Psychiatry’s Last Tango? — A Response to Bonnie Burstow

Redmond O'Hanlon, DPhil
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For the past few years, I’ve been trying to put words on my multiple dissatisfactions with mainstream psychiatry and its shameful lack of rigour, compassion, reflection and ethical practice: hence my enjoyment of Bonnie Burstow’s percussive, hard-hitting MIA article in September. (I have not read her new book, and am almost afraid to do so, since it may well make irrelevant the final draft of my own critical monograph on psychiatry!)

It struck me recently that many of those who really pushed the boundaries here were people who came from outside the field of psychiatry, like Richard Bentall, Bonnie Burstow, David Cohen, Peter Gotzsche, Iona Heath, James Hillman, John Read, David Smail, Bob Whitaker and Irvin Yalom; or some other remarkable people within psychiatry, like Pat Bracken, Ben Goldacre, David Healy, Jo Moncrieff, Phil Thomas and R.D. Laing, who all had significant expertise in other domains, like psychology, philosophy, anthropology and Classics.

I believe that if psychiatry is to survive it needs to become a rigorously self-critical profession, widen its horizons and bring together insights from French post-structuralist theory, from anthropology, philosophy, psychology, sociology and literature. It needs to elaborate a therapeutic credo that transcends the confines of the Western Ego, dispenses with traditional diagnoses, and focusses on key affective territories in so-called disorders like depression, BPD and PTSD. I should point out here that I employ terms like BPD, depression and PTSD because they are still so widely used, even by relatively enlightened researchers and practitioners. I do not consider them as states or diseases, but as disabling strategies for dealing with deep psychic pain, especially trauma, loss and mourning: my opposition to diagnosis, and all the trappings of the biomedical model, is absolute.

I believe, also, that music should be brought into the picture here, in the wake of Novalis’s pithy remark that illness is a musical problem so music must therefore be part of any solution. I think it might be well worth while trying to develop this idea and see where it might take psychiatry, drawing on the work of Colwyn Trevarthen, Oliver Sacks and the neuroscientists. A musical approach to therapy might help resuscitate a dying profession, making it more sensitive, soulful and compassionate.

Modern culture is highly dissociative, so I suggest that meditation and mindfulness training could fruitfully be built into psychiatric and therapeutic practice. This might prove to be especially important in work with so-called personality disorders and PTSD where patients often need help with fully experiencing the present moment in all its depth, freshness and novelty. (The trauma work of van der Kolk and Rothschild are my gold standards here.) In tandem with the memory reconsolidation work of Phelps et al., such a practice could prepare the ground for a quantum leap beyond early trauma and knee-jerk autonomic hyper-arousal which imprison victims in past images, visceral reactions and beliefs, destroying themselves and all those unfortunate enough to become trapped in their relational orbit.

Sophocles wrote:  “For mortals, greatly to live is greatly to suffer.” This is fundamental to the tragic vision of the Ancient Greeks who knew just how important for the psyche was the journey into the depths of suffering and darkness. (See Parmenides’ great poem and Peter Kingsley’s brilliant exploration of it in his book on the “Dark Places of Wisdom”.) Sophocles’ line is not, of course, a call to self-flagellation before breakfast, but a bracing reminder that when suffering arrives we should let it inhabit us fully, make use of it and mine it for its potential gifts. Psychotropic medication shoots this messenger on sight, no questions asked.

In more recent times, Paul Brand wrote that because his leprosy patients very often reported a complete lack of any sense of bodily integrity, what he’d most like to give them is the gift of pain, insisting on the vital importance of a vibrant pain system for physical health, survival and a sense of being whole. For him, this is a necessary condition for achieving wholeness; without it we become dissociated, fragmented, less real. (It’s more than interesting that the words “whole,” “hale,” and “health” are cognate.) I think his reflections open up very important vistas for the treatment of psychic pain, as the relational cost of psychological dissociation is so crippling: to rewrite Dante’s warning at the gates of Hell, “Abandon hope, love and sanity all ye who dissociate from your pain.”

I believe that if psychiatry has any future it needs to attend fully to an individual patient’s story, breathing and body language, within an Attachment Theory perspective. It needs to take narrative medicine seriously, paying special attention to the detailed images, patterns and nuances of a patient’s often fragmented, enigmatic, even embryonic life-narrative, which must remain sovereign, and to which every diagnosis must remain subordinate: this is an approach that seems to me more “soulful”, subtle, complex and useful than Lucy Johnstone’s practice of formulation.

Physical and psychological suffering may be traced to fear, often terror, and to the varied maladaptive modalities, especially dissociation, that we use to deal with abuse, pain, loss, betrayal, separation, non-validation, abandonment and loss of love. A focus on individual narrative, on the specificity of maladaptive, regressive, creative or liberating modalities, combined with mindfulness training, a meditative practice and certain arts/body therapies would help psychiatrists to reframe the story of their patients’ lives, get in touch with what they really want, who they really are, and who they are  called to be.

