves.”

If Dr. Middleton is correct, and psychiatrists very often find themselves powerless conduits of the forces of social expectation, it has to be said that they have kept any misgivings that they entertain regarding such powerlessness deeply hidden.  I don’t ever recall hearing, or even hearing about, a psychiatrist who conceptualized the committal process as anything other than a necessary and benign step in the “treatment” of an “illness,” one of whose “symptoms” is anosognosia.  At the present time, here in the US, the Tim Murphy Bill is working its way through the legislature with the full and enthusiastic support of the American Psychiatric Association.

Dr. Middleton laments the fact that psychiatry has been  “drugging and incarcerating inconvenient people for centuries,” and although he calls for changes in this matter, he mitigates this call with the contention that  “wider expectations remain.”

Dr. Middleton’s statements in this regard are not entirely clear, but he seems to be saying something along the lines:  there’s a dirty job here, and somebody has to do it.  This may indeed be true, but it skirts the fact that what makes psychiatric commitment and enforced drugging and electric shocks such a dirty job, is the deception, that it is being done to treat an illness.  This is the innermost core issue that we do indeed have to address.  And if the psychiatric hoax is eliminated, the other core issues actually become amazingly simple.  How can we, as a society, help people in distress, particularly those who have become agitated, aggressive, and/or suicidal?  Take the psychiatric elephant out of the living room, and an endless array of commonsense strategies present themselves.

People, both individually and collectively, have been successfully and compassionately ameliorating one another’s distress throughout human history.  It is not quantum physics, or high tech.  It involves no great biochemical or neurological insights.  There is no need for electrical equipment, and there are no treatment guidelines or treatment plans.

But when every potential strategy or development has to be subordinated to the fell hand of psychiatric hegemony, and when every proposal has to be integrated into the psychiatric hoax, genuine progress becomes impossible.

. . . . . 

“Obviously there are those who think that what they do is appropriate and justified, but I would venture that many psychiatrists actually do what they do more often because they feel themselves to be powerless servants of wider social pressures, and would dearly like to be able to do it differently.”

Here again, I can only say that if indeed many psychiatrists feel themselves to be powerless servants of wider social pressures, they are keeping very quiet about it.  And as for the contention that they would dearly like to be able to do it differently, I can only ask:  what’s stopping them?

In my experience, psychiatrists generally are deeply attached to the medical model of human distress, and to the various broken brain theories, because, spurious and disempowering as these concepts are, they provide psychiatry with the appearance of legitimacy, and enable them to make a good living pushing pills.

I can accept that some psychiatrists “in their hearts” recognize that their profession is a sham, and that their “treatments” are a mockery of genuine medical practice, but it is also a stark reality that such misgivings seldom find expression in protests or other tangible action.  Dr. Middleton and the other members of the Critical Psychiatry Network are obvious exceptions to this observation, but it is also the case that they constitute a miniscule minority within the psychiatric community.

It is commendable and courageous of Dr. Middleton to address these issues in so outspoken a manner, but, in my view, his portrayal of psychiatrists as innocent victims of forces beyond their control is neither helpful nor convincing.  Psychiatrists embraced the expansion of their “diagnostic” net to include all manifestations of human distress, willingly and enthusiastically.  And they embraced the various chemical imbalance and other broken brain theories with the same self-serving ardor.  Neither these concepts, nor the actions on which these concepts confer the appearance of legitimacy, were forced on psychiatry.  Nor, in my view, is there any way that the embracing of these concepts and practices can be construed as honest error.  This was blatant and shameless turf-grabbing and drug-pushing.

Indeed, at the present time, when confronted with the kinds of criticisms embodied in Dr. Middleton’s own paper, it is the general response of psychiatry to re-affirm its commitment to these spurious concepts, to promote its principles and practices through PR and lobbying, and to denounce and marginalize its critics.  Only five months ago, the very eminent psychiatrist Jeffrey Lieberman, MD, Chair of Columbia Psychiatry Department and former President of the APA, denounced Robert Whitaker as “a menace to society” on the grounds that Robert had expressed some criticisms of psychiatry, even though Robert’s criticisms have always been factual, measured, and respectfully worded.  That in itself was bad enough, but even more telling and disgraceful was the fact that, as far as I can ascertain, although there were some isolated expressions of disapproval from a few psychiatrists, there was no reaction of censure or disapproval from psychiatrists generally, or from any psychiatric association, to this extraordinarily uncivil, ungracious, and unprofessional remark.

Psychiatry is not something good that needs to engage in some soul-searching and minor corrections.  Rather, psychiatry is something fundamentally flawed and rotten.  It is, and consistently demonstrates itself to be, utterly beyond the remotest possibility of reform.

19 COMMENTS

  1. “But if no pathology is found, which would almost always be the case, the physician should inform the client that his sleeplessness is not a medical matter, and is therefore outside the scope of a physician’s practice. ”

    I’m very curious. Why would it almost always be the case that no pathology is found? Is it because they’re adept in failing to properly care?

    I’m somebody whose sleep disorder (which I was born with) has been routinely ignored and dismissed by uncaring people (including medical professionals) in favor of so-called mental illness. Thankfully, God gave me an incredible mind so I was eventually able to figure out, for myself, what caused my sleep disorder.

    See, CARE is the number one necessary ingredient for proper intuition and knowing (diagnosing). If somebody does not truly care (about a total stranger), they’re highly likely to fail. I can’t count how many times, in my life, that I’ve been ignored and dismissed. My cardiac condition? Ignored. Dismissed. My sleep disorder? Ignored. Dismissed. But oh, hey…. my “mental illness”?

    Let’s get me all that treatment I need, stat.

    See?

    Even after I was officially diagnosed as having a sleep disorder (via only a sleep study – not brain scans) not one person in my life acknowledged or understood it. It was continually dismissed as laziness and depression. In reality, my sleep disorder was caused by my maternal grandfather’s polio. He survived polio and later developed narcolepsy. I ended up with Non-24 Hour Circadian Rhythm Disorder (it has other names).

    The brainwash, mind control cult of psychiatry really needs to be stopped.

  2. Middleton: “… I would venture that many psychiatrists actually do what they do more often because they feel themselves to be powerless servants of wider social pressures, and would dearly like to be able to do it differently.”

    Remember who this quote is coming from: Hugh Middleton, a rich, highly educated, white, old, male English psychiatrist. You can’t blame him. The bias is inherent.

    How I read this: “Many psychiatrists actually do what they do because they enjoy making an average income of $186,000+ a year, the 2012 statistic for average US psychiatrist income, rather than quitting psychiatry and choosing a non-prescribing profession, for example a licensed psychotherapist, which has an average US salary of $49,000 (from Payscale).

    If admitting the truth required it, how many psychiatrists would be willing to give up an income of $186,000 for an income of $49,000? If it resulted in this loss of income, how many psychiatrists would be willing to publicly admit that DSM diagnoses are fraudulent and unevidenced, and psychoactive medications not actually able to treat any known brain illness?

    As it becomes broadly known that DSM diagnoses are fraudulent and medications minimally effective, the fact that psychiatrists remain silent and continue prescribing is evidence that money and power are far more important than caring about patients and being honest to the public.

    As for this: “(Prescribing medications) is all the doctor can do under such circumstances (of a person seeking help for a sleep problem)…” As Hickey said, this is an incredible statement. The psychiatrist can indeed admit that no mental illness is causing the sleep problem. Further, the psychiatrist might suggest the option of psychotherapy, or attempt psychotherapy with the client himself, or suggest a range of non-medical options.

    By prescribing a pill, the psychiatrist is lying to the client in the sense of falsely representing that a DSM “illness” with no validity or reliability is “causing” his sleeping problem.

    I read Middleton’s original article as a well-intended but self-deceptive avoidance and denial of the fact that psychiatrists really are practicing a hoax, i.e. deceiving clients that medications are actually “treating” the “mental illnesses” that the APA fabricated in the DSM.

    It’s telling that Middleton did not return to answer any of the comments on that original article. He was likely uncomfortable in facing some of the Hickey-like points raised by many commenters in that article, preferring to remain ensconced in comfortable self-deceptions about his profession.

    As for this: “”How can our institutions mark and respond to the fact that someone might have become overwhelmed and incapacitated by life’s challenges without having to identify them as ‘ill’?”
    Hint: Stop diagnosing them.

  3. The pity is that for so many of us medication is largely treatment in its entirety. Get lucky and perhaps you can see a therapist. Get really lucky and you get to see a therapist who is actually skilled in treating your particular issue.

    Exactly where is the list of therapists who will provide quality services and can establish a history of fostering favorable outcomes? After all, where it is asserted that “… psychiatry is something fundamentally flawed and rotten” shouldn’t persons be able to readily access psychological alternatives to medications or are the alternatives to medication available for the lucky few?

    • Joe,

      I think real help can come in all shapes and in all sizes. And it doesn’t have to be from a licensed professional. One of the great tragedies of psychiatric hegemony is that it has stifled “natural” helping, by pretending that all human problems need to be addressed by experts. But, having said that, you are also correct in pointing out that wealthy people have more options than poor people.

  4. Actually it has been amusing to me how mainstream media had been covering Jeffrey Lieberman’s book while doing their best to ignore works that were critical of that profession in the here and now. One of the most obvious reasons for this is the media’s own ties to the pharmaceutical industry. How objective can, say NBC Dateline News be, when covering “mental health” issues, given that their major “sponsors” are pharmaceutical companies.

    As for Middleton’s response, no surprise at all really. Critical Psychiatry itself began as something of a collective response to “antipsychiatry” by psychiatrists critical of psychiatry, some of whom had been previously associated with “the antipsychiatry movement”. Some psychiatrists grasped where antipsychiatry was heading, where it might be said to be at today. Given a demand for the end of the profession, they start showing their true colors. Critical Psychiatry has, in the main, been trying to suggest that antipsychiatry belongs to turbulent 1960s, and to say that now we’re beyond that. We aren’t beyond any need for radical change today. People are still being destroyed, and quite literally, by psychiatry. If psychiatry is the destruction of humanity by the psychiatric profession, antipsychiatry is the salvation of humanity by the destruction of the psychiatric profession.

    Don’t get me wrong, I have infinite admiration for those psychiatrists who go against the current of psychiatry, and I still see how they, those of them still among us, do a world of good. I am speaking of psychiatrists like Peter Breggin, Thomas Szasz, and Loren Mosher. The things is, the need for such psychiatrists is so great precisely because of that current. Jeffrey Lieberman’s book gets played up by the media because he wasn’t in any sense a critic of psychiatry as it is practiced today, he’s just going after that bad ‘ole psychiatry of the past, and because of his numerous ties to the pharmaceutical industry. Commerce tugs at media “heart” strings again with, of course, visions of dollar signs.

    I feel I am healthier today for my not consulting a psychiatrist, than I would be were I taking counsel from one. In fact, had I been a compliant mental patient, and followed “medical” advice, I probably wouldn’t be alive today. Aren’t they mostly pill pushers, and harmful, damaging pills at that. Supporting the position of most psychiatrists is kind of like promoting expansion of the “mental illness” industry as an attempt at violence prevention. It just doesn’t make sense, especially given the amount of violence that psychiatrists themselves back. Who needs guns when you’ve got thugs with hypodermic syringes, right?

    Anyway, although the conference behind the post was in many ways a good thing (I’ve been watching the videos), I couldn’t help noticing that were absolutely no women among the speakers. This despite the fact that there seemed to be many more women than men among the attendees. I believe Joanna Montcrieff had been invited to speak, but for one reason or another was unable to make the event. Amazing in this day and age. I’d say if this is not unusual, even critical psychiatry has a long ways to go when it comes to catching up with the rest of the world.

  5. “If you’ve already tried an antidepressant and it didn’t work, don’t lose hope. You and your doctor simply may not have found the right dose, medication or combination of medications that works for you. Here are some medication options that your doctor may discuss with you:

    … Add a medication generally used for another condition. Your doctor may prescribe a medication that’s generally used for another mental or physical health disorder, along with an antidepressant. This approach, known as augmentation, may include antipsychotics, mood stabilizers (lithium or anti-seizure medications), anti-anxiety medications, thyroid hormone, beta blockers, stimulants or other drugs.” Mayo Clinic: Depression (major depressive disorder): Treatment-resistant depression 2015.”

    Aren’t all doctors required to learn about anticholinergic toxidrome in med school? How odd the Mayo Clinic doctors are recommending for depression, combinations of drugs that are known to cause anticholinergic intoxication syndrome, which emulates – almost exactly – the positive symptoms of “schizophrenia.”

    “Agents with anticholinergic properties (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants; disopyramide) may have additive effects when used in combination. Excessive parasympatholytic effects 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.” (http://www.drugs.com/interactions-check.php?drug_list=2330-1540,1744-1113&types%5B%5D=major&types%5B%5D=minor&types%5B%5D=moderate&types%5B%5D=food&types%5B%5D=therapeutic_duplication&professional=1)

    “The symptoms of an anticholinergic toxidrome [can] include blurred vision, coma, decreased bowel sounds, delirium, dry skin, fever, flushing, hallucinations, ileus, memory loss, mydriasis (dilated pupils), myoclonus, psychosis, seizures, and urinary retention … Substances that may cause this toxidrome include the four “anti”s of antihistamines, antipsychotics, antidepressants, and antiparkinsonian drugs[3] as well as atropine, benztropine, datura, and scopolamine.” ( https://en.wikipedia.org/wiki/Toxidrome)

    Why in the world would psychiatrists be recommending drug combinations – known to cause “psychosis” and “hallucinations” – to depressed people? They must think “psychosis” will cure depression? How counterintuitive.

    “Our social, political, and community institutions cannot respond effectively and appropriately to individuals experiencing distress until the medical hoax has been exposed and ousted,” excellent point, Philip, thank you. Psychiatry is a medical hoax.

    “Put very bluntly, a lot of psychiatric prescriptions are issued (not only to detained patients) because a negotiation has been conducted between the prescriber, the patient and the patient’s associates resulting in ‘agreement’ that the patient should take something to quieten them down.”

    “The patient’s associates?” I had not agreed to have the rapist of my child, and the pastor who denied my other child a baptism on the morning of 9.11.2001, be claimed as medically relevant “associates” of mine, prior to being poisoned by psychiatrists. I had not even realized it was lies and gossip from these supposed “associates” (my family no longer “associated” with the child rapists, and I’d just met the pastor) that was the entire basis for my anticholinergic toxidrome poisonings, until after I read my medical records.

    And it does appear that child molesters and abusers seem to be the most common, psychiatrically trusted, “associates” of all so called “schizophrenia” patients today:

    http://psychcentral.com/news/2006/06/13/child-abuse-can-cause-schizophrenia/18.html

    And as pointed out above, the “gold standard treatment” for “schizophrenia,” the neuroleptic drugs, can and do cause the positive symptoms of “schizophrenia.” And they also can cause the negative symptoms of “schizophrenia.”

    “Neuroleptic induced deficit syndrome is principally characterized by the same symptoms that constitute the negative symptoms of schizophrenia—emotional blunting, apathy, hypobulia, difficulty in thinking, difficulty or total inability in concentrating, attention deficits, and desocialization. This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to ‘improve’ what he perceives to be negative symptoms of schizophrenia, rather than antipsychotic side effects.” (https://en.wikipedia.org/wiki/Neuroleptic-Induced_Deficit_Syndrome)

    One must wonder why the psychiatrists so earnestly and eagerly trust in child abusers to function as “associates.” And I find it odd that I was required to sign HIPPA forms to allow my doctors to communicate about me, amongst themselves. However, no forms of any kind are required for a doctor to, unbeknownst to the patient, get most of their information about a person from child abusing non – “associates.”

    “Why is it that the people whom psychiatry ‘quietens down,’ are denied the rights and due process that have become an integral aspect of ‘quietening people down’ in non-psychiatric contexts?” Good question, personally I believe we’d have an much more “ordered society” if we started arresting the child molesters, rather than turning the child abuse victims into “schizophrenics” with the neuroleptics, instead.

    “It isn’t nice, but very often psychiatrists find themselves powerless conduits of such forces [expectations of social order], and understanding what they do and why has to include a recognition of this. We have been drugging and incarcerating inconvenient people for centuries and although this must change, wider expectations remain and they are deeply embedded in our understanding of how an ordered society should conduct itself. Of course we have to shout as loudly as we can in criticism of those who cynically exploit the opportunities this provides, but we also have to address the core issues themselves.”

    2/3’s of all “schizophrenics” today were abused children, whose abuse was ignored by psychiatrists, then the psychiatrists turned these child abuse victims into “schizophrenics” with the neuroleptic and other psych drugs. SHOUTING! Please stop turning child abuse victims into “schizophrenics,” psychiatrists.

    “And, of course, the truly important question: is this person, whom psychiatry deems to be in need of quietening down, actually expressing a genuine and important grievance in the only way that he or she knows how? never even gets asked. Psychiatry, with its routine dismissal of people’s concerns as symptoms of illnesses, is the very epitome of disrespect.” Absolutely.

    “The status quo is not the result of some blind or random historical processes. Rather, it is the direct product of psychiatry’s insatiable lust for prestige and recognition, harnessed to pharma’s equally insatiable lust for profits.” It is also a sign of a society where paternalism and lack of ethics has completely run amok, historically and today, only sick societies have advocated belief in psychiatry. It is also a sign of a society run by these war mongering bankers.

    https://www.youtube.com/watch?v=5hfEBupAeo4

    Many, including me, do not care for or respect the goals and historical behavior of psychiatry’s current masters. Perhaps the “powerless conduits of such forces” should consider the possibility that societal evolution, based upon mutual respect for all, rather than the psychiatric industry’s current divide and conquer theology, would be better than maintaining the current status quo?

    “Obviously there are those who think that what they do is appropriate and justified, but I would venture that many psychiatrists actually do what they do more often because they feel themselves to be powerless servants of wider social pressures, and would dearly like to be able to do it differently.”

    Yes, Thomas Jefferson warned the people of the US that this day would come.

    “If the American people ever allow private banks to control the issue of their currency, first by inflation, then by deflation, the banks and corporations that will grow up around them will deprive the people of all property until their children wake up homeless on the continent their Fathers conquered…I believe that banking institutions are more dangerous to our liberties than standing armies… The issuing power should be taken from the banks and restored to the people, to whom it properly belongs.”

    Mr. Jefferson has a good suggested cure, and I’d add that the multinational corporations that grew up around these “too big to fail” banks, like the pharmaceutical cartel, should be broken up as well. True competition is what made America great, when it was. And, everyone knows “power corrupts, and absolute power corrupts absolutely.” And there’s a Messianic Jew writing books, pointing out that we’re in the midst of a Jubilee year (I think he calls it the Shemitah). And this is supposed to be about financial freedom for God’s people, rather than fiscal enslavement by those who make up money out of thin air, and charge usury to governments on this Monopoly money.

    “It is commendable and courageous of Dr. Middleton to address these issues in so outspoken a manner, but, in my view, his portrayal of psychiatrists as innocent victims of forces beyond their control is neither helpful nor convincing.” As pointed out above, I think psychiatrists may be stupid and / or deluded “victims of forces beyond their control.” We all kind of are at this point in history, but as mentioned, I do believe that if all of humanity, including the psychiatrists, worked together to rid society of the “forces” only seemingly “beyond their control,” we could all live in a much better world.

    Although, I too am appalled, “Psychiatrists embraced the expansion of their “diagnostic” net to include all manifestations of human distress, willingly and enthusiastically. And they embraced the various chemical imbalance and other broken brain theories with the same self-serving ardor.”

    I also agree, “Psychiatry is not something good that needs to engage in some soul-searching and minor corrections. Rather, psychiatry is something fundamentally flawed and rotten. It is, and consistently demonstrates itself to be, utterly beyond the remotest possibility of reform.” Thanks, as always, Philip for fighting those who work to divide and conquer societies for the evil within humanity.

