“Alternatives to Psychiatry Are Here to Stay” — New York Times

Kermit Cole
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The New York Times airs criticism of psychiatry, and offers alternatives to it, in an article by Benedict Carey in today’s Health section. An Alternative Form of Mental Health Care Gains a Foothold brings attention to the proliferation of the Hearing Voices Network, the increasing acceptance of the Open Dialogue approach, and the contribution of the Foundation for Excellence in Mental Health care has made, saying “For the first time in this country, experts say, psychiatry’s critics are mounting a sustained, broadly based effort to provide people with practical options, rather than solely alleging abuses like overmedication and involuntary restraint.”

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From the article:

“At a time when Congress is debating measures to extend the reach of mainstream psychiatry — particularly to the severely psychotic, who often end up in prison or homeless — an alternative kind of mental health care is taking root that is very much anti-mainstream. It is largely nonmedical, focused on holistic recovery rather than symptom treatment, and increasingly accessible through an assortment of in-home services, residential centers and groups like the voices network … For the first time in this country, experts say, psychiatry’s critics are mounting a sustained, broadly based effort to provide people with practical options, rather than solely alleging abuses like overmedication and involuntary restraint.”

“Alternative care appears to be here to stay, however. Private donations for such programs have topped $5 million, according to Virgil Stucker, the executive director of CooperRiis, a residential treatment community in North Carolina. A recently formed nonprofit, the Foundation for Excellence in Mental Health Care, has made several grants, including $160,000 to start an Open Dialogue program at Emory University and $250,000 to study the effect of HVN groups on attendees, according to Gina Nikkel, the president and CEO of the foundation. Both programs have a long track record in Europe.”

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

15 COMMENTS

  1. Well, it may be a preliminary trickle of consciousness and beginning of a modified narrative. Couldn’t help noticing this though:

    For the first time in this country, experts say, psychiatry’s critics are mounting a sustained, broadly based effort to provide people with practical options, rather than solely alleging abuses like overmedication and involuntary restraint.”

    Yeah, impractical fucking whiners…

    Talk about backhanded “compliments.”

  2. The NYT consistently prints the oldest, most retro, most conventional, most pro-pharma health information available anywhere (on all health topics). If you heard of it 10 years ago, you can be sure you’ll read it in the NYT health section.

    So, if EVEN the NYT’s decrepit health section managed to publish this piece, then the ‘alternative’ psych movement (or whatever people wish to call it) must be making serious inroads into the mainstream. That’s my ‘good-news’ takeaway.

    Of course, asking its reporters to speak with Robert Whitaker or many others before Drs. Pies and Frances…well, that will take the NYT breaking quantum barriers in space. In any event, I was pleasantly surprised to see the article there today.

    Liz Sydney

  3. This is very promising news indeed.
    For the sake of journalism, they are historically pretty wrong.
    Declaring a first is an interesting strategy.
    Built on what that needs be deligimised and forgotten?
    The many other firsts?
    Don’t people clearly remember the position of one of the most prominent ‘firsts’, Lauren Mosher, and what happened to his and colleagues soteria development and evaluation/s?
    As to non-psychiatric other ‘firsts’ – obviously they are none but inspired by bringing together strands of knowledges and practices in ‘creative’ ways – why are they silenced.
    Business strategies, UPS. Sociohistorically – and presently – untrue though.
    Or where is the ‘excellence’ enterprise for more cost effective (sorry) grassroots creative hybrids, from the people and that are closer to the people, like consumer operated services, icarus project networks, peer respites, alliances with other community groups to foster tolerance and living in diversity?
    May be we know that claims for excellency are not what is at the core of such organisations that want to be closer to the people they ‘work and socialise’, ‘exchange and practice’ with?
    Insofar as Open Dialogue would be de-psychiatrised and de-clinicised, as do Hearing Voices Groups, which don’t need be run/facilitated by mental health professionals, that would be exciting social development projects.
    As long as philosophies and practices are firmly grounded within psychiatric systems’ institutions and funding/billing, the functionally in´herent degree of privilege and exclusion, as well as distance from not middle class people’s daily lives, will not bring neither cost effective no socially empowering and meaningful change.
    That’s a big one. I am aware.

    • Insofar as Open Dialogue would be de-psychiatrised and de-clinicised, as do Hearing Voices Groups, which don’t need be run/facilitated by mental health professionals, that would be exciting

      And very threatening to the “mental health” industry!

  4. Psychiatry is a PSEUDOSCIENCE, and a DRUG RACKET. To say that “alternatives” to psychiatry are “non-medical”, implying that psychiatry is somehow “medical care”, is like saying a car wash is expert mechanical care. The ONLY thing “medical” about psychiatry is the fact that a (wasted)medical school education is involved. Oh, yeah, and the MEDICAL DRUGS…. Psychiatry is the personification of MEDICAL FASCISM…. Screw the NYT….

  5. I trained in psychiatry, psychoanalysis and crisis intervention and since I couldn’t make a living doing psychotherapy in the age of drugs and custodial mental hospitals I was lucky enough to get a job with Dr Paul Polak at the mental hospital in Denver. We had a team that treated new admissions with intensive family therapy and seldom needed drugs and we had 1 week to try to resolve things so that admission to a longer term unit wouldn’t be necessary.
    I thought this was extremely successful, but a few years later the unit was disbanded and its duties assigned to mental health centres who didn’t have the staff to do the job.
    I ran the adolescent unit there for a few years using individual, group, and family therapy, and very seldom needing drugs, but the politics and the hospital administration had changed. They thought it would be cheaper to use drugs and increase the admission and discharge rates.
    And so the revolving door began.
    I went back to Canada and ran a crisis intervention service at the general hospital in Edmonton until the psychiatrists decided they didn’t want us keeping people out of hospital instead of getting more hospital beds and giving them proper medical treatment for their medical illnesses.
    After doing 2 years as an associate professor in the department of psychiatry at the University of Manotoba, and discovering that they were only interested in their supposed biological approach to mental illness I gave up and went int private practice in Ottawa, where there were quite a few psychoanalysists.
    Strangely, though , my patients were mainly people who had failed to recover with many years, even decades, of attempted therapy and hospitalizations.
    This presented a huge challenge, but by great good fortune I had had , by total accident, a psychotic patient as a training case in London, along with a gifted supervisor, Dr Donald Winnicott. He had helped me to calm down and to listen to my patient until I actually understood something.
    This gradually worked and the patient became well.
    I did this in Ottawa but , unfortunately neither the psychiatric nor the psychoanalytic groups I belonged to were interested. One group wants to treat severe mental illness as a physical disease, and the other wants to avoid it, perhaps because Freud called it “narcissistic neurosis” and said it was untreatable.
    I have had little success communicating with Canadians about this, although it was Canadian health insurance that funded the therapy and the research.
    After I retired at 75 I tried to interest newspapers and the CBC but to no avail.

      • Psychotherapy seemed to help me for a time. Finally I realized I had “outgrown” my negative responses to bad situations. The Medicaid funded therapist refused to acknowledge this. She kept giving me bum advice, telling me to go against my conscience and putting down my religion. Finally I moved away. Now I no longer deal with a psychotherapist, shrink, or caseworker who cajoles me to attend endless rounds of day treatment. I get what pills I still take from a real doctor. Despite withdrawal problems from tapering my Effexor (I count beads to remove every morning and flush them down the toilet) I feel better. No more depression, either, despite some physical agony and chronic exhaustion. 🙂

        • Good for you, FeelinDiscouraged! I hope you feel empowered. I get so incensed when I read about codependent and unethical providers. The goal of therapy should be assisting a client in meeting their stated goals in a timely and effective manner. Empowering the client to think for himself or herself, understanding a person’s spiritual and cultural background and respecting this. We at just a guide, a facilitator, not the director. The client is the director of their own life and the expert in their own healing. Best to you in pursuing your dreams.