My Response to a Defender of Psychiatry

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On October 13, an interesting article was published on the Huffington Post Blog.  The author is Jessica Gold, MD, a psychiatry resident at Stanford University; the post is titled Inpatient Psychiatry: Not all Needles, Drugs And Locks.

The article is a personal experience/opinion piece, the gist of which is that people who criticize or condemn psychiatry simply don’t understand the complexities and needs of psychiatry’s “patients”, particularly the need for locked wards.

The article is generally unremarkable in that the arguments adduced are well-worn by more senior psychiatrists.  But it is interesting, and indeed tragic, to see a new entrant to the field absorbing psychiatry’s defensive nonsense, and trotting it out uncritically for public consumption.

. . . . . . . . . . . . . . . .

Dr. Gold begins by describing the kinds of interactions she experiences in social settings when people learn that she is a psychiatrist.

Then:

“However, what frustrates me most are the times when after describing my day-to-day as a psychiatry resident, I am met with bewilderment, followed by misplaced sarcasm as I am asked, ‘And why would you want to do that?'”

Dr. Gold then becomes reflective:

“After reminding myself not to get defensive (as I continued to do throughout writing this piece) or just stop the conversation completely, I became intrigued. While doctors may not evoke the same respect and adoration of the days of house visits, no one asks the other doctors (non-psychiatrists) in my family with such strong negative connotation why they chose their respective specialties.

I began to wonder if it’s because the difference between a locked ward and a medical ward can seem confusing and scary to an outsider or a patient. Without knowing the safety rationale, it can feel degrading to have your clothes taken away, along with your cell phone, shoelaces, and sharp objects, only to sleep in a boring room with heavy, non-moveable (or throw-able) furniture. If you lack insight into your illness and do not understand the necessity of hospitalization, it can feel prison-like to be on a locked ward without the ability to leave it. And, without understanding the therapeutic benefit of engaging in connections with others on the unit, it can feel restrictive to have visiting hours and not be able to have a significant other or family member spend the night.”

So Dr. Gold is frustrated by the sarcasm she encounters when social acquaintances discover that she is a psychiatrist, and notes that other medical specialties do not generally attract this kind of response. She wonders if the reason for this differential response might be:

“… because the difference between a locked ward and a medical ward can seem confusing and scary to an outsider or a patient.”

This is a truly delightful piece of self-deceptive spin.  Psychiatry’s so-called patients might well feel scared of locked wards, and understandably so.  But the notion that fears of this sort underlie the general public’s negative perception of psychiatry is arrant nonsense.  The general public’s negative perception of psychiatry, as compared to genuine medical specialties, is grounded in a realistic appraisal of psychiatry’s spurious concepts and destructive “treatments”.  In particular, psychiatry is negatively perceived because:

  1. Psychiatry’s definition of a mental disorder/ illness, as set out in DSM III, IV, and 5, embraces virtually every significant problem of thinking, feeling, and/or behaving. Psychiatry uses this definition to fraudulently medicalize problems that are not medical in nature.
  1. Psychiatry routinely presents these so-called illnesses as the causes of the specific problems, when in fact they are merely labels: abbreviated rewordings of the presenting problems with no explanatory function or value.  These labels, which cause enormous damage to the individuals to whom they are assigned, serve only to legitimize the pushing of drugs, and to enable psychiatrists to bill for the services they provide.  Unlike real diagnoses, they provide no insight into the nature or essence of the presenting problems, but are nevertheless defended tenaciously by psychiatrists and their pharma funders.
  1. Psychiatