Me, Allen Frances, and Climbing Out of a Pigeonhole

Robert Whitaker
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Four weeks ago, after I wrote a blog about a study that concluded there was no good evidence that antipsychotics improved long-term outcomes for people diagnosed with schizophrenia, I was cc’d on an email that had been sent to a number of “thought leaders” about what I had written. At least as I read the email, it put me into the usual pigeonhole for critics of psychiatric drugs: I apparently was globally “against” medications, and I had displayed a type of simplistic “categorical” thinking.

All of this led to my having an email exchange with Allen Frances, who urged me, if I indeed thought antipsychotics had a use, to make this publicly known. My writings on this topic, he wrote, had:

“Caused collateral damage in 2 ways: 1) misleadingly discouraging meds for those who have tragic outcomes without it, and 2) contributing to the adversarial relationship between service users vs providers & families that is unique to the US and a major reason our system is such a mess. I am absolutely frank with you because I think you are intellectually honest and well meaning, but also unbalanced by the pressures of leading a crusade and by a lack of clinical and life experience with the constituency whose needs you ignore. With relatively small changes in the emphasis of your message and a clarification that you support selectivity, you could broaden your mandate to include the needs of the severely ill inappropriately in jail & homeless and could help heal the rupture between users and providers & families. I understand that you haven’t caused the problems and the limitations of any one person in healing them, but you are in a unique position to help and I think it would be irresponsible of you not to try once you fully understand the other side of the story you are presenting.” (Quoted with Allen Frances’ permission.)

Pete Earley also wrote to say that if I wrote such a piece, he would like to publish it on his site.

Now, my first response was to point out the obvious, as I did in my reply to Dr. Frances: I think his understanding of my “influence” is greatly exaggerated. My second response was to shake my head in wonder: That is quite the paragraph! But then I began grappling with whether to respond to his request to declare that I “support selectivity” in the use of antipsychotics.

It was, after all, a request that, at the outset, puts me into a pigeonhole not of my own making (anti-med), casts me more generally in an unflattering light (my work is misleading, unbalanced, irresponsible, and so forth), and then asks me to do something I never do, which is express my opinion, to “service users,” on how antipsychotics should be used. I have an opinion on what the scientific literature has to say about the use of antipsychotics, but that is a very different thing. The latter reflects the source of my writings on this subject, and its limitations.

Plus, I have written about my thoughts on this many times: I think the scientific literature argues for using antipsychotic medications in a selective manner that seeks to minimize their long-term use.

However, while I was dithering on whether to publicly respond, Allen Frances wrote a blog on the Huffington Post titled “Psychiatric Medications are Not All Good or All Bad.” There were pro-medication fanatics, and anti-medication fanatics, and Allen Frances, in his private email to me, was in essence asking me to climb out of the anti-medication fanatic camp (my pigeonhole), and join him and Virgil Stucker, from the Foundation for Excellence in Mental Health, in this “middle way” camp.

Having read this, I can now see a reason for responding, as it can help put the issue that society needs to address into clear focus. In his “middle way” piece, Allen writes that psychiatric medications are “very helpful” when prescribed for “clear-cut psychiatric disorders.” In his view, the problem with our societal use of psychiatric drugs is that they are overused, and that it is when they are prescribed to people without any real disorder that they cause harm. This is a critique that is entirely consonant with the conventional narrative: the drugs are effective, and the problems arise from poor prescribing practices. There is nothing in that critique that challenges conventional wisdom.

I think the issue is of a very different sort. I think science is telling us that antipsychotics, on the whole, worsen long-term outcomes, even when prescribed for “clear cut psychiatric disorders,” and thus, if psychiatry wants to develop evidence-based protocols, it needs to figure out how to minimize their long-term use. And that is a belief that directly challenges the conventional wisdom, and calls for a very different response.

Although this is going to make for a long blog, in order to respond to Allen Frances’ request, I think is important to once again detail my “journey” through scientific literature. It takes time to reject a conventional narrative and see the world in a new light.


Step One: Mad in America

As I have often written before, when I first dove into this subject of psychiatry, while co-writing a series with Dolores Kong for the Boston Globe, back in 1998, I did so with a conventional understanding of antipsychotics. Our reporting took place within a societal narrative that went like this: Antipsychotics were an essential treatment for schizophrenia and other psychotic disorders. They fixed a chemical imbalance in the brain, and thus were like “insulin for diabetes.” These drugs kicked off a psychopharmacological revolution, a great advance in care. Their discovery in the 1950s made it possible to close the mental hospitals, as the severely mentally ill could now live in the community. And, if patients didn’t want to take the drugs, that was because they lacked insight into their disease, and didn’t know the drugs were good for them.

Given that context, Dolores Kong and I wrote, in one part of the series, about how unethical it had been for psychiatric researchers to have conducted studies in which antipsychotics were withdrawn from schizophrenia patients. Would a study ever be conducted where insulin was withdrawn from a diabetic?

The one nettlesome factor for me, when we wrote that series, was that when I called up David Oaks of Mindfreedom for a quote, expecting him to say how awful such studies were, in that they took away helpful treatment, he said instead that there was good reason for “patients” to hate those drugs, and stop taking them. They often made people feel like zombies, he said, and then he added something about the drugs causing “brain damage.” I then called up a “thought leader” to ask about this, but he assured me that while antipsychotics did have side effects, the people who didn’t like them didn’t understand that they were sick and thus needed the medication, and as for the drugs causing brain damage, if anything it was untreated psychosis that caused brain damage, and the drugs helped protect against that.

But Oaks’ words stuck with me, a seed of doubt had been planted, and after I got a contract to write Mad in America, I came to see that there was a “counter-narrative” that could be investigated. If there was anything evident in a study of the history of the treatment of the “seriously mentally ill,” it was that the “mad” patients regularly saw the treatments forced on them in a different light than those who prescribed the treatment. There were competing narratives, and that remained true in the modern pharmacology era. In the conventional narrative told to the public, antipsychotics are characterized as a great medical advance. Then there is the counter-narrative told by many who had taken the drugs (and often forced to do so). And here is what I found while writing Mad in America: when you hold up these contrasting narratives side by side, history and science provide reason to conclude that the patient narrative has much merit, and give the lie to the conventional one.

Every important detail from the conventional narrative, which tells of a great medical advance, can basically be filed under the heading of “not really true.” The arrival of the antipsychotics into asylum medicine did not lead to deinstitutionalization; a change in social policy did. The dopamine theory of schizophrenia arose from an understanding of how drugs acted on the brain, and not from an understanding of what was going on in the brains of people so diagnosed, and when researchers looked to see whether people diagnosed with schizophrenia had overactive dopamine systems as a matter of course, they didn’t find that to be so. The drugs were not like insulin for diabetes. Nor was there evidence that the arrival of the antipsychotics kicked off a great advance in outcomes for schizophrenia patients. Indeed, in a 1994 paper, Harvard researchers reported that long-term outcomes were now no better than they had been in the first third of the 20th century, when water therapies were a mainstay treatment.

In contrast, a scientific understanding of antipsychotics supported the patients’ counter-narrative. Thorazine, Haldol, and other first-generation antipsychotics powerfully blocked dopamine pathways in the brain, which reduced one’s capacity to respond emotionally to the world and to move about it. Hence the zombie feeling. Antipsychotics did cause brain damage, as could be seen in the twitchings of people who developed tardive dyskinesia after years on these drugs. Moreover, research had shown that in compensatory response to the drug’s blockade of dopamine receptors, the brain increased the density of its dopamine receptors, and, there was reason to worry that this increased the person’s biological vulnerability to psychosis. Given these facts, there was plenty of reason for people diagnosed with schizophrenia and other psychotic disorders to want to stop taking them.

In terms of the “evidence base” cited by psychiatry for its use of the drugs, which is held up by psychiatry as its trump card in this battle of narratives, it is easy to see that the evidence for long-term use is flawed. Researchers had conducted any number of studies in which a group of stabilized patients were either maintained on an antipsychotic or abruptly withdrawn from the drug, and with great regularity, the drug-withdrawal group relapsed at a higher rate. This was seen as proving that continual drug use lowered the risk of relapse, and thus provided evidence for maintaining patients indefinitely on the medication. But, of course, another conclusion to be drawn is that the high relapse rate is a drug-withdrawal effect, and not evidence of the long-term risk of relapse in unmedicated patients. The relapse studies also didn’t provide any evidence about how well schizophrenia patients functioned on the drugs, or their quality of life, particularly over the long term.

As such, while writing Mad in America, I came to think that the problem with antipsychotics was that their use arose from a false narrative, as opposed to good science. Conventional antipsychotics needed to be seen for what they were: as agents that blocked dopamine receptors, which produced a cascade of effects. One effect, it could be argued, was that this blockade reduced psychotic symptoms better than placebo over the short term. Other effects of antipsychotics were decidedly negative, and as for long-term use, the evidence cited for this was flawed. Any helpful prescribing of the drugs would need to be done with that clear-eyed view of the science, and, most important, with a willingness to listen to the thoughts of those who were prescribed them. But the field had painted a picture for society of medications that were curative and essential, and in order to maintain that story, the field had to dismiss the protests of patients as evidence of anosognosia.

That was the history told in Mad in America. The book wasn’t about whether antipsychotics were “good” or “bad,” but about the story told by psychiatry about the drugs (to society and to itself). It was that false storytelling, together with the dismissal of the patients’ subjective experiences on the drugs, that was a prescription for using the drugs in a way that did harm. The false storytelling—as the subtitle of Mad in America suggested—led to “bad medicine.”

As for the merits of the newer atypical antipsychotics, when Mad in America was published (2002), the new “atypicals” were being presented as a great advance on the first-generation antipsychotics. At that time, I believed that it was too early to know whether that was so, particularly since this “advance” could not be found in the trial data submitted by the makers of the atypicals to the FDA, but only in the articles published by researchers paid by the pharmaceutical companies to conduct the clinical trials. So, it seemed to me, the jury was still out on whether the atypicals would prove to be so great, and as subsequent government-funded studies revealed, the data submitted to the FDA proved prophetic. The new drugs could not be said to be an advance on the old.


Step Two: Anatomy of an Epidemic

In Anatomy of an Epidemic, I focused specifically on this question: What did the research literature reveal about the long-term effects of antipsychotics and other classes of psychiatric medications? Did they improve the long-term course of schizophrenia, depression, bipolar disorder, and other such major disorders? Or not? What did psychiatry’s own research show?

Moreover, I wasn’t intent on investigating whether the benefits of a class of psychiatric medications outweighed their risks. I wanted to see what the literature revealed about their long-term effects on the benefit side of the equation only. Did the literature show that the medications reduced the target symptom of the disorder over the long-term? Did they improve functional outcomes? For a class of drugs to be seen as “effective,” there has to be something on the benefit side of the risk-benefit analysis, as otherwise there are only aggregate risks to be tallied up. And I wanted to see if such benefits were visible in the scientific literature.

Now, when you focus on that question, you have to dig out a history of science, which stretches back to the years before the introduction of Thorazine, but suffice to say, by the end of the 1970s, leaders of the NIMH had expressed a concern that antipsychotics might have the perverse effect, over the long-term, of making patients more biologically vulnerable to psychosis than they would be in the normal course of the illness. This worry arose from a retrospective study conducted by Samuel Bockoven, and by three long-term studies funded by the NIMH, and was expressed by William Carpenter, one of the leading authorities in schizophrenia research. In addition, there was growing concern about the frequency with which medicated patients were developing tardive dyskinesia, and this led Jonathan Cole, who was then head of the NIMH’s Psychopharmacology Service Center, to write an article provocatively titled: “Maintenance Antipsychotic Therapy: Is the Cure Worse than the Disease?

This worry arose at the same time that researchers were discovering how the brain, in order to compensate for the drug’s blockade of its dopamine receptors, increased the density of these receptors. Two Canadian researchers then argued that this drug-induced dopamine supersensitivity could lead to more severe psychotic symptoms, and severe relapses upon drug withdrawal. Thus, after 25 years of studying antipsychotics, researchers had come to a stunning possibility: These drugs might worsen the very symptom they were designed to treat, and that was apart from all of their other adverse effects.

As a discipline, psychiatry soon put that concern out of mind, or at least pushed it away from the forefront of its concerns. Then the atypicals arrived in the 1990s, and soon the field was convincing itself that the new drugs were markedly better than the first generation drugs, and would produce profoundly better long-term outcomes.

But although psychiatry may have pushed worry about drug-induced dopamine supersensitivity out of mind, in Anatomy of an Epidemic I kept that concern—and other related concerns about their long-term effects on functional outcomes—front and center. Thirty years had passed since that worry was first raised, and thus there was plenty of new research that could be reviewed, and what I found was this: A review of such studies, time and again, provided reason to think that antipsychotics were worsening outcomes in the long-term (in the aggregate). MRI studies by Gur and Andreasen showed that the drugs caused changes in brain volumes that were associated with a worsening of positive symptoms, negative symptoms, and functional impairment. The World Health Organization, in two cross-cultural studies, reported that schizophrenia patients in three developing countries had markedly better outcomes than in the U.S. and other developed countries, and that in those poor countries, only a small percentage of patients—16%—were regularly maintained on the drugs. Philip Seeman’s animal research led him to publish a paper on why antipsychotics fail over time, and it was because the drugs induced an increase in dopamine receptors with a “high affinity” for the neurotransmitter. Then came Martin Harrow’s long-term study, in which the patients who stopped taking medications had markedly better outcomes starting at 4.5 years. This evidence was of many different types—MRI studies, cross-cultural studies, animal studies, and a long-term naturalistic study—and it was all of a piece. And thus a coherent scientific narrative, stretching across fifty-five years, emerged: a worry about the long-term effects of antipsychotics arose within the first twenty-five years of their use, and evidence of many types since then confirmed that initial worry.

Now, given that evidence, what does that say about the “best use” of these drugs? That is a question that psychiatry, the mental health establishment, and society should discuss. But it is a discussion, I believe, that should begin with a full airing of the scientific literature.

If one wants to think “categorically” about this evidence (and in fact, “evidence-based medicine” regularly encourages categorical thinking), then an argument can be made that, if the drugs indeed worsen outcomes in the aggregate, then they shouldn’t be used long-term. The evidence calls for the development of some other form of treatment and care.

But that is an argument to be made by others. My own thinking, as I sought to write about solutions in the final part of Anatomy of an Epidemic, was this: at the very least, the “evidence” argued for a selective-use model, one that would involve trying to help first-episode patients recover without the use of antipsychotics, and for those prescribed the medications, there still needed to be an effort to minimize their long-term use. That was a model that could still take advantage of the drugs’ “short-term” efficacy in certain patients, and also provide for long-term use in patients that didn’t seem to do well without the medications. And so I scoured the research literature to see if there were any reports of a provider using antipsychotics in that manner, and that brought me to the research papers published by the Open Dialogue group in Tornio, Finland. They used antipsychotics in precisely that way and they told of five-year outcomes that were dramatically better than the norm in the United States and other developed countries, where the standard is to maintain schizophrenia patients on the drugs as a matter of course. For me, that program served as a “proof of principle”: the research literature showed that the use of antipsychotics needed to be rethought, and the Open Dialogue results told of the vastly improved outcomes that could be achieved by doing so.

Step Three: Post Anatomy

The first edition of Anatomy was published in 2010, and since then new research has been published relevant to this question. The evidence showing that antipsychotics shrink the brain has grown more robust. Philip Seeman published another paper on how both an atypical antipsychotic and a first-generation antipsychotic induced the dopamine supersensitivity that, in his animal models, led to the failure of antipsychotics over time. Martin Harrow published his 20-year outcomes, and published more detailed analyses of the better outcomes for the unmedicated patients. In one article, he reported that medication-compliant patients were much more likely to be psychotic over the long-term than those who got off the drugs early on and stayed off them, and he discussed whether drug-induced dopamine supersensitivity was a reason for that remarkable difference. Lex Wunderink published a randomized study that showed better long-term outcomes for those patients who got off the medication or down to a very low dose. And so on: all of the study results published after 2010 simply provided more evidence that the use of antipsychotics needed to be rethought.

The recent study by epidemiologists at Columbia University and City College of New York, which led them to conclude that there isn’t good evidence showing that antipsychotics provide a long-term benefit, is simply one more data point in that larger body of evidence. Their study didn’t involve an assessment of the benefits versus risks of antipsychotics; rather they conducted a search of the literature to see if there was evidence that the drugs provided a long-term benefit, and in particular, whether the drugs reduced the chronicity of psychosis over the long-term. But they didn’t find evidence that the drugs were effective on this target symptom over the long-term, and that is why I titled my blog, “Timberrr! Psychiatry’s Evidence Base For Antipsychotics Comes Crashing to the Ground.” The relapse studies don’t provide evidence for their long-term use, and these researchers couldn’t find any alternative evidence that the drugs improved long-term outcomes.

So, as Allen Frances asked me to do, I have made my thoughts known. I do not think antipsychotics are “good” or “bad.” Instead, I think the scientific literature argues for a dramatic rethinking of their use, organized around two principles:

  • Try to avoid immediate use of neuroleptics in first episode patients, as there will be a significant percentage who will recover without the medications (but aided by other forms of treatment), and this is a good outcome for those patients.
  • Once the medications are used, there should be an effort to minimize their long-term use, with regular support for drug-tapering protocols.

Now, as Sandy Steingard has written, incorporating those principles into clinical care may be quite difficult. But if psychiatry is going to be “evidence-based” in its practices, and if it is going to put the interests of its patients first, then I believe it has a duty to develop selective-use protocols, which seek to minimize long-term use of antipsychotics (and other psychiatric medications). I also believe that our society should provide the resources to enable this rethinking of the drugs.

This is Not a “Middle Way”

In his Huffington Post blog, Allen Frances argues for prescribing practices that he describes as a middle way. Prescribe them to the right patients, because for these patients the drugs can be life-saving, but curb the overuse and polypharmacy that can prove harmful to so many, particularly for those who have ordinary problems, as opposed to real psychiatric disorders. As you can see in his blog, he also sees this middle way as informed by his own clinical experience.

But, here’s the rub: the “middle way” he describes is not an evidence-based practice. It is not a practice that is informed by science that tells of drugs that induce a dopamine supersensitivity, which may increase the biological vulnerability to psychosis; or of science that tells of drugs that shrink the brain, with this shrinkage associated with worse negative symptoms and functional impairment; or of animal research that tells of why antipsychotics fail over time; or of science that tells of much higher recovery rates over the long term for unmedicated patients. Those are drug effects that are not immediately visible to the clinician, but rather are made known through the illuminating powers of science, and they pertain to those with “clear cut psychiatric disorders” too.

I know this blog is ridiculously long. But climbing out of a pigeonhole, while trying to explain one’s thinking on a complicated topic, can be a laborious thing to do.

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120 COMMENTS

  1. It does not look like Frances has understood your analysis. It looks like he is seeing it through his own lens.

    I find his comment, “…..the needs of the severely ill inappropriately in jail & homeless…” interesting. I wonder what he things causes people to be in jail or homeless? Pressumably he thinks they are due to inapropriatly treated mental illness. This leaves my wondering if Frances is aware of the very high prison population in the USA compared to the rest of the world or how homelessness is effected by social factors such as poverty?

  2. I think you have done a lot better job listening to people with lived experience than Alan Francis has. I think that first paragraph that totally miss understands all your point.

    And totally miss understands all the criticism that recovery movement people have been directing to wards Alan Francis.

    The bottom line is the disease model is ineffective for treating trauma and life situations. If psychiatrists can sort out what was a so-called really illness and what was trauma and life situation yes then you can drug the “real illness”.

    but the dsm-5 clinical reviews show that psychiatrists can’t even do that. And the research on trauma, hearing voices, etc shows ‘real illness” is few and far between.

    Another fail for Allen Frances. Some people can’t hear the people they purport to speak for. He needs to take that high horse ear wax out of his presciber fantasy land.

    • Sadly, logic, commonsense, and clear and critical thinking are not sufficient to overcome the defensive denial that psychiatrists use to deal with their cognitive dissonance. One could feel for their anxiety if it wasn’t for the continued destruction of their patients. How do we accept even one ruined life over the self esteem of the perpetrator?

  3. Psychiatry almost killed me and trashed a decade of my life.

    When I post facts that may cause some so called “collateral damage” it doesn’t bother me because I know psychiatry is doing so much more harm that good over all.

    “The Needs of the Many Outweigh the Needs of the Few”

    I will continue speaking out against psychiatry.

      • Treatment. Oh yes… the stripping of all your civil rights and denial of human frailties. I understand this violation.

        And our country dares to speak of the atrocities of others?

        For those who demand medications, I simply ask that they don’t demand me to take them.

  4. You go for help but instead get locked up, strip searched, told to squat and cough and told “things can get rough” when you refuse wile you are standing there naked with your bare feet on the hospital floor with strangers looking at you.

    If you disagree with your “treatment” like in my case a near overdose of three powerful drugs they threaten to penetrate your body and insert drugs using force and violence.

    But it’s Roberts fault people avoid help.

    That makes alot of sense.

    • Why was I in that “hospital”? I know readers want to know.
      Well I was up to my neck in lifes problems full of anxiety and drank myself sick for about a week. A little vodka but mostly Pinot Grigio white wine. Totally sick unable to continue drinking to keep the anxiety at bay without throwing it up I surrendered and went to the ER looking for help, detoxification.

      I was shipped off to that “hospital” and endured that absolute nightmare. One of the worst parts of the hospital nightmare was befriending people and then having to watch them get assaulted by staff and not be able to step in without getting it yourself.

      I posted enough, leave some room for other people.

        • Thank you for sharing your difficult story cat. Glad you survived through that psychiatric nightmare. I couldn’t agree more about the value of Rob Whitaker’s work for us and others as they search for ways to ease their’s and others’ mental anguish. We all have come together in search of truth on this website. You are so wrong Dr Frances. Please ask us before you make these unfair and baseless judgements about Mr. Whitaker’s books, lectures and work.

  5. But, here’s the rub: the “middle way” he describes is not an evidence-based practice. It is not a practice that is informed by science that tells of drugs that induce a dopamine supersensitivity, which may increase the biological vulnerability to psychosis; or of science that tells of drugs that shrink the brain, with this shrinkage associated with worse negative symptoms and functional impairment; or of animal research that tells of why antipsychotic fail over time; or of science that tells of much higher recovery rates over the long term for unmedicated patients. Those are drug effects that are not immediately visible to the clinician, but rather are made known through the illuminating powers of science, and they pertain to those with “clear cut psychiatric disorders” too.

    Fantastic. 🙂

  6. So many of us have told our stories of having gotten so ill on the psych drugs, the trauma of coming off of them, and the subsequent clarity and well-being we experience AFTER ditching them. Many of us can look back with clear insights regarding our experience, and it is not favorable at all to psychiatry and its practices. It’s a shame these stories are not more highlighted and explored, for the sake of the clients and others seeking relief from severe distress, disabling anxiety, and perpetual confusion.

    I believe the needs of the clinicians are being more reflected here, and they are hard to budge from their beliefs, because it really throws a wrench into their reality, in many ways. That is something they need to face, I strongly believe. Too many of us understand this all too well, mental health practices as a political tool, rather than as a pathway to healing.

    • I agree with you that all clinicians (psychologists and social workers too) need to face the true facts of what the accepted “treatment” is actually doing to people. My question is how do you get people to do this? I work in a state “hospital” and every time I ask something that comes even slightly close to calling the “treatment” into question it sets off reactions in the clinical staff, especially the psychiatrists, that are unbelievable. At one meeting where I questioned the value of ect as a “treatment” I was verbally tarred, feathered, and ridden out of town on a rail! I asked the psychiatrist giving the talk on ect why it is that psychiatry wants to induce seizures and convulsions in people as a “treatment” while every other medical specialty tries to keep people from having seizures and convulsions. His reply was that the seizures that he induces in his “patients” with ect benign and are not harmful like other kinds of seizures. When I questioned this statement the room exploded with people yelling and screaming at me. When I tried to talk with the two psychiatrists who may be more open to considering new ideas they claimed that Robert Whitaker is a very angry man! So, how do we ask the questions that will get them to face the issues that they need to face?

      • Definitely the million dollar question, Stephen. I’ve had the exact same experiences as what you describe, at staff meetings, as well as at a NAMI conference to which I scored a free pass, and I very mildly challenged all of this. In fact, I really just questioned that perhaps, we are being a bit over-zealous with ‘medication’ (my feelings and opinions were much stronger, but I knew I’d encounter hostility if I went full guns), and I STILL got hostility thrown at me! As well as some very unkind words from the psychiatrist who was taking questions from the audience, when I went up to the mic. The fact that he attempted to make me feel public shame was my best insight into his toxic personality. Shame, shame.

        I also cornered the APA prez at the time, in the corridor, and asked him about the harms of medication, which, of course, led to some vague and dismissive statement before he ran off in the other direction. Seriously.

        You are correct, they will not hear a thing, and woe to anyone that even hints that something may be off here. That is very deeply entrenched brainwashing and indoctrination, akin to cult-thinking. Those neural pathways seem to be set in stone.

        So, what is to be done? Again, the million dollar question–in that, whoever cracks this code deserves that million, and much, much more.

        • You have to keep in mind, that in order for the psychiatrists to accept the truth, regarding the fact their drugs actually create the symptoms of the illnesses they are purported to cure. The psychiatrist has to come to the realization that he has spent his entire life creating “mental illnesses,” with his drugs, in people for profit. Which has got to be a pretty hard pill to swallow, if one does have any ethics. Not to mention, he would have to realize his entire medical education was a sham. He was duped. All tough pills to swallow.

          But, so are the “psychosis” creating, antipsychotics.

          • I think you’ve hit on an important point here. If they’re truly ethical people then they will have to admit that they’ve been doing harm to people and that’s probably just too much to face. I do know of two psychiatrists who took their shingles down and quit practicing when the Bio-Bio-Bio stuff took over completely. They stated that they couldn’t be a part of what was being done to people in the name of “good treatment” if they were going to be able to look at themselves in the mirror each and every morning.

          • True, Someone Else, and even though people are justifiably angry, we can show compassion for the unwitting perpetrators of systemic harm—iatrogenic and otherwise–knowing that they were doing what they were taught and trained to do. Everyone deserves a chance to awaken, heal, and make amends for their mistakes and misjudgments. No one on the planet is perfect, and we all have learning curves.

            And many of us are hit in mid-life with hard truths, realizing that we’ve been living inside an illusion all along. That’s a big challenge, but it’s called growth and evolution, and we all face it. It’s extremely humbling.

            For me, that’s what going through the mental health system was about, facing the hard truths of my own life, and how I create my own reality. Once I got it, and it took some work to shift my consciousness to that degree, I was free.

            However, when a significantly large number of people with lived experience through all of this harm, and who are trying very hard to recover from all of that, say in just about every tone possible up and down and in between, repeatedly, for years and years, in print, in person, or on film,

            “Hey, you guys are doing tons and tons of harm to people, and this is how, and here is a lot of evidence, especially our myriad voices of experience, those of us who were seriously injured and derailed from our lives because of this most unfortunate detour through the ‘mental health’ system and its many tangents,”

            and they keep coming back with one bullshit response after another–and I call it ‘bullshit’ because it is always heady, vague, speculative, sometimes demeaning (you take your chances there) and completely dismissive of the client/survivor, one way or another, including saying ‘we need more research’ and ‘what about our feelings?’–at what point will everyone say, “Enough already! It’s so obvious! And you’re just postponing the inevitable, while dragging others down with you, because you are stubborn as all get out.”

            It’s hard to hold compassion when you put reason AND evidence in their faces and they continue to ask for their feelings to be included. Would that they only knew and felt what an over-drugged, blatantly stigmatized, marginalized, second-class citizen feels, and so, so often, at THEIR doing, via their so-called ‘treatment.’ Then, I’ll be ready to talk about empathizing, when it goes both ways.

            There is no compromise, here, not if we want healing and justice to happen, both individually and socially. Sorry to be so blunt and clichéd, but it’s quite clear to me that the insane are running the asylum.

            People really need to wake up in order for all of this to go away, which is what I would like, as well, for the greater good of society. It is not a healthy field, not in the slightest. In fact, it is pure toxic. Isn’t that hella obvious by now?

            I feel strongly that it cannot redeem itself, it must bow out of the healing game, because there is not healing here. That is fraudulent advertising, from where I sit.

            ADA says, “Reasonable accommodation for reasonable request.” I don’t see that happening here, not at all.

          • Stephen, your point about the two psychiatrists made me think about why there was a move towards the bio-bio-bio psychiatric system. No doubt, because it made life easier and more profitable for the psychiatrists. And it’s the pharmaceutical industry’s wet dream. But we do also need to place blame on the medical insurance industry, who would rather pay for “quick fixes,” rather than actual cures. And the entire allopathic medical / pharmaceutical industry’s theology that treating symptoms, rather than actually curing people, is also to blame. One does, of course, also need to blame all those profiting from all this, and funding all this misinformation – both in the medical schools and the fraudulent pharmaceutically funded research about the drugs. And, confess, historically, it’s been evil governments that espouse belief in psychiatry. And our current government is profiting off all this pharmaceutical harm of it’s citizens. I could go on.

            Good rant, Alex, completely agree.

          • It is my honest opinion from a variety of perspectives. No time to mince words. I also hold to my opinion regarding tower of babel, or just plain ‘tower’ tarot card. It really is a time of radical change and transformation, it’s happening globally.

      • I wonder though Stephen if you were talking about the old ect or the new ect? Because we’ve gone solar, none of that old coal fired stuff around here.

        Seriously though, I have a letter from our Chief Psychiatrist who, explaining the diagnostic process used by a Community Nurse stops at the point where I am sure he was going to write ‘he has a set of magic bones which your not capable of reading”. I kid you not. I might have believed it had I not done my first 2 years at college studying psychology, and could see through his ‘verbal’ in a minute.

        How do we get them to face it? Only two options when you have no defense, attack or retreat. Be prepared for both.

        • “… stops at the point where I am sure he was going to write ‘he has a set of magic bones which your not capable of reading”
          This seriously was the belly buster laugh for the day but because I can visualize it in my head. But, I would give a shaman more credit than a psychiatrist.

          Great exchange and so spot on. The system is upside down and the “Healers” are sicker than those they purportedly help. How to right this upside down problem, inject honesty (without facing persecution) and to make actual change is a real dilemma. Refusing to partake in the game as individuals and creating a community will eventually make a difference I hope.

          • I really should publish the letter. I don’t know the role in the US system but our Chief Psychiatrists role is to oversee the provisions of the Mental Health Act.

            In this letter it is obvious he does not know what a burden of proof is (suspect on reasonable grounds) and would therefore fail a first year law course, and is of the belief that the Community Nurse was capable of traveling through time and space to make observations of thoughts.

            3 weeks before I had been angry at a person for attempting to blackmail my wife. The law states that the CN needs to make actual observations before having grounds to detain. So he did his Dr Who trick, went back in time and observed me having “thoughts of harming others” This, according to our Chief Psychiatrist is quality psychiatric diagnosis.

            So our Chief Psychiatrist wouldn’t pass a first year law or psychology class, and he is being paid how much to provide advice to the Minister? And we wonder why there seems to be a problem? Lucky the hae the powers to cover these thigs up or they’d be screwed.

          • Funnily the Community Nurse does know what the protections of the Mental Health Act are, and more importantly how to subvert them with the corrupt practice of verballing (ask the questions and write down the answers you want to hear on the stat dec). Insignificant matters become symptoms of a mental illness and the victim is injected with a cocktail of drugs and laying in a cell before even having the opportunity to speak to family members.

            Even more effective that police doing it to obtain wrongful convictions, because the victim is now restrained with the drugs, and appears to be ‘mentally ill’. I’ve heard it called “noble corruption” and is thus enabled by the authorities because we just know they’re guilty, I mean ill

            To commit these acts of fraud one needs to know both the Act and psychology. He would make a better Chief Psychiatrist lol

          • I don’t know that Americans would appreciate the levels of excitement in law enforcement at being provided access in our new MHA to a system where evidence which can not be tested can be fabricated, and the victim is then rendered incapable of defending themselves due to the effects of drugging.

            Needless to say they were ready to go within weeks.

            Law and order minus the courts? waaahahahaha

        • Exactly. He tried to convince me that the way they do ect now is so much better than in the “old days” when things were so primitive. Of course, then I had to explain that with the use of oxygen and anesthetic that the threshold for inducing the seizure goes higher so you have to zap people with even more electricity than they did in the old days. Needless to say, my observation was not welcome, even though it is the truth. Go figure, what does truth have to do with any of this?????!!!

  7. Dr. Frances,

    I am a mother of a young adult who experienced “florid psychosis” according to his therapist, yet came through the experience after 2 weeks, with minimal meds (Benzos used for a few nights to help him get back to sleeping at night) using a dialogic home and family based approach with a psychiatrist trained in Open Dialogue. This was 18 months ago. The psychosis has not recurred, he is not using any meds and he is in his third year of college. This would not have happened this way if we had taken him to an ER.

    Robert Whitaker has raised very valid and important issues about the dishonest and problematic ways psychiatry is practiced in this country. As a licensed therapist, a “peer” who experienced my own full recovery 38 years ago and as a family member, I am so thankful for Robert Whitaker’s work. I am not alone.

  8. What a lovely thing to see some actual clear thinking on the issue of the use of psychiatric medications: someone who understands the difference between “express[ing] my opinion, to “service users,” on how antipsychotics should be used” and “hav[ing] an opinion on what the scientific literature has to say about the use of antipsychotics”.

    The whole field of psychiatry does not seem to be able to tell the difference between these two things, constantly ignoring and misrepresenting what their own scientific literature actually shows, conflating this data with their personal/professional opinions with how they think medications should be used and how they and the pharmaceutical companies making them want them to be used.

    Allen Frances is amongst the many who, for whatever reasons, repeatedly fail to recognise this essential difference. Given he personally urged you to engage in this dialogue and make your position on the use of psychiatric medications known, I would hope he (amongst many others) has the capacity for enough insight to recognise this central point you have clarified.

    I look forward to a response from him and would very much like to see him demonstrate a capacity for equally clear analysis and expression of his perspective.

    Keep it up Robert. x

  9. Dear Mr Whitaker,
    if you keep telling the kiddies that there is no evidence to support the existence of santa you will take away the carrot and leave only the stick, and contribute to an adversarial relationship between parent and children.
    We are aware that it is not a real carrot, but this noble lie has been cotributing to effective outcomes for clinicians and family members for many years now. Please cease and desist with this truth, and show your support for santa and his helpers publically.
    regards
    santa.

    Thank you Mr Whitaker.

  10. There are several delusions apparently operating in Frances’ thinking, including:

    1) Seemingly not realizing that a primary reason for the “unique adversarial relationship” between service users and providers/families in the US might be because overdrugging and biological labeling are so severe in the US, and that service users mostly hate taking the drugs and being labeled with fraudulent non-illnesses – especially those labeled with “real clear-cut disorders”. Indeed, Grace Jackson’s research indicates that the United States, a country with 4% of global population, consumes over 60% of antipsychotic drugs taken annually.

    2) Seeming to misunderstand what is being said about outcomes/research on drugs on average/aggregate, and what is being suggested for individuals. Whitaker is not discouraging meds for people who might be judged to need them by certain professionals. He’s saying that from the 30,000 foot view, most of the data shows that drugs either aren’t needed or should be used short-term only.

    3) Delusionally assuming that mental health “professionals” can reliably distinguish between people who “have severe mental illnesses” and those who don’t. This assumption is so common by psychiatrists: assuming the are talking about something real and reliable when they say “schizophrenia” or “bipolar”. The reality is there is no sharp line between people “with” or “without” these labels – and they are labels applied to people, not brain diseases people have – it’s a continuum with people’s problems constantly shifting due to diferent life experiences. There’s no clear-cut group that absolutely needs or absolutely doesn’t need drugs. And the reliability of the labels like schizophrenia is just crap: These labels are fake artificial demarcations, like saying that three stars in the sky really are Orion’s Belt, as I commented in another post. These words mean little in these individualgroup level studies, even less when applied to an individual. The DSM 5 field trials with their horribly low reliability were the nail in the coffin for DSM diagnoses.

    In his writing, Frances ignores that drugs are still being prescribed for “illnesses” that don’t even exist in the sense of being able to be reliably identified and in being valid. The writing of Mary Boyle (Schizophrenia: A Scientific Delusion), Richard Bentall (Madness Explained), Jeffrey Poland, Stuart Kirk, Paula Caplan, and other qeustioning psychiatric diagnosis is still powerfully relevant. As well as the admissions by Insel and Hyman that the DSM is a fraud. There can’t be a “middle way” that is “evidenced-based” when your diagnoses are a scam.

    That’s what Allen Frances really is: An Emperor without any clothes, the defender of a fraudulent system. His is an approach that privileges anecdotes and rhetoric over real data and evidence, because the psychiatric system he helped build doesn’t have real evidence or validity. But of course, as its former emperor, he can’t admit what a fraud it is.

    To Robert Whitaker, I like your article but find it a bit offputting to see the use of words like disorder and illness. Although, I guess you are often saying things in terms of how others in the mainstream say them. I encourage you to continue to overtly discuss the lack of validity and reliability of these “clear-cut psychiatric illnesses”: That is one of the Achilles’ heels of psychiatry.

    Also, and again, the voices of Allen Frances (and it has to be said, to a degree, although inadvertently, Robert Whitaker) are being privileged and heard above those of the people who are actually psychotic or taking the drugs. How often do we hear from them in public discourse about what they think about having to take these drugs or about the validity of labels like schizophrenia? Hardly ever. Instead Allen Frances and Pete Early and E. Fulley Torrey and even occasionally Robert Whitaker talk on and on as if they had the self-appointed right to lay out the course for what happens to people in our society having psychotic breakdowns…. when they aren’t one of us, they aren’t among the people who have been in the system or been on these drugs for years… Whereas the primary choices should actually be down to services users and their families who are provided with access to reliable accurate information, as it must be said that Robert Whitaker supplies a lot of here in his links.

    • “Hardly ever”? Are you not aware that the comment section you wrote this in is a space created for precisely that purpose — for people with experience of the labels and the drugs to say what they think about it? And that our forums also serve that purpose? And our entire Personal Stories section, and a number of our blogs? Inclusion and amplification of the survivor voice is a key part of the mission of this organization that Robert Whitaker started, so your criticism seems pretty misplaced.

      • I am talking about the much bigger picture Emmeline (that’s what I meant by “public discourse”, perhaps it wasn’t expressed clearly). MIA is only a few drops in the ocean of the nationwide conversation about “mental illness” and psychosis. The volume of readership and reach of major news organizations like major newspapers and TV reporting and NAMI/MHA is much greater than MIA and in these arenas, relatively few psychiatric survivors are heard when “mental illness” is discussed. Although, perhaps the situation is changing a little bit for the better.

        But yes, I do give credit to Robert Whitaker for letting more survivors be heard here on MIA, absolutely.

        • I should have also referred to the mainstream news as what I was talking about. As Robert implied in his post, Allen Frances probably gave him a bit too much credit when he said he/MIA had “great influence” on a larger scale. But on the other hand it’s hard to see the relative strength/influences of these different factors because it’s somewhat subjective.

  11. While Allen Frances sees himself as very different from a typical establishment psychiatrists with his recent book critiquing the DSM-5 (favoring the DSM-4 for which he chaired the task force), Frances is essentially no different from every establishment psychiatrist in this KEY VARIABLE: continued arrogance that his position is the “middle way” and thus the best way.

    The reality is that Frances’s position is nothing more or less than Frances’s position.

    History is replete with big shots who believe themselves rational and reasonable because they call for a middle way, using that as a negotiating technique to manipulate the rest of us to take seriously complete bullshit.

    Remember the “Three-Fifths Compromise”? That was the “middle way” of solving the problem of how slaves were to be counted for purposes of representation.

    Frances’s “middle way” positions often begin with taking seriously complete bullshit. That’s clear with Frances’s DSM-4. The entire DSM idea has NOTHING to do with science but is instead completely based on the highly subjective and biased opinions of a committee of psychiatrists, the majority of whom have financial ties to drug companies. So, maybe the DSM-4 is the “middle way” or less bullshit than the DSM-5, but Frances’s DSM-4 is still bullshit.

    So, let’s start taking seriously the issue of credibility. Let’s start with the research reality that psychiatry has, historically, been repeatedly WRONG ABOUT EVERYTHING it has once claimed with total certainty. Wrong about its claims for treatment effectiveness, wrong about its assertions of treatment safety, wrong about its denials of medication dependency, and so on.

    So, one could argue that the “middle way” should be between laughing at psychiatry or being enraged by it.

    Or let’s stop playing the rhetorical game of “middle way” and simply take ownership for one’s position.

    My position is that society start listening -– REALLY LISTENING — to ex-patients of psychiatry who have been horribly failed by psychiatry and for society to fund very different alternatives that have nothing at all do with psychiatry — Bruce

    • Thanks so much for calling it what it is.

      One only need to look back to the days of blood letting and conversion therapy to see the roots of this “profession” have always been based on bullshit. The big wave of change came when psychiatry teamed up with big pharma and they made a killing financially and in those entrusted to their care, literally. How psychiatry ever gained any credibility is still puzzling but if you tell people a lie often enough it isn’t questioned.

      The terrifying part of it all is to watch the suspicions about the profession come out to see the government react in keeping things as they are. This new screening they are pushing as another “prevention” tool is disturbing. They have failed at prevention so they will get more freedom to pursue and victimize? That’s not a middle ground, that is a blatant step backward. It’s bullshit.

    • “My position is that society start listening -– REALLY LISTENING — to ex-patients of psychiatry who have been horribly failed by psychiatry and for society to fund very different alternatives that have nothing at all do with psychiatry.”

      Wow, thank you for this very clear and directly stated position, Bruce.

      As an ex-patient of psychiatry who was horribly failed (to put it mildly) by psychiatry, with a fully documented resume to prove it and a loud voice, and also a film with a choir of survivor voices, to sell it–and also as one with a well-established and generally acclaimed healing and teaching practice that has nothing to do with psychiatry, and which I’m looking to expand into a healing arts center featuring healing through creativity–I say, “From your lips to God’s ear!”

      I appreciate the virtual support, very powerful. Thank you, again 🙂

  12. Thank you Bruce. I’m getting really weirded out with all this talk about “medications,” studies, outcomes and whatnot when the elephant jumping up & down in the middle of the room is that there are no mental diseases, period. Any drug is missing the point if the idea is to solve the problem, which is not a medical one but a political one.

    There’s no point in schmoozing these people, Mr. Whitaker, they’re never going to “come around” or stop trying to get you to equivocate; it’s not in their interest. Just keep presenting the science, or lack of such, as you see it. The truth will out.

    • I am a big fan of yours since you are one of the few who understands that no “mental disorder” is a medical problem. I contend that we are discussing a social welfare problem that is created or worsened when politicized as a medical problem. Are you suggesting that we are discussing a political problem about nothing?

      Best wishes, Steve

      • “I contend that we are discussing a social welfare problem that is created or worsened when politicized as a medical problem.”

        Yes, but our internal landscape is what translates into our external reality. If we are predominantly focused on shadow, then that is what we create for ourselves, in and around us. Not at all to judge where anyone’s focus should be, we all choose our focus and how we navigate that, that is personal and we all have a right to choose this.

        But energy works on a cause-and-effect basis, and we are energy as is the world around us. How and on what we focus is what we end up projecting outward, as our personal reality.

        So if we want to change what is outside of us, we have to, first, make internal changes that will inspire us to shift our focus, and therefore, our energy. In turn, that changes our internal landscape to something lighter and more desirable, which will translate as such outside of ourselves.

        I believe that we sink into mental distress and despair when we feel powerless to make the changes we so desperately desire. Feeling powerless takes us from angry and enraged to despondent and hopeless. Knowing our power to create internal change so that we can create social change is what relieves that distress, because we become acquainted with our power to manifest what we need.

        My experience, in any event.

        • I agree that we create our own realities from a personal perspective but we interact socially and our culture currently considers emotional distress to be a “mental illness.” I do not believe that we can effectively challenge the dominant cultural view of emotional suffering without a challenging narrative. I am trying to create a consensus around an opposing narrative to offer the public for consideration.

          Best wishes, Steve

          • Seems to me that we all have our own personal narrative, that’s our story, which can evolve over time, with new perspectives.

            I don’t see how something like this could be universal. I think the mainstream narrative is based purely on stigma, in that is the illusion of speculation from superficial observation. The solution would be for people to own their projections, but I don’t see that occurring a lot.

            In the meantime, what can we learn from a sick society?

          • For example, my own personal narrative of what I, myself, considered to be my own mental illness–which is what it felt like, not via a ‘disease,’ but by virtue of the fact that my self-perception was way off, very low self-esteem which caused me terrible anxiety and insecurity, even though I was out and about in the world, trying somehow to make it work–is due to my upbringing, which was very strict middle class blend in and don’t embarrass the family, which came with a great deal of control and abusive oppression that stifled my voice and spirit.

            My family is very academically oriented (father and brother both professors) and I am artistically inclined, and that was a huge problem for my dad, and it became very personal and demeaning, as a result of my not wanting to follow his directives. That was quite scary for me, given that at the time of my youth, this was the template of my personal universe.

            I wasn’t aware of this on a conscious level, I thought it was this way for everyone.

            Only when I was growing into an adult did I realize that I had some pretty dark feelings which made me feel very confused, extremely anxious, and emotionally unstable (ungrounded).

            Then, instead of simply hearing my woes about my family issues and offering me perspective, I was, instead, offered ‘medication’ by the “mental health establishment”–and a diagnosis–which I eventually accepted, and I went on to have a life, medicated and diagnosed, but still, with a career, formal education, and a long-term relationship which is going stronger than ever after 30 years now.

            20 years after receiving my initial diagnosis and scripts, just after finishing graduate school, the psych drugs broke down my system completely, and to me, that became severe mental illness, in that I could neither function, think, speak, nor hear with any clarity at all, and I became completely disabled for a good long while. My brain was cooked and burned at that point.

            So I ditched the drugs (long, complex process) and worked with what I had internalized from my family–and brought in a lot of self-compassion, along with forgiveness to release resentment and blame in order to take control of my own life and well-being.

            Then I did a variety of healing practices having nothing at all to do with the mental health community but with other modalities of healing, in order to re-route my neural pathways to create new and better, more neutral responses to life’s challenges, from an expanded perspective and awareness which I learned through spiritual and energy studies. This was a completely natural process, with self-agency being the priority.

            And, most importantly I made peace with and accepted my family dynamic and learned to operate independently of it, while continuing to have a relationship with them, although now it was on my terms–that is, I confronted them about their oppressive ways, as well as their blatant stigma, and set a firm boundary around this. As a result, they had to face their own fears and other issues.

            My family has healed in many ways, as a direct result of my healing and truth-speaking. I sent them my film where I tell my family story, and that began our dialogue, which before then, was impossible to instigate, they would get extremely defensive.

            They understand this all much better now, which is a relief for me, and which allows me to continue my life upbeat, optimistic, and centered in my own reality, healthy, grounded, and clear. These days, I’m simply creating to my heart’s content, which is my freedom now.

            So that’s my personal narrative of how I became what I have no problem referring to as ‘mental illness’–first, from family oppression, stigma, and abuse, and then from the same treatment by the “mental health” community, 100,000 worse and totally systemic, via drugs and blatant stigma and discrimination; and subsequently, how I healed from it, after a long bout of disability, via forgiveness, truth-speaking, heart healing, expanded awareness, teachings in perspective, creative endeavors, and natural remedies which supported my body’s ability to heal on its own, with good self-care. That was the clincher.

      • Are you suggesting that we are discussing a political problem about nothing?

        I concur that much or most of the human suffering generalized into categories of “mental illness” can be labeled as social welfare issues if you will. However the causes of said “social welfare” problems lie in the political/economic structure; in this day & age the latter takes the form of corporate capitalism. That’s what I mean by political.

    • I, too, agree old head, other than there’s tremendous amounts of money generated in creating the DSM “mental illnesses” with the psychiatric drugs. But now that the DSM has been confessed to be invalid and unreliable, I’m quite certain the ongoing stigmatization with these disorders should end. But it’s so very profitable, and maintaining it, does allow all mainstream doctors to have the power to legally defame, torture, and murder people to cover up their easily recognized iatrogenesis. And it allows all the paternalistic religions to cover up their child molestation problems, too. And all the bad governments throughout history have advocated belief in psychiatry, as well.

  13. Robert Whitaker,

    You must be so exhausted trying to present this information over and over and over, in response to critics who twist what you say, accuse you of things you haven’t said, and NEVER< NEVER<NEVER actually talk to the points you make. There must be so many psychiatrists reading this post – but I wager not one would be able to write a logical summary as to why or how this carefully worded, extremely thought out presentation of research could possibly be thought of as 'simplistic' or 'categorical'.

    Thank you for being `the messenger' and having the courage to put up with all the `shooting' that comes with that role.

  14. Great blog Bob!
    I see Allen that patronizingly thinks you’re- “unbalanced by a lack of clinical and life experience with the constituency whose needs you ignore.” He’s pulling the good old medical professional rank on you there, with a guilt trip attached. How dare you, a journalist, be so unwilling to be mentored by him, a licensed MD, into the “middle way?” At least Allen didn’t publicly call you a “menace to society” as his comrade Dr. Lieberman did.
    As a clinician who has spent my career since 1978 specializing in serving people in all kinds of extreme or psychotic states, I daresay I’ve spent more hours face to face with people with a psychosis diagnoses than Allen has. He’s wrong about you being guilty of causing harm, that you are ignoring the “needs” of people he believes need antipsychotics, by your not publicly embracing his “middle way.” You’d have to partially embrace the disease model to do that, but to do that you’d need to ignore all the evidence you have discovered all these years- all the evidence you’ve shared that really meets a huge unmet need of countless people- the need for the truth.
    I never believed in the disease model. So in the spirit of Open Dialogue, Soteria, I-Ward, Diabasis and many other approaches that don’t pathologize emotional suffering, but instead help people have a full emotional life, antipsychotics are seen for what they are, very powerful drugs that block, numb and suppress emotion. When that happens, all the emotion-fueled so-called symptoms of extreme states slow way down and recede- but those emotions and behaviors aren’t given a chance to be understood, integrated and resolved.
    Allen needs to have a conversion. He needs to put his energy into promoting proven services that help people while avoiding the use of meds. But to do that he’d have to abandon the disease model.
    Stranger things have happened to people who finally see the error of their ways.

  15. I’d like to remind Allen Frances that there appears to be an awful lot of profiteering by the psychiatrists, who force child abuse victims onto the antipsychotics. Especially, given the reality that 2/3s of all so called “schizophrenics” today are child abuse or ACEs survivors. And, of course, symptoms or concerns of child abuse are not a brain disease, they are real life symptoms or concerns relating to an appalling crime.

    And when psychiatrists, who are masters at ignoring their patients real problems because they’re lost in their delusional world of trying to pick “the right diagnosis,” force child abuse victims onto the antipsychotics. The antipsychotics cause a “chemical imbalance,” resulting in a real illness.

    The neuroleptics can create the negative symptoms of “schizophrenia” via neuroleptic induced deficit syndrome, which is frequently misdiagnosed, resulting in higher neuroleptic levels. And the neuroleptics can create these symptoms:

    “memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

    These are the central symptoms of neuroleptic induced anticholinergic intoxication syndrome. But psychiatrists can not distinguish these symptoms from the positive symptoms of “schizophrenia,” or what my psychiatrist claimed in his medical records were “the classic symptoms of schizophrenia.”

    I do so hope the psychiatric industry gets out of the business of turning child abuse victims, or their concerns relatives, into “schizophrenics” with their neuroleptic drugs. Since, covering up child abuse is still technically a crime in the US. Although keeping the child molesters on the streets raping more and more children is, no doubt, very profitable for the psychiatric industry.

    Robert, thank you so much for speaking out about the harms of the neuroleptic drugs.

  16. Never having taken ‘zines or atypicals himself, Mr. F has no comprehension why patients invariably want to stop them. But if you really want to make him go ballistic, tell him you’ve met people who take niacin and megascorbate every day and like it so much they’ll never go on meds again. If you never met anyone who has taken them for years, you just did when you read this comment.

  17. Why is there even any dialog, its like negotiating with terrorists.

    Thats an off the wall comment right ?

    Maybe to people who have never been subjected to their “treatment”. In its broadest sense, terrorism is any act designed to cause terror to achieve a goal. You don’t like those ‘side’ effects ? Are you worried about the effects on your health ? Ingest these pills or we assault you with the Haldol needles and Depot injections. Don’t try and run the doors are locked. Are you terrified yet ? Will you comply ?

    Thats just my experience, many others have endured far far worse .

    Do not negotiate with terrorists. Tell them to end the atrocities and then maybe we can talk.

    • I think it’s apt, sadly. I certainly felt terrorized at their hands. I think you say a key thing, “Maybe to people who have never been subjected to their ‘treatment.'” Nothing safe, fair, just–or even in the slightest warm and empathic–or in any way healing about ‘the system.’

      Yes, to those who have not experienced this, we may seem to be exaggerating or catastrophizing, but I know this is not the case. I experienced and witnessed it as pure barbarism, seriously. This is supposed to be healing, and it’s the exact opposite, in the worst way possible.

      I agree, there is no reasoning here, as long as these practices continue to be employed, continue to do harm, and continue to be justified.

  18. Robert– Dr. Francis is for doctors and their extra-judicial, mealy-mouthed authority, more than he means to alert the press that the knowledge base for his backwards profession has to keep getting independently sorted out. Such as aside from ECT and psychosurgery staying famously unquestioned by the popular in-crowd for managing media representation of APA positions. Why can’t he grow up about that practical need?

  19. One way “to minimize long-term use of antipsychotics” is not to force them on people in the first place. When the results of long-term studies are such that they are, the existence of laws forcing these drugs on people are all the more tenuous.

    Allen Frances, like many in the mainstream mental health system, ignores the evidence. If some people within the system had that choice, they would not be taking the drugs they are taking. It is a pity indeed when a person develops Tardive Dyskinesia for taking a drug against his or her will and wishes, a drug that he or she knew to be dangerous and damaging. A drug that he or she would not be taking of his or her own volition.

    It would be my hope that by focusing on this evidence, this evidence that psychiatry itself is ignoring, that we could indeed be restoring to certain people the right to make those choices for themselves rather than having them made for them by relatives, institutions, or the state.

    I don’t think we’re going to get there without a dialogue. People need persuading, and that means arguments. It’s a fight alright, but it’s a fight that we should, because the evidence is on our side, be able to win.

    My support for Open Dialogic practices, for instances, stems from the fact that the person at the center of the treatment regime, the patient, is given a voice on a par with the other parties in the treatment process. I would hope that, in such a process, the patient was listened to whenever they voiced a preference or concern about the treatment they received.

    I think people should have the right to refuse unwanted treatment. Right now, even when they are damaged by unwanted treatment they have no recourse to legal actions that will lead to justice. “Standard practice” is a magical ruse employed by the courts to excuse all sorts of atrocities. The evidence, if comprehended and utilized, could change all that. I applaud Robert Whitaker’s efforts to draw attention to these long-term studies. If short-term psychiatric enslavement may have serious detrimental effects upon a person’s well-being, the effects of long-term psychiatric enslavement have to be far worse.

    • You didn’t read Dr Allen Frances words.

      “Far too many people who need drugs don’t take them — either because treatment is unavailable or because they don’t realize or accept the fact that they need it.
      So we are trapped in the cruel, dumb, and sometimes tragic paradox that the wrong people often take meds, while the right ones don’t.”

      This is the opposite of your opinion of “I think people should have the right to refuse unwanted treatment.”

      This all comes from medicine having the burden to deal with the mentally ill, or those who are not obeying orders. Why aren’t you obeying orders?

      It is all about obeying orders. Be the cog in the machine that is consuming and poisoning the natural resources of the planet. “‘Doomsday Clock’ remains at 3 minutes to midnight amid ‘serious danger'” http://www.cbc.ca/news/technology/doomsday-clock-1.3421856

      • I did read Allen Frances words.

        I certainly wasn’t saying that his opinion was my opinion.

        I agree with you. It is about obeying orders (i.e. compliance). It isn’t about facilitating or protecting physical health. Following orders here, as many of us have personally seen, can destroy a person’s physical health.

        Not to follow orders, as you put it, is to act against medical advice, and there are consequences, in the mental health world, to acting against medical advice, that is, that given mental health law, doing so is quasi-criminal. Insubordination is their (the behavior police/people like Allen Frances) justification for throwing people into the loony-bin. Only they have another word for this insubordination, they call it “sickness”.

        • Maybe I should back up a little, I thought I was defending Robert Whitaker from accusation of “collateral damage” made in a email exchange between Allen Frances and Robert Whitaker.

          Frances accuses Whitaker (1) of encouraging non-compliance that leads to negative outcomes for patients.

          I think, all in all, those negative outcomes might have more to do with standard practice then they have to do with these revelations regarding long-term studies. Suppressing evidence is not going correct anything. The outcome of non-compliance, in the long run, such studies suggest, in the face of Frances fear, more positive.

          He accuses Whitaker of (2) contributing to an adversarial relationship between “service users” and family and providers that is making a mess, in his view, of the mental health system in the states.

          I don’t see that Whitaker has anything to do with this relationship merely by revealing the results of these long-term studies. They do, though, show why a person would be leery of treatment when that treatment is detrimental (asked for or unasked for).

          Frances, at this point, is promoting the same narrative, that of conventional bio-psychiatry, that Whitaker would be exposing as deceptive and damaging. I don’t think it has anything to do with promoting an adversarial relationship. It has to do with whether standard practice is effective and helpful, or a damaging impediment to recovery.

          Frances “middle way” is the way of wearing blinders, and denying the facts. Whitaker is merely focusing on what long-term studies reveal. These long-term studies show that this over emphasis on finding a quick fix, a chemical solution, may be making things a lot worse than they were. Given this situation, perhaps those “service users” in a adversarial relationship with family members and providers have all the more reason to be adversarial, but to blame the situation on Whitaker is to wax ridiculous. If pharmacological approaches are actually making people more “sick” rather than facilitating health, as these long-term studies indicate, then we’ve got a more serious problem than any adversarial relationship between “services users” and providers. We’ve got a need to see that a different approach is implemented and employed than the one that at present is proving to be so disastrous.

          • Yes to the “Insubordination is their (the behavior police/people like Allen Frances) justification for throwing people into the loony-bin”
            The problem of free will versus real brain disease (an actual physical problem with the functioning of the brain).
            The delusional Dr Allen Frances believes the drugs are medicine.

            This is all coming from hunting the woozle. https://en.wikipedia.org/wiki/Woozle_effect
            The psych doctors can not admit to making a mistake in the past and very few can hold them accountable.

  20. “contributing to the adversarial relationship between service users vs providers & families that is unique to the US and a major reason our system is such a mess.”

    “that is unique to the US”

    US Children Diagnosed With Bipolar 72 Times More Often than Kids in UK https://www.madinamerica.com/2014/10/us-youth-diagnosed-bipolar-72-times-often-uk/

    “contributing to the adversarial relationship”

    The adversarial relationship starts the minute they lock the door and tell you to get naked for the strip search “or else”. The many other atrocities that await are also make a contribution.

    The therapeutic alliance refers to the relationship between a healthcare professional and a client (or patient)… Come on Allen you should know these things !

    “Help heal the rupture between users and providers”

    One thing I have noticed is the lack of any apology for any of the psychiatric industries atrocities.

    For example the latest one, the Risperdal atrocity and all of them the endless parade of lawsuits and crimes and lies and frauds and no one from the pharmaceutical industry goes to prison.

    “Help heal the rupture” Are you kidding ?

    Please anyone who may be reading this show me one apology from the psychiatric or pharmaceutical industry for harms done, just one “we are sorry for the criminal behavior of our colleagues that was harmful”

    “We are sorry for the criminal behavior of our colleagues that was harmful”

    Start healing the rupture with that.

    • Right you are. This phenomenon is “unique to the US” because we are uniquely brutal and relentless in pushing these drugs on people whether they need/want them or not. It is typical of oppressive forced to blame someone less powerful for their failures, but an honest assessment would tell anyone who really cared that a huge negative response from your clientele is a message that YOU need to do something different!

      —- Steve

      • Uh Huh…it happens every day in Australia too and believe me, I know from first hand experience. Brutal, cruel, traumatising and unnecessary.

        More than 10 years down the track I still wake sometimes with nightmares about my treatment in the Hospital’s Psychiatric Ward. My stomach churns if I want to go near there to visit a friend in a general/surgical ward of the hospital (ie not even near psych), and once after being injured I had to leave the ER because I was simply too afraid of what the hospital might have in store for me.

        It’s now more than five years since I last took any meds at all and really, the trauma inflicted on me by psychiatrists is all that remains of my “mental illness”, other than having lost my job and being disinherited by my parents who couldn’t handle having such a fundamentally defective child….even though up till that time I had been a very highly functioning and productive member of society.

        ….and so, why wouldn’t there be friction between “patients” and psychiatrists given this sort of scenario when psychiatrists claim they only “unmask” such defects with their meds rather than cause them?

        Allen Francis and his psychiatrist buddies just don’t get it.

        • Oh ya I forgot to mention the effect of the psychiatric interventions on family relationships or “service users” & families.

          Stand by the telephones in almost any locked psychiatric facility and listen.

          Patient: Please family get me out of here this place is an abusive nightmare hellhole and all they want to do to me is zombify me with horrible drugs !!!

          Family: Oh you are just being difficult again you need to stay and get the help you need. (Family read all the psychiatric propaganda)

          Patient: FU family, you are letting them do this to me, you are supposed to protect me, how can you side with them ? I hate you.

          Just stand by the phones and hear it over and over again and over again.

          Anyway Kim same with me if I have to go near a hospital AND when I see people wearing rubber gloves I just get this fear and this adrenaline to get ready for what ever.

          • Me to wife on phone from locked ward.

            Me: Could you bring me some cigarettes, clothes and my denture. I didn’t get the chance to get them when police snatched me from my bed in my pyjamas.

            Wife: I’m not going near that place, I’ve seen what they do to people in there.

          • Me: could you give me my daughters phone number then?

            Wife: [thinks] No because they might tell her that in order to detain you I drugged you with benzos and put a knife in you pocket for police to find. teach you to disagree with me.

          • Wife: [thinks] and now that me and the Community Nurse are engaged in a criminal conspiracy to conceal the drugging with benzos from you, he is going to arrange for you to be injected with a cocktail of drugs, make you ill so they have something to treat.
            You will be delivered home to me in 8 weeks dribbling from the mouth never to disagree with me again.
            Oh, and if you think that the police are going to do anything to help you, they like having people drugged without their knowledge before questioning them, and you’ve got buckleys of anyone helping you.
            Lawyers? Nah, the Clinical Director just removes the documents containing the evidence of the drugging before sending them and you look like a paranoid delusional claiming you were drugged without your knowledge.
            The magic of medicine eh?

      • Oh…and I was 50 when all this happened and so had a 30-year history as a fully fledged and high functioning adult and mother of two before the shrinks got hold of me and ended my career and dismantled my family.

        Probably why I appreciate MIA so much – it gave me the knowledge I needed to dig my way out.

        Thanks, Robert Whitaker.

        Can’t say the same to shrinks, Mr Frances. You guys are EVIL!

        • I agree with all of you, similar experience. Husband’s siblings came to town to “set up bank accounts” and organize a predatory loan to get all my money out of our house, and into their names, while I was illegally held by this now FBI arrested doctor.

          http://www.justice.gov/sites/default/files/usao-ndil/legacy/2015/06/11/pr0416_01a.pdf

          Nothing but a bunch of thieves, torturers, and murderers.

          Although, thankfully, my family was able to comprehend that gas lighting someone, then stealing all her money, based upon fraudulent lies about “lifelong, incurable, genetic mental illnesses” – which were actually only iatrogenic illnesses – is unethical behavior. So I was able to reestablish a mutually respectful relationship with my siblings and parents. What a sick and criminal organization the psychiatric industry is.

          • Not so lucky. State needs wife to remain silent about the crimes. In return she gets to keep 6 figure sum, and State will ensure that Boans get’s no access to the courts. Biggest problem being that his set of documents demonstrates a number of offenses totalling over 100 years of prison terms. The set authorised by the Clinical Director for the lawyers shows…. Boans is crazy and needs to be drugged. Deny him human rights and were good to go.

            What I can’t understand is that if a Clinical Director has the authority to conceal such offenses, why have they not had me delivered to a hospital and arranged an accident? Just fiddle with the paperwork again and ….cough cough.

            I get the feeling after thinking about this article deeply that Frances is wanting Mr Whitaker to say that just a little bit of brain damage is good sometimes. Looks to me from the history, they were given an inch and have taken more than a few kilometers. It’s those ‘conversions’ where the accidents seem to occur lol. Can’t be easy to hold that ground Mr Whitaker, and I admire your courage in saying what you see.

          • I had six figures stolen, too, boans. Getting the spouse gas lighted by psychiatrists is a great way to steal from a person. I had no idea the entire psychiatric industry was fraudulent, I had thought all doctors had promised to “first and foremost do no harm,” and all humans had learned that making up fictitious “mental illnesses,” then torturing and murdering people based upon such medical fictions was immoral behavior after WWII. I’m amazed the entire psychiatric industry never learned this was not acceptable human behavior.

          • Probably sounds a little …. crazy but….when I say the Clinical Director has authorised these offenses I know this because it was supposed to look like a clerical error. But the clerk included the authorisation from the C.D (internal memo).
            Now I know that these matters were not reported to the authorities because I have the letters from them. So he has demonstrated the power to authorise what were clearly criminal offenses including conspire to conceal evidence of a criminal offense (intoxication by deception, benzos), deprivation of liberty, kidnapping, false documents by public officer and on it goes. And he gets to fiddle with the documents?

            Call me suspicious lol. They would call me paranoid and delusional if they didn’t know I could prove it, and wow wasn’t the response to them finding out I still had the documents not what I thought it would be.

          • I have my doubts about what was done to me, but consider the situation. In order to become an “outpatient” of a mental institution here, all that needs to occur is for a person to make a phone call and point a finger. A call was made and my documents show that immediately I became this Community Nurses “patient” (never met the guy before). He comes to my home, and makes up reasons to have me incarcerated and drugged and the police cart me off.

            So I was thinking that if I make a call and name XXX person, they are now a patient of a mental institution. And I would be well within my rights to inform others that this is the case. I could call police and explain that I am having problems with this mental patient and could they assist.

            Of course it seems ridiculous that a finger point makes a person a mental patient, and it is more likely this Community Nurse is simply bluffing people and engaging in criminal conduct with the knowledge that his colleagues will support his criminality. And that they did.

            And then explaining to others that what was done was criminal? The words I’ve heard are “He would never do that”. And if we simply neglect our duty and don’t look??? It never happened. Still, it’s handy to know you can make anyone a mental patient with a phone call. Once touched with that stink, your life is changed forever.

          • What is more likely is that this man is attending peoples homes, engaging in what would be patently obvious to his newly acquired “patients” as kidnappings, and then using the resulting trauma as justification for incarceration and forced drugging.

            Nice work if you can get it.

          • Unless of course he had “reasonable grounds” and “specifies the “observed facts”.

            Missed a couple of meals and lost a bit of sleep?

            “not sleeping/eating” Great for Muslims during Ramadan Ask the suspect to incriminate themselves in front of police, and when the refuse to do so “refused to answer re substance abuse” (don’t mention the fact they have been drugged with benzos without their knowledge). Travel through time and space and observe “thoughts of harming others”. After detaining the person for the above, one then observes the suspect as “agitated and pacing” So the result of being detained is justification for detention?

            And our Chief Psychiatrist says this is quality mental health care and more than enough to justify a belief that the suspect requires hospitalisation and forced treatment?

            This is lawlessness and criminality being enabled in the name of medicine? The street hustler uses poise, the white collar criminal position.

          • “This is lawlessness and criminality being enabled in the name of medicine?” Absolutely correct, according to my and my child’s medical records, I was drugged based upon lies from the people who raped my four year old child, and a pastor who denied my other child a baptism, on the morning of 9.11.2001. I had no idea, gas lighting concerned mommies, to cover up child abuse for the religions, is what “holist, Christian talk therapy” was all about. Now I know, and think the entire world needs to know about this “dirty little secret of the two original educated professions.”

        • Thanks Kim. Australia sounds worse than the USA, if possible!

          I’m steering clear of the Land Down Under. If I had to make a trip there, I would have to hide out in the bush and only associate with wild animals and the aborigines who lack the “science” to force psychotropic drugs and ECT on me. From what I hear about aborigines of all races and countries they seem to be healthier and happier in general than civilized people. I wonder why? 😀

          • Actually RachelE hiding out with the Aboriginals would increase the chances of you becoming sick and being incarcerated exponentially. In fact when our new MHA was being debated in parliament they were even discussing the forced sterilisation of children via the provisions of the Act. One Prof D’arcy Holmes thought it might be a good idea. Mind you it was never discussed in a way that would look like it was directed at the Aboriginal community, but we all knew what the unintended consequences were going to be wink wink.

  21. Great blog as usual. I only have one comment to make. Allen’s rhetoric relies on a misuse of language; ie begging the question by referring to people as ‘severely mentally ill.’ But this is exactly the issue under debate. Are they, in any scientific or evidence-based sense, suffering from medical ‘illnesses’? Replace that term with ‘severely traumatised and socially marginalised’ and it immediately seems less obvious that they should be medicated for life. I also think use of the term ‘antipsychotic’ plays into this misleading picture. As we know, the drugs do not rectify biological dysfunctions that cause ‘psychosis’, whatever that is. Clarity of language is the first step towards changing minds and changing practice. Keep up the good work! Lucy Johnstone

  22. “The severely ill inappropriately in jail & homeless ”

    Everyone knows its basically illegal to be homeless in America, sooner or later the police find a reason to scoop up the homeless and feed them to the prison industrial complex.

    Well I was labeled “severely ill” and didn’t have anywhere to go after the “hospital”.

    I figured out the cost of my “treatment” would have bought me an OK house. The bill for that month long nightmare was about $20,000 because the same people who decide who is “sick” and who is well were charging about $750 per bed and had the doors locked.

    $20,000 is a down payment on a $100,000 home.

    Abilify
    2mg 30 tablets $717.30
    10mg 30 tablets $717.30
    20mg 30 tablets $1,011.76

    http://www.truemedcost.com/abilify-price/

    Wow look at that the pills the pill cost is more that the cost of an $80,000 mortage payment. They scripts I left with cost more, not that I would actually ingest the overdose they prescribed.

    Imagine if a they used that money to give severely ill people housing instead of enriching the psychiatric and pharmaceutical industries.

    Five-year Study Re-affirms that Housing Stabilizes People
    https://www.madinamerica.com/2014/06/five-year-study-re-affirms-housing-stabilizes-people/

  23. I finally read the whole blog as opposed to skimming, and a few things stand out.

    For me it was enlightening to hear of Bob Whitaker’s evolution from reporter to who he is today, and how he gradually came to deconstruct some of the narrative of the mental illness industry. It was startling to learn that only via an incidental phone call to David Oaks in 1998 did Mr. Whitaker first realize there was widespread opposition to these mind-numbing chemicals, as well as the whole “mental health” world view — especially since I remembered the national movement-led boycott of Smith Kline & French pharmaceuticals exactly 20 years earlier due to their production of Thorazine and Stelazine.

    My guess is that RW may be somewhat taken aback and overwhelmed at what he has unleashed simply as a result of methodical applied research into the pseudo-scientific contentions of an industry which bases its success on its basic precepts going unexamined.

    I also think that he is starting to feel some intense pressure from the system, and that having the laser beam of public attention focused on him by Frances et al. is understandably causing him to think that he has something to be defensive about. It’s hard to imagine that after all the research he has done he would be able to reach any other conclusion than that antipsychotics et al. are “bad,” yet it seems that he is sort of juggling words trying to avoid the accusation of having an actual opinion on this (& Bob if you’re reading this sorry about using 3rd person).

    Did they improve the long-term course of schizophrenia, depression, bipolar disorder, and other such major disorders? Or not?

    It’s interesting that Mr. Whitaker has been targeted by the psych establishment honchos as the enemy when he makes it clear that, however critical of psychiatric misrepresentation he may be, by using such diagnostic terms without quotation marks or serious criticism he implicitly accepts the medical model. This is simply an observation. Because however furious they may be with him, the conversation so far is remaining within the parameters of good “medications,” bad “medications,” and dosage, hence they still control the narrative. As the research delves into issues such as the positing of false “diagnostic” categories based on decontextualized behavior, and the linguistic impossibility of “mental illness” as a reified metaphor — their wrath will grow more intense. Until they lose.

    So thanks Bob, and don’t let them get to you, they’re spooked by their own reflections; it’s not your concern. 🙂

  24. We conscientious objectors of conventional psychiatry -wittingly or otherwise- surrender to being pigeon-holed when we collaborate with those peddling the labelling disease model of non ordinary states of consciousness,because n/o states of consciousness itself yearns for a three dimensional response and relatedness , from community and society, as well as from loved ones..

  25. I had to figure much of this out since childhood, I now go to psychs knowing more about pharmacology than them- dopamine AGONISTS-as opposed to ANTagonist antipsychotics- officially used to treat Parkinson’s combined with a few other things finally solved my lifelong depression and alcohol issues (to the point of moderating drinking- AA was of no help)- took years of study and experimentation with overseas meds to find such a combination.

    (almost) Every psychiatrist I have seen takes the easy road for their patients- whether depressed/lethargic or manic/violent- favoring antipsychotics that will dampen the feelings- a true zombie state or “chemical lobotomy.” I even know one that recommends clozapine for simple depression and OCD (No hallucinations, schizophrenia, psychosis) despite the well known risks including metabolic syndrome leading to diabetes.

    I believe that medications are useful when used appropriately, with the goal of enabling a person to work through their emotions, not lobotomizing them with dangerous antipsychotics. It is also imperative that incentives, financial or otherwise aka kickbacks have no place in prescribing decisions. Medical science is still in its relative infancy understanding neurochemistry and all the variables involved, much less what introducing synthetic agents will do- safety should be a paramount concern.

    I would suggest research NOOTROPICS- general term describing any substance synthetic or natural/herbal/etc that expands the brain, so to speak- increasing neuron growth/regeneration, oxygen flow to the brain, the memory-critical chemical acetylcholine, dopaminergic, and many other mechanisms. In a sense, the opposite of antipsychotics- which are practically “dumb drugs.” They are also, by definition, of high safety and little/no potential for dependence.

    Widely used by students as “smart drugs” of a sort- I have suggested them to friends and family struggling with lingering memory and mental deficits from past antipsychotic use. There is also evidence of benefit for treating specific psychiatric disorders. I do not list examples of such medications, or detail personal experience here, as the effectiveness of each varies dramatically between individuals, and there have been moves by the FDA and other gov agencies to suppress such info in the past. Research yourself- the internet is full of valuable information, some of the best done in foreign countries- the language barrier being one obstacle to sharing knowledge.

  26. This seems to be fairly average, to think ones opinion to be a perfect balance between two extremes, but still baffling to try and bring the seemingly different points of view together, while also condensing everybody. Especially when saying pretty agreed upon, in general. Even the mental health field had criticized the broadening of diagnosis. They also claim that people are under medicated. It’s also become a popular phrase that the jails are the new mental hospital. I don’t hear anyone arguing that getting locked up for petty reasons, or having legitimate problems, that it can be made worse by being locked up. However, I’m at a loss to what Allen Framsis wishes to accomplish by insisting that everyone is really focussing on the wrong things. I don’t see a point on trying to win over people to a point of view they probably will never agree to. Especially when a lot of it’s condescending, and supposed to be taken at face value. Not to mention, none of it groundbreaking. It’s just do this, because otherwise bad things will happen. Hypothetically we unite deal with all these supposed worse problems, and are left with the mental health system, then what? Then we can fix all these problems he is dismissing, or will we still have to accept it as good enough? For this to even happen hasn’t been clearly stated. Stop over diagnosing, treat the right people, so they don’t end up wrongly incarcerated. Last, focus on what really matters, and find common ground. How? Very subjective, and no clear solutions.

    • Allen Frances is the captain of a decades old, sickeningly paternalistic sinking ship. Who has jumped ship in the hopes of saving himself, which all know is considered unethical. So he’s trying to claim his prior crimes against humanity are still valid and acceptable behavior, while also claiming those going down with the ship, are the ones to blame alone.

      He needs to confess the psychiatric industry had knowingly, due to greed and self interest, aided and abetted the pharmaceutical industry in creating a DSM-IV, which was an iatrogenic illness creation “bible,” not a “bible” of genetic mental illnesses. Frances hasn’t yet been able to mentally comprehend the appalling magnitude of his sins, it strikes me. Thus his further need for confession.

      • Frances is clearly delusional. He needs neuroleptics big time… Used “selectively” of course, but necessary for his delusions and “lack of insight”…it might open up new worlds for him…help him experience what those he claims to want to help experience….

      • “Allen Frances is the captain of a decades old, sickeningly paternalistic sinking ship. Who has jumped ship in the hopes of saving himself, which all know is considered unethical. So he’s trying to claim his prior crimes against humanity are still valid and acceptable behavior, while also claiming those going down with the ship, are the ones to blame alone.”

        I love the metaphor Someone Else. I’ve been thinking (a dangerous thing to do here in Aust where it is grounds for detention lol) along some nautical lines myself. I don’t know that the ship is actually sinking just yet though.

        Dr France’s claim that there are so many people in prisons who are ‘mentally ill’ and require treatment looks a lot like ‘psychiatric blackbirding’ to me.

        https://en.wikipedia.org/wiki/Blackbirding

        Are we not merely observing the building of bigger ships, and new ‘islands’ being opened up for this lucrative and profitable ‘industry’? Murphy would provide housing for the large numbers of captives, thus requiring little investment in infrastructure, and combined with expanded definitions of those who can be snatched from the community?

        More birds, more islands lol

        • “shang·hai (shăng-hī′, shăng′hī′)
          tr.v. shang·haied, shang·hai·ing, shang·hais
          1. To kidnap (a man) for compulsory service aboard a ship, especially after drugging him.
          2. To induce or compel (someone) to do something, especially by fraud or force:” This one works, too, boans. Technically, describes how many of the ‘peers’ are being brought into the industry.

      • You do have a point, because he definitely seems to be attempting to distance himself for sure. However, I’d be curious to who exactly he’s criticizing in the psychiatry field. I mean DSM 5 is pretty much mocked everywhere, including mainstream psychiatry. They even make excuses like they were behind in deadlines. He also doesn’t call anyone out, or give examples of what specifically is wrong. He just says meds are overpresrecribed, or for too little long where they shouldn’t be. He, however never says how exactly we can determine these cases differ from those who truly need them, or who’s to blame. Pretty agreed upon. Do you think he’s also holding out on some level, that psychiatry will recover from all of this? He also seems to want to get people who were wronged or are critical on his side. He seems to portray an odd mix of desperation, and arrogance. I just happen to search him to see if anything new came up, and coincidently he just responded to this very post. https://www.psychologytoday.com/blog/saving-normal/201602/do-antipsychotics-help-or-harm-psychotic-symptoms

        • Seemed odd his way of trying to win people here over, but perhaps he is realizing that it’s never going to happen. Although I guess anyone who wishes to address him directly could go to this article. There definitely seems to be a separation. It makes sense when he might not want to post directly to this site, given most people’s stance towards his views. Are there people not on this site, who would be following this discussion? I don’t know, but this is one of the most one sided responses I’ve ever seen. He clearly takes so much out of context, at least completely bends the truth, and over emphasizes what he wants to see.

  27. I know I have already responded to this post, but I can’t stop thinking about it, and the more I think about it, the more upset I become. I can’t believe there has not been a huge response to the recent study by epidemiologists at Columbia University and City College of New York. Does it make any sense at all that ’thought leaders’ would spend their time criticizing Mr. Whitaker’s response to that study, rather than discussing the study and what the findings might mean to ‘evidence-based’ practice? I had a similar strange experience when I asked for opinions about the study from local ‘thought leaders’. What resulted was a tirade against Robert Whitaker, despite my protest that Robert Whitaker did not participate in this review. The reaction was certainly one of ‘shooting the messenger’, and no one was paying any attention at all to the ‘message’. I guess the reason people do this (consciously or unconsciously) must be because they are unable or unwilling to deal with the information. It is so unfair to Mr. Whitaker, although I must say, I have never seen such an example of ‘grace under fire’ as he displays in the face of so many untrue insults.
    Like Mr. Whitaker, I believed in the mental health system until we had a personal encounter with it. Our experience was very recent, was at a top notch center and the things that happened to our family were considered ‘best standard’ practice. I believe the professionals involved in our situation truly wanted to see our family member recover, and a few of the many professionals involved even were truly empathetic and honest. Yet the treatment was very wrong for our family member. I believe the treatment greatly worsened our family member’s symptoms, and put our family member on a much more severe (even life-threatening) path. When we started to question the ‘narrative’, the change in attitude of many of the professionals was remarkable. The only way our family was able to piece together how to best help our family member, was by gaining access to the type of information that Mr. Whitaker has brought to light: We found our answers in what many here would call the ‘true narrative’ of psychiatry. We think the ‘faulty narrative’ of psychiatry changed our family member from having (likely temporary) significant difficulties, to having very severe, chronic difficulties. The ‘faulty narrative of psychiatry’ which does not allow people to view coercive treatment or psych medications as potentially harmful to some people, (even in the short term), prevented our caring professionals from hearing our concerns, and from figuring out what was making our family member sicker. Thanks in a large part to Robert Whitaker’s investigative journalism and to the information, education, people and ideas we have accessed through MIA and the recovery movement, our loved is now on the road to recovery rather than remaining in a chronic state.

    • ….still can’t stopping thinking about this article and about Allen Frances and Ronald Pies ‘responses’ over on psychology today….I guess God never granted me with the serenity to accept the things I cannot change…….

      So what I am now wondering is, is Pete Earley going to post this piece by you as he said he would ? – You do indeed talk about the selective use of antipsychotics in this piece:

      “Instead, I think the scientific literature argues for a dramatic rethinking of their use, organized around two principles:
      Try to avoid immediate use of neuroleptics in first episode patients, as there will be a significant percentage who will recover without the medications (but aided by other forms of treatment), and this is a good outcome for those patients.
      Once the medications are used, there should be an effort to minimize their long-term use, with regular support for drug-tapering protocols.”

      (The one thing I wish you had also added in this summary is that another reason to avoid immediate use of neuroleptics is because some of the people who may have recovered without medication (but aided with other forms of treatment) , become worse AFTER medication is given, which may mean that the medication initiates a more chronic course of illness in some people. – I know you have written about this and why this might happen extensively, but I think it belongs in the summary.)

      I guess I know the answer is probably no, that Pete Earley did not publish the piece but I wonder what he would say if asked to publish a piece by Sandra Steingard that was endorsed by you? At the very least I would like families to become more aware that they should at least support their loved one by taking `time’ to research and figure out the best course of action (e.g. months rather than the hours or days that usually occur in inpatient units) before starting on such a risky path as taking antipsychotic medications. (…My apologies if suggesting that Pete Earley might publish such a piece sounds very naive!)

  28. I haven’t been on MIA in a few months. I’ve read all of Dr. Whitaker’s books and from personal experience know antipsychotics hinder, hurt, cause Akathisia, profound brain fog, muscle spasms, inability to function, etc etc etc. I was able to get my prescribing psychiatrist’s notes and were they revealing to his inadequacies on what was wrong with me but he kept prescribing stronger drugs. Keep hammering away at the absurd statements saying these drugs work to make people better. These drugs inexplicably change us into non functioning adults. How tragic studies showing these drugs are not helping are being shrugged off. Allen Frances obviously has his head in the sand and in Big Pharma’s pocket.

    I am grateful I happened to stumble on a book “Toxic Drugs” that lead me back into a life psychiatry free, psychiatric drug free and to finding me again (or what was left)..

  29. I used to be compliant in every possible way, because I believed the lie that “Mental Health” was here to help me. I took my drugs exactly as prescribed.

    Now I am a rebel and a passive-aggressive liar. Oh, well, one good Lie deserves another.

    They told me I had a chemical imbalance and needed to spend the rest of my life in a drugged haze. NO MORE. Even if they lock me up and drug me I will know that I’m sane and they are the liars and phonies they have always been.

    They lied to me, so I will lie to them whenever necessary. If they find out I’m off my drugs, and I will never tell them I am, I will shed tears of sorrow (I’m a great actress and can sometimes cry on command.) I will pretend to have regained insight into my condition and promise to take the drugs exactly as prescribed. All the while, I will be planning how soon I can taper off of them again, even as I swallow them meekly and passively in the hospital. I can be a model patient–luckily I have a long record as one so they won’t suspect me as much.

    Even as I begin tapering off my final drug–Effexor–I attend meetings at the local “Mental Health facility” in order to avoid suspicion. I see my psychiatrist regularly and religiously order refills on her prescriptions (which I carefully bury deep in my garbage.) I see my therapist and pretend to agree with her when she tells me I should only date other “bipolars” because only one of the could understand someone like me. (Stick to your own kind!)

    I finally got her to quit talking about it, by saying I had discovered I was asexual.She has no business telling me who to date. If it hadn’t been for my accursed diagnosis I probably would be married with children by now. And have a decent career. Thanks modern psychiatry! You have really helped with the quality of my life! 😛

    I’m thinking about relocating, but of course my diagnosis will follow me wherever I go. At least, if I move to the state capital–my current community numbers 6,000–I will be sure not to sign up for any “services” beyond necessary. Low-income housing is hard to come by. I have a plan that may work though, in a big city. I may post it in one of the forums.