But here’s the rub.  Here lies the hare, as the French so piquantly say. Finding a new, more enabling story and becoming more deeply aware of the obstacles that bar access to a life worth living may not be enough to overcome the elephant lurking in the shadows that biomedical psychiatry dares not look at: the external conditions over which a person may have little control. The druggy doxa fuelling the biomedical model of psychiatry blatantly side-steps the socio-political infrastructure by locating the problem IN the isolated individual and proposing medical solutions to socio-economic or existential problems. However, psychiatry is not the sole profession in the dock here: lest we become too complacent about our own preferred therapeutic practices and model(s), we should all bear in mind the fragility of any therapy which treats mental distress as a problem located solely within the monad: fundamental, even revolutionary changes in how our society is organized may be required to give any therapy the best chance of helping patients to lead a life worth living, and furnish an environment in which their children’s primary needs are met.

We all need, then, to be aware, with Bonnie Burstow, Karen Horney and David Smail, of the extent to which the socio-economic context sets harsh limits to the alleviation of psychological pain. In other words, we must all interrogate every individual therapy, asking if it confronts the real infrastructural context which so often renders humans helpless and, ideally, SHOULD generate depression as a perfectly appropriate, non-dissociative response to, say, homelessness or other unbearable living conditions. And, further, we might fruitfully consider the proposition that we may be asking the “mentally ill” to carry disavowed double binds, cultural contradictions and toxic social conditions that make life unliveable for many people, but in which we are all complicit. Should we not now start foregrounding the crucial importance of community, interrogating the politics subtending all therapies and looking to more radical social treatments as opposed to, or in addition to, individualized ones?

I’d like to suggest that the various horrors being perpetrated by modern psychiatry have their roots in a desperate attempt to survive at all costs. People eat or kill their friends and neighbours when survival is at stake. And recent surveys clearly show that very few turkeys now vote for Christmas, unless they are terminally ill or weary of life here-below. Psychiatrists are unlikely to vote themselves out of existence either, so it needs myriad Bonnie Burstows to help them on their way.

The wider cultural druggy doxa, rampant neo-liberalism and psychiatrists’ technical, pharmacological training enable, indeed encourage “research” like Study 329 and widespread academic corruption, so perhaps my Utopian hopes might be realized only in a brave new world where both individual blossoming and community support really matter. If some of my suggestions here were taken on board by psychiatry they might, just might, enrich, rejuvenate and possibly save its bacon, IF, AND ONLY IF psychiatric training and society itself were completely revolutionized. There are many economic and cultural forces working against my  little Utopian fantasy, but what’s really at stake here is a wider, deeper vision of what a person is, what healing is all about, and what sort of world we want to fashion.

To conclude, I wonder why more ink is not spilt on debating this question: Is psychiatry a science? Or an art?  Or both? For most of its critics, psychiatry is merely pseudo-science, but its hubristic scientific pretensions have not only castrated itself, impoverished the “discipline” – but, more tragically, have killed innocent patients beyond number. Only if psychiatry enlists the humanities might it once again become what it was under Hippocrates, and avoid becoming irrelevant. Or extinct.

33 COMMENTS

  1. Psychiatry IS irrelevant and it SHOULD be extinct. It is not science or medicine or an art. It is a poisonous, bloated toad that has, as critics have noted “killed innocent patients beyond number”. It cannot be reformed or redeemed. It is a cancer. It offers up “poison” (drugs) and “shock” (traumatic brain injury) as “treatment” for those in distress.
    “Psychiatry” is invalid and it can not be “reformed”. It must be “abolished”.

    But how can that be achieved?

  2. “I’d like to suggest that the various horrors being perpetrated by modern psychiatry have their roots in a desperate attempt to survive at all costs. People eat or kill their friends and neighbours when survival is at stake.”

    Wow, powerful statement. And what an apocalyptic image! Sounds like sheer madness to me.

  3. Is psychiatry a science? Or an art? Or both?

    How about neither? What do you consider alchemy?

    Everything you point out is true. All psychiatry — not just “biological” psychiatry — is based on the idea that “mental illness” is a real thing, not just a metaphor that should be discarded considering the way it has been used to justify so many unspeakable atrocities. Hence there is no need to find ways to save it; we need to point out its inherent contradictions as clearly as possible and let it crumble under their weight. Of course the first step must be to abolish coercive psychiatry; after that educated public opinion will deliver the death knell. After that we can deal with mental distress by addressing its primary cause, which is the alienation which is part & parcel of capitalism. Good article.

  4. Hi Redmond,
    Thanks for this beautifully written article. One can tell that you have a strong writing/philosophical background from the beautifully disturbing metaphors.

    Let me add to Oldhead’s comment above and affirm that “psychiatry” – better understood as medicalization/diagnosing of life problems and the extinguishing of mental capacities via drugging – is not at all a science, and definitely not an art. It’s rather perverse to even associate the word “art” with psychiatry, similar to associating the word “artistic” with lying, murdering, stealing, assaulting, destroying, and abusing. There are some people who finds those things artistic, but they’d be diagnosed as sociopaths! As oldhead said, psychiatry can be better categorized as the equivalent of alchemy, astrology, or a clever swindling scheme. The main motivators are profit, control, and Macchiavellian survival instincts, hardly things you associate with going to the local art gallery.

    Psychiatry as you reenvision it would essentially no longer be psychiatry. It would be a form of existential psychotherapy or psychoanalysis.

    I suggest that we stop considering how to reform psychiatry and start taking more actions designed to fatally undermine it, to bring its precariously perched house of cards crashing down, something which will happen when a sufficient proportion of the population becomes aware of its lies and harms and demands change. The practice of medically diagnosing and drugging people for life problems deserves redemption and salvation as much as do Bernie Madoff, Kim Jong Un, the Paris killers, and other hated terrorists and autocratic rulers.

  5. Rhetoric, I see, is still rhetoric.

    I believe that if psychiatry is to survive…

    I didn’t know psychiatry was ailing, but if psychiatry were ailing, and if it were to expire, then if not we, I at least would have cause to celebrate. Good riddance!

    Enough already! Psychiatry is abduction, torture, imprisonment, brainwashing, and killing. 5 thing I definitely don’t feel I need more of.

    I’ve read psychiatrists speak of diagnosis as an art. Psychiatric diagnosis mind you. I think real medical people do things differently. What psychiatric diagnosis isn’t is science. How can you diagnose a non-existent disease? Easy. The same way kids make imaginary friends. What’s wrong with imaginary friends? There’s that diagnosis again.

    Talk about a costly venture, sometimes people without friends see a psychiatrist. To my way of thinking it would be less costly, and perhaps easier, just to make a few friends. We’re not talking rocket science here.

    • Ah, friends. If our society weren’t so sanist, the majority of Mad people would have them and psychiatry would go the way of the dinosaur. And people are really missing out on all that we have to offer. Most Mad people are more loving, forgiving, joyous, and, yes, more responsible than the people who’ve thrown us away. Not many other people appreciate the value of having people by your side when life gets hard.

  6. Thank you for this thoughtful article. My hope is that we always assume that there is meaning in our own or others’ existential and emotional suffering. Then, as individuals or as supporters of others we can seek to help understand or ease the pain. Calling something an illness or a disease without evidence of such is invalid, damaging and irrelevant.

  7. Thanks for this very timely & insightful essay on the dissociative nature of Western culture. As you say: Modern culture is highly dissociative, so I suggest that meditation and mindfulness training could fruitfully be built into psychiatric and therapeutic practice. This might prove to be especially important in work with so-called personality disorders and PTSD where patients often need help with fully experiencing the present moment in all its depth, freshness and novelty. (The trauma work of van der Kolk and Rothschild are my gold standards here.) In tandem with the memory reconsolidation work of Phelps et al., such a practice could prepare the ground for a quantum leap beyond early trauma and knee-jerk autonomic hyper-arousal which imprison victims in past images, visceral reactions and beliefs, destroying themselves and all those unfortunate enough to become trapped in their relational orbit.”

    I’ve finished an essay on my own journey, beyond my first “label” scizophrenia, in 1980. An essay which explores the evolution of my life & the formative causation & morophogenesis of my mind. Using R.D. Laing’s intuitive comment about the dissociative Paradox of Modernity; we are all in a posthypnotic trance induced in early infancy. A heart based essay about the nature of “I am” & how as; “Lose your mind, to come into your senses.” -Fritz Pearls. Especially, the Sixth Sense of Infancy, which is lost to the rationalizing, adult mind. Ipso-Facto – “We are all in a posthypnotic trance induced in early infancy.” -R.D. Laing. Lost in the delusion that the words of public rhetoric, in the politics of our experience, is the reality of our motivation.

    An essay which explores the “simulation” of mindfulness practice in the Western world, after spending three years “immersed” in the largest Buddhist culture on earth. Hence I write:

    MINDFULNESS is a word that frustrated me enormously, before I spent time with Buddhist monks in Thailand. Having experienced the grounding exercises employed by many CBT therapists and others, using a Western version of Eastern rituals, which is largely a “simulated” version of ancient ritual, in my opinion. A version, which was, at times effective in calming the driven motivation of euphoric mania, giving me some sense of internal self regulation and the possibility that the metabolic energies involved, had some behaviour reorienting purpose. Yet I found it hopelessly inadequate for self regulating periods of major depression and the associated suicidal impulses to escape, overwhelming psychic pain. Until my full time exploration of ancient rituals and a compelling need to make the words of The Polyvagal Theory, flesh, changed my method of mindfulness practice to a mind-less, sensation awareness. Awareness of the muscular tensions and vascular pressures that underpin my thought process, like the tension always present in my tongue during my private ideation. The I-talk of internal self communication which is an aspect of the habitual formative causation of speech. A “felt-sense” (Gendlin, 1982) of self, employed in my self exploration journey, using Peter Levine’s “sensate” awareness of nervous system function, to resolve my life long issue of traumatized orienting responses. Specifically, through developing a felt-thought sense of my subconscious “neuroception” (Porges, 2011) of safety and security. Particularly, the internal sense of ontological security that traumatic experience had robbed me of, and a “treatment oriented,“ (McGorry et al, 2012) crisis intervention approach, simply re-enforced. Particularly, my first diagnosis of schizophrenia within 15 minutes of contact with a pharmacology oriented psychiatrist, who never mentioned the words, ontological insecurity or nervous system, during a three year period. While an ancient tradition of esoteric self exploration, brought an inner wisdom to mystical feelings during three episodes of euphoric mania, in 2010, 11, & 12. Made possible through a daily interaction with a Buddhist tradition of meditating on the Void of nonbeing, beneath the mind’s sense of duality. Which, as I have tried to indicate above, with Brian Massumi’s explanation of self-affectation, as the dual process of mind-body/body-mind, self-regulation.

    A body-mind awareness, which as you read these words, may bedoesn’t mean it disappears into the background. It means that it appears as the background against which the conscious thought stands out: its felt environment. The accompanying sensation encompasses the thought that detaches itself from it. Reading, however cerebral it may be, does not entirely think out sensation. It is not purified of it. A knitting of the brows or pursing of the lips is a self-referential action. Its sensation is a turning in on itself of the body’s activity, so that the action is not extended toward an object but knots at its point of emergence: rises and subsides into its own incipiency, in the same movement. The acts of attention performed during reading are forms of incipient action. (Massumi, 2002)”

    Interested readers may read more of my; 4 words: Nervous System, Mental Illness essay here:
    https://www.academia.edu/18666917/4_Words_Nervous_System_Mental_Illness

    As I have written here before, I write for the isolated, who have been re-traumatized by the pragmatic, time limited and treatment oriented approach of mainstream psychiatry. Writing that shows a black & white trail of experiential healing, using Peter Levine’s “sensate” awareness of “how” The Body Keeps the Score. And more importantly “how” to surrender to our “innate” capacity to heal overwhelming experiences. As I’ve just written elsewhere, I believe the true task of this community, is to show “how” the observations of all the people you mention above, are correct. For there is enough “developmental science” out there and particularly the “psycho-physiological” discoveries by people like Porges & McCarty, to bring a truly modern perspective to the ancient secrets of heart, written into the very clever, “esoteric/exoteric” narratives, on the human condition.

    Although, here on MIA, folks would have to loosen their “paternalistic” projections onto the nature of God, to discover the reality of a 3 letter word for Ultimate Reality, Within?

    • Just to explain again, in black & white, how I understand the vicarious sense of reality, I label my mind.

      FORMATIVE CAUSATION AND MORPHOGENESIS. Are 4 words from Rupert Sheldrake’s book, New Science of Life, which are relevant to my transformation of experiences, that mainstream psychiatry’s bio-medical view of my behaviour, saw as unmanageable without professional help and the long term use of medications. Although I noted, during my extensive research that much literature from science disciplines such as “psychophysiology” or research from Heartmath Institute, or the trauma related understanding of human experience, of people like Peter Levine and Bessel van der Kolk, cannot be found in so much of the pragmatic, treatment oriented literature of academic psychiatry, such as: The Recognition and Management of Early Psychosis. (McGorry, et al, 2012)

      Yet my medication free transformation, involving the experience of three affective psychoses or euphoric mania’s in 2010, 11 & 12, where managed using Levine’s understanding of how to discharge the energies, trapped within my body, by the uncompleted motor actions of traumatic experience. How to surrender to an innate capacity to self-heal overwhelming experiences. A charge and discharge understanding of nervous system function, and the morphogenesis of the mind, through the excitatory and inhibitory process of nerve cell activity. Subtle, involuntary activity within body-brain which can be sensed through the corresponding muscular tensions and vascular pressures, involved in respiratory sinus arrhythmia or high-frequency heart-rate variability.

      Which plays a primary role in regulation of energy exchange by synchronizing respiratory and cardiovascular processes during metabolic and behavioural change. With my self education about the impulsive nature of energy exchanges within my body, by adapting to a felt-thought sense of the internal landscape which creates my awareness of the external landscape, enabling the self-regulation of my behavioural change.

      With Sheldrake’s understanding of evolution, as habitual motion and spontaneous change, bringing me an awareness of the conception and evolution of my own life. Especially, the spontaneous change in my psychophysiology, which led to my first diagnosis of mental illness in 1980. Essentially because I was so self-ignorant of my own nature. The nature of the patterned relationship of my internal organs, mediated by my nervous system, and the formative causation of a sense of reality, I grew to call my mind.

      Best wishes to all,

      Batesy.

    • David, this is brilliant as usual. Mental illness nervous system–YES!

      When I was going through my trials in the system, I kept telling my partner I wanted a nervous system transplant. I knew that energy was pinging it like mad, and I’d feel everything. Where were my defenses? I wondered.

      Then, I realized it was a matter of shifting my perspective, to where ‘the art of feeling’ was actually a gift of being, and also of guidance, rather than the burdensome curse I was believing it was, simply from how my feelings were making me feel!

      By this time, however, my nervous system had been quite tattered by “psych drugs” and also by living and operating in a highly stigmatizing, discriminating, and bullying community. So I did a lot of healing and grounding in order to regenerate and strengthen my nervous system, and it shifted so drastically that I actually felt as though I had a new nervous system, so in a way, I got my wish.

      Life is way better now, with this level of freedom to roam around in the world as I please, without the fear of being dragged down into the mud once again, traumatized by normal and to-be-expected life stressors. I can hold my own now, I always know my way back to center because my nervous system (and heart) guides me there.

      “Although, here on MIA, folks would have to loosen their “paternalistic” projections onto the nature of God, to discover the reality of a 3 letter word for Ultimate Reality, Within?”

      Haha, well that’s a good point, about projecting paternalism. And yes, I agree that the entire universe is within us. If we could only see this and own it, then we’d see our power to change the world. At least those of us who can make this inner reality-outer reality connection have a good broad perspective about how change occurs. So it’s completely true, that to create change around us, one has to BE the change. It’s the only way.

      Thanks, always, David, for your extraordinary insights. Your lived experience and gained wisdom as a result are true gifts. I hope you experience them this way.

  8. when I went into psychiatry a very long time ago the concept I had in my mind was false….I thought psychiatry was a medical specialty that was in between psychology and neurology…I was wrong…in 1963 my training was about disease and drugs..I became unhappy about what was going on there…I developed my own model for understanding all this awful suffering-the bio/psych/social/economic/political model…It has been a battle fighting the STANDARD of psychiatric care….I threw the pdr and the dsm in the trash can…but psychiatry is still in my heart…..the psychiatry that I hope some day will be realized…we need to know what is CAUSING all this suffering and then prevent it….a DRUG is not going to do that most of the time…this is from a very old tired so-called mentally ill psychiatrist…. who is retired and doing research into the cause of mind problems..

    • I think there’s still a lot we can learn from neurology. 🙂
      The issue is what power agenda it’s being used to serve…. as I think you’ve seen… but it’s always a good sign when more scientists and specialists stop writing behind pay-walls and start talking with social movements more. Good to hear you here.

    • It does appear child abuse or ACEs is what is causing most (2/3’s) of the “suffering” (see John Read’s research into child abuse and schizophrenia).

      And, of course, when psychiatrists drug non-brain diseased child abuse victims, the crime victims end up suffering from the common adverse effects of the psych drugs. For example, the neuroleptics can cause the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome. Which is almost always misdiagnosed, resulting in higher doses of the neuroleptics. And these higher doses of the neuroleptics can create the positive symptoms of “schizophrenia,” via the central symptoms of neuroleptic or poly pharmacy induced anticholinergic intoxication syndrome, aka anticholingeric toxidrome.

      I’m quite certain most of the SMI’s are iatrogenic, not genetic. And perhaps our society should go back to arresting the child abusers again some day?

  9. Warning, wall of text ahead. Read the whole thing, it is well worth it.

    Is psychiatry a science? Or an art? Or both? Psychiatry is neither science nor art. It’s a pseudoscience. It uses labels for social control. It sells poison for profits. Like bpd said above, “It’s rather perverse to even associate the word “art” with psychiatry, similar to associating the word “artistic” with lying, murdering, stealing, assaulting, destroying, and abusing.” Maybe a hundred plus years ago psychiatry could have been called an art. Now it’s associated with fraud, abuse, torture, drugging, and murder.

    I’d like to suggest that the various horrors being perpetrated by modern psychiatry have their roots in a desperate attempt to survive at all costs. You may be able to make that claim for modern psychiatry, but psychiatry since it’s inception decades ago has been associated with kidnapping, torture, abuse, and all manner of evils. Just look at their so called ‘treatments’ throughout history: hydrotherapy, shock therapy, insulin-shock therapy, lobotomy. Modern psychiatry is simply the modern version of ‘old’ psychiatry, and both modern and old psychiatry are rife with abuse, oppression, and evil. There is nothing good about psychiatry. Never has been.

    The wider cultural druggy doxa, rampant neo-liberalism and psychiatrists’ technical, pharmacological training enable, indeed encourage “research” like Study 329 and widespread academic corruption Right, so shouldn’t a system that encourages widespread corruption be abolished? The system itself is at fault. Trying to fix it will be a band-aid solution at best. You don’t try to fix a tumor. You remove it.

    [W]e must all interrogate every individual therapy, asking if it confronts the real infrastructural context which so often renders humans helpless and, ideally, SHOULD generate depression as a perfectly appropriate, non-dissociative response to, say, homelessness or other unbearable living conditions. The druggy doxa fuelling the biomedical model of psychiatry blatantly side-steps the socio-political infrastructure by locating the problem IN the isolated individual and proposing medical solutions to socio-economic or existential problems. What you’re saying is that our current social/economic/political system, which perpetrates and exacerbates homelessness, joblessness, poverty, hunger, etc, is the problem, with ‘mental illness’ being a natural response to such social ills, but which psychiatry labels a ‘mental illness’ within the individual, is the problem. Agreed. The current social/political system is the problem. Psychiatry focuses on the biological (even though no biological cause has ever been found for any ‘mental illness’) yet ignores the social/environmental and psychological. So called ‘mental illness’ (which is not an illness) is a natural response to a toxic environment, be that poverty, homelessness, joblessness, loss, abuse, neglect, or any number of other social/environmental interactions.

    You mentioned multiple dissatisfactions with mainstream psychiatry and its shameful lack of rigour, compassion, reflection and ethical practice. This isn’t just one or a minor slight. These are many major problems. A discipline that lacks compassion or ethical practice? Aren’t those qualities of a sociopath? How could you argue to keep such a discipline alive? That’s like arguing for torture. The answer is no. Just no. There is nothing good about it. Get rid of it. It promotes and supports evil while trampling on the good. Psychiatry is evil. Abolish it.

    As Frank mentioned above, “Psychiatry is abduction, torture, imprisonment, brainwashing, and killing.”. Biological psychiatry is a pseudoscience. Psychiatry is based on lies and marketing, not science. It should be abolished completely. Keep psychology, abolish psychiatry. Psychiatry is a medical profession that uses medical treatments (drugs and electroshock) to ‘treat’ something that is not medical/biological. You might as well say psychiatrists are experts in and have a PhD in unicorns. As cool as it might be if unicorns existed, they don’t exist. They are a myth. Just like the suggestion that ‘mental illness’ is a real biological illness, brain disease, or chemical imbalance. It’s a myth. It doesn’t exist. Psychiatrists have a PhD in unicorns. So why do these unicorn experts have the power to kidnap and forcibly medicate people against their will? It’s insane. The truly insane people have taken over the insane asylum.

    Psychiatrists don’t treat the insane. They are the insane. They diagnose people with a so called ‘mental illness’ (blaming biology/brain) without having any medical tests to prove the existence of said ‘illness’, then prescribe drugs that frequently have ‘side-effects’ that mimic the very ‘symptoms’ of the supposed ‘illness’ the person was diagnosed with. And if the drug-induced side/adverse effects mimic a different ‘mental illness’ or the individual tries to withdraw from such drugs, they are then given another ‘mental illness’ diagnoses and prescribed even more drugs. The crazy people have taken over the crazy house. Psychiatrists don’t treat the insane. They are the insane.

    Keep psychology. Abolish psychiatry. Many uninformed people confuse the two. Psychiatrists have a medical degree and are the drug dealers. But they have a medical degree and use medical ‘treatments’ for something that is not medical/biological. Get rid of the unicorn experts. They talk fancy, but when you get down to it, they talk complete and utter crap. They have no idea what they are talking about.

    The answer to biological psychiatry (to abolish it), is very simple. Psych-ology and psych-iatry both (supposedly) study the mind, or more specifically, the psyche. Psychiatry, and specifically biological psychiatry, focus on the brain, not the mind, which is why psychiatry claims mental illnesses are brain diseases or chemical imbalances. This is wrong. Although the brain and mind are connected, they are not the same thing. The brain is physical. The mind is non-physical. The answer to (replace) psychiatry and the DSM is the psyche. Use the map of the mind. Use the map of the psyche And yes, it has been mapped. Perhaps not in minute detail, but it has been mapped. Use it. Abolish biological psychiatry. Use The Map of the Psyche. Why accept a profession that claims ‘mental illness’ is a real biological illness/brain disease/chemical imbalance (which we know is false), when the mind has already been mapped? It shows what so called ‘mental illness’ really is, which is a different perspective or point of view, different personality traits, emotions, or behaviours, or a natural response to a toxic environment, and certainly not an illness or disease or chemical imbalance.

    Biological psychiatry is a pseudoscience. It’s a cancer on the human race. Abolish it. The mind/psyche has been mapped. Use it.

    • No argument with the great bulk of what you say.

      As an aside, I’m uncomfortable with cancer analogies. Not only because people have so much trouble with analogies and metaphors which involve the body/mind, but because many assumptions about cancer I think are backwards and destructive. There is much support for the idea that a tumor is a last ditch immune response, i.e. an attempt to contain or process an overload of toxicity, radiation, etc. Unless it blocks a vital function, the tumor itself is not going to kill anyone, and cutting it out could actually trigger metastases, like a kind of whack-a-mole game with the immune system. Many people with cancer die from the destruction of the immune system by radiation and chemo”therapy.” They proclaim that a “cure” means surviving for five years when remission generally takes closer to seven years to become apparent. Meanwhile the person’s diet/lifestyle issues which may have encouraged the disease process are subordinated to the drive to eliminate the tumor.

      I think the only accurate cancer analogy here would be to say that, just as our bodies are clogged with poisons, our spirits are suffocated by negativity and alienation. Still, someone would miss the point and try to market an anti-alienation drug.

      • Okay, perhaps my cancer analogy was off. Would you have preferred if I’d used a different analogy? Gangrene perhaps?

        The point I was trying to make still stands. Psychiatry is not something you can fix or heal. It’s far too toxic and morally bankrupt. It can’t be fixed. It needs to be abolished.

  10. I can hardly believe that I’m about to make a (very) conditional plea for reforms to psychiatry*, but here it goes. Psychiatry would be good for Mad people if it were run by people like Mr. O’Hanlon. The people on this comments page are unhappy with the torture that psychiatry has inflicted upon them, but, so far, nobody has raised a single objection to Mr. O’Hanlon’s proposed solutions to psychiatry’s MAJOR problems. We don’t have to turn away from psychiatry’s goodness in order to vanquish its evil. Let’s support Mr. O’Hanlon and take over the neighborhood.

    * pro-force psychiatry ( (1) psychiatry that a legislative or judicial body forces or “encourages” a person to obey (2) psychiatry that a person must “comply” with in order obtain basic resources and rights such as custody of their children, housing, and professional education

    • We don’t need a more benevolent dictator.

      Psychiatry’s number one problem — and our number one problem with psychiatry — is that it’s based on false premises, right? It’s not of matter of getting it back on track, there never was a track. Except maybe the one heading to the concentration camps.

      • I meant to say *EXCLUDING pro-force psychiatry. Maybe psychiatry that is pro-choice can be reformed, but we must not waste our time trying to domesticate the rabid animal of pro-force psychiatry. That beast must be put down and incinerated before it kills again.

        What do you think about therapies like attachment therapy, compassion focused therapy, and minimally clinical therapies like equestrian, horticulture, and biblio-therapies?

        • These therapies are all good J but the problem here is semantics. Psychiatry today is 99% diagnosing and drugging. Most psychiatrists make token references to being interested in psychological therapies but are not truly interested nor do the practice them themselves, because it’s far easier to profit from the sheep in 15 minutes with a diagnosis and a pill.

          The therapies you suggest are excellent ideas and should be encouraged wherever possible. But, they are not psychiatry; they are forms of psychology or psychodynamic treatment. It can’t be overemphasized that false diagnosing/medicalization/drugging are at the heart of present day psychiatry and it would be better because of the fraudulence and harms of this pseudosciecnce if psychiatric practice in this mode were simply abolished.

    • Forced psychiatry {* above (1) and (2)} should be abolished. Reform is not the right word to use in such instances. Reform is merely less force or more force depending on the fashion of the moment. If abolition of forced psychiatry is what you meant by reform, you might have made your meaning a bit more clear.

      Reform is, like, they remove restraints. They reapply restraints. They remove restraints again. That’s reform. Severe treatment, or less severe, but treatment nonetheless, depending on the times. Freedom from non-consensual coercive mistreatment, we don’t have that yet, and you only get it with abolition (i.e. emancipation.)

      • Goodness in psychiatry?

        There comes a time when a system becomes so corrupt that the only way to change it’s negative impact is to dismantle it and start new. Forced psychiatry is just a more overt face of that “profession” that operates in the business of violating human rights on a daily basis. The attitude and the ego of psychiatry as a whole is it’s largest problem and so invasive in society, it can only be obliterated.
        You do not save what has destroyed millions of human lives without a single ounce of admission or remorse. If psychiatry were to DSM itself, it would be labeled sociopathic as it has no regard for it’s victims and doesn’t acknowledge or admit it’s part in their suffering.

    • What goodness is there in psychiatry? Psychiatry today is primarily diagnosing and drugging. And neither of those are good to say the least. Diagnosing is invalid and unreliable, causes pessimism and hopelessness, and research on it is not associated with improvement in outcomes in any study (see Sami Timimi’s and John Read’s studies on diagnosis and outcomes).

      Drugging… how to say everything about this… the long-term side effects, damage to functional capacity, and the psychological effects of internalizing that you have a brain disease are truly horrendous. The whole debate on this site about whether drugging should be kept in some form is short-sighted in my opinion; we’d be much better off as Peter Gotzsche says if 99% of drugs were removed from the market. A very limited amount of drugs might be kept for people in truly extreme states short-term and that’s it, but without pretending to those people that such drugs treat some known mental illness.

      As I said in my comment, following O’Hanlon’s thinking would lead to psychiatry being effectively dismantled and replaced by psychology: supporting people as individuals (e.g. forumulation based psychotherapy, Open Dialogue),
      promoting various forms of psychosocial support, rarely if ever drugging.