    • Thank you for posting your knowledge on psychiatric drugs. I love the technical explanations.

      This was just posted: “An Adequate Dose Clinicians are often faulted for failing to give an antidepressant medication at a high enough dose. What is “high enough”?

      Are you kidding me? Not a high enough dose? I am not a doctor, just an ex-patient who’s taken all the psychiatric drugs and experienced the emotional and mental disorders they induce and they are promoting this article on a Psychiatric website where “perhaps the dose isn’t high enough”. Are they trying to finish killing us off? Is ‘high enough’ when they’re stricken with akathesia, or a pyramid of other very serious adverse reactions and they want to take out their aggression’s with a gun? Is this considered ‘high enough’.

      • I actually read something recently that showed how a dose beyond a certain range is not going to improve the likelihood of response, and that in fact most psychiatrists used way too HIGH of a dosage, leading to avoidable adverse effects and even reducing the likelihood of anything positive coming out of the experiment. They recommended getting a person OFF of something that did not improve matters at the recommended dosage rather than continuing to increase it. Which makes way too much sense, even if you buy into the whole psychiatric paradigm, which I absolutely do not.

        — Steve

  6. I used to work at a community-volunteer-based suicide/crisis hotline. I spoke with one woman who had been trying different antidepressants for over a year, and was absolutely desperate since none of it has worked at all and she thought maybe she was just condemned to feeling awful forever! I asked her, “Has anyone ever told you there are other things you can do besides trying antidepressants?” She was instantly silent for a moment, and then calmly said, “No…” She’d been exposed to an entire year of the message that antidepressants are the ONLY answer, despite their obvious failure to be of the slightest assistance, and no one ever even intimated there might be another solution! She was quite willing to try anything, and we quickly came up with both a short- and long-term plan for her to start moving in a totally different direction. But it astounded me that she’d been misled in this way! And this was in about 1993 or so. I am sure things are far worse today.

    —- Steve

    • Steve

      Good point. And I would add this to the discussion, when someone who has been prescribed antidepressants (that are promoted as the solution to their problem) and they don’t get better, then they can easily conclude that they must be hopelessly “genetically defective” when these much advertised and touted SSRI’s do not work for them. This will inevitably make them feel even worse about themselves and their future possibilities of getting better.

      Richard

    • Steve,

      Thanks for this. As I’ve said so often, it’s not quantum physics. The woman had clearly been told – and believed – the broken brain lie, and thought that there were no other options. There are literally millions of people in her plight today. And pharma-psychiatry rakes in the profits.

  7. Thank you for this excellent response to Dr Middleton’s paper. It was very disappointing to read the paper, and it made me question once again how critical ‘Critical Psychiatry’ really is.

    The problems raised here are not unique to psychiatry. Medical practitioners have been complaining for years that they are forced to prescribe antibiotics because patients demand them. Recent data indicates that this practice is still continuing on a large scale, but at least a sizeable minority of doctors seem to have absorbed the message about antibiotic resistance and are not writing prescriptions just because patients ask for them. Psychiatrists who have any integrity have to do the same.

    Of course the other issue is how the demand is generated in the first place, as you point out, and it is least said exceedingly rich for a profession that has created the demand to criticize patients who respond to the marketing and come asking for medication.

  8. Phillip

    You nailed this one as is your usual practice. Every so-called open minded psychiatrist should be challenged to read and respond to this blog piece. Unfortunately, a theme of the Critical Psychiatry movement seems to be trying to find some way to salvage the profession at any cost. This will require the most artistic forms of philosophical, scientific, and moral gymnastics; an impossible and unenviable task at best.

    Phillip, I hope you read and respond to my MIA posted blog entitled “Benzodiazepines: Psychiatry’s Weakest Link.”

    Richard

  9. Richard,

    Thanks for this. I think you’re right. Critical Psychiatry realizes that psychiatry is fundamentally flawed, but they’re reluctant to take this to its logical conclusion: if the problem isn’t an illness, then one doesn’t need doctors and medicines to address it.

    I have read the article, and I will respond.