      This is why as I’ve been saying in other comments people should take action in their own lives against psychiatry, and take action when they see diagnosing and drugging being done to others, with these sort of steps:

      – Do not accept diagnoses. Do not work with ignorant mental health “professionals” who take diagnoses seriously, except to fool the system when needed for insurance purposes.

      – If possible never take psychiatric drugs, and if on them try to taper off to the maximum degree possible. If absolutely necessary do this alone.

      – Convince others to reject diagnoses and to look into resources for coming off drugs.

      Mr. O’Hanlon would never run a psychiatric hospital or be a psychiatrist. He would be a therapist. I really think we should find some new name for this proposed reform to psychiatry… “psychology”? “Empathy”? Psychiatry is kind of like the word schizophrenia; it’s finished as a useful word.

  11. “I should point out here that I employ terms like BPD, depression and PTSD because they are still so widely used, even by relatively enlightened researchers and practitioners. I do not consider them as states or diseases, but as disabling strategies for dealing with deep psychic pain, especially trauma, loss and mourning” Oh dear, here goes nothing…
    Historically many of the most pernicious smear labels used to objectify and dehumanise have been defended in the same way. It’s an apologist narrative and one that isn’t tempered by declaring how well meaning you are.
    The narrative of labels like depression and PTSD are almost entirely constructed as either an illness or a response to traumatic event/events that befall the person. They happen TO someone. They lay no blame with the individual and they certainly don’t call into question the ‘goodness’ of the core of the person they’re applied to. Whatever the etiology of these ‘conditions’ is theorised to be, the one thing mainstream and critical approaches have in common with regards to these two labels is that they are never said to be the fault of the individuals character or moral make-up.
    Not so with the ‘BPD’ label, remotely. Nowhere, and I mean NO where is the term ‘BPD’ used by anyone who understands it’s history, function and impact on those it is employed against.
    It is of course regularly used by the ever expanding ‘treatment’ industry that surrounds it. Entire careers are built on the backs of distressed women to help them learn to ‘regulate’ themselves and be good little (adult female) girls. Because it’s overwhelming women it’s applied to, or gay men who are deemed exhibit ‘feminised’ forms of distress. Although aggression , fast driving and promiscuity (which form a portion of the Chinese menu style check list of ‘borderline’ psychopathology) are conversely celebrated in men, gay or straight.
    Your claim that these labels are used by the ‘relatively enlightened’ is entirely incorrect. Burstow herself has spent decades deconstructing and laying bare the invalidity of misogynistic smear labels like ‘BPD’.
    I find it totally unacceptable that MIA continue to platform this smear label as if it’s validity is still up for debate. It’s even more worrying that this is repeatedly done by male contributors and male editorial staff who otherwise self identify as ‘critical’. Worrying but not surprising unfortunately.
    The ‘borderline’ label doesn’t require that a woman employ ‘disabling strategies for dealing with deep psychic pain’. It only requires she be female, non-conformist, non-compliant and/or distressed/’angry’/challenging the shrink. Women have had this applied for attempting to bring sexual harassment suits in working environments. It has been used to invalidate testimony in cases of child sexual abuse and sexual assault and as leverage in custody battles. It is a profoundly dangerous label that can be expanded to an alarming degree to pull people into the net of inclusion.
    The comically named ‘high functioning borderline’ alleged populates the ranks of high powered law offices and investment banking, wreaking havoc on her poor unfortunate (male) colleagues.
    The descriptions of these destructive creatures reads like a drunken John Grisham channelling Oprah. The internet is chock full of creepy people who are self declared ‘experts’ at helping the rest of the world spot/manage/control/sue/divorce these femme fatales.
    Van De Kolk for all of his humour and irreverence, didn’t listen sufficiently closely to his colleague Judith Herman when she described ‘BPD’ as ‘little more than a sophisticated insult’.
    For all of his brilliance in the area of childhood trauma, he lacks any political critical analysis of labels like ‘BPD’. Not everyone, by a long shot, to whom this label is applied is lacking an ability to ‘regulate’ themselves emotionally. In fact, the very idea of emotional ‘regulation’ as an ideal is a highly subjective and almost puritanical notion.

    If writers/academics don’t understand the label’s deeply political motivations to silence and pathologise women, then perhaps they shouldn’t write about it at all until they’ve done the research.
    Because it is a direct descendent of ‘witch’ and ‘hysteric’ and is employed in much the same way today. It renders the recipient entirely non credible and is such a total double bind as any attempt to argue back against it’s application only compounds it’s ‘validity’ in clinical settings.
    After all, what’s more ‘borderline’ than an unruly, non-compliant female who argues with the nice doctor eh?
    To be blunt. It takes a special kind of privilege blindness to come onto a site like MIA as an aged, white, professional, male and defend your right to employ slurs while claiming to be an ally.
    I’ve no doubt you’re well meaning but it’s no longer enough; for the dead and the irreparably traumatised by the brutalising involvement of psychiatry in their lives.
    As for the ‘survival’ of psychiatry… *sigh*… The cure for that particular delusion would be to sit down and read Burstow’s new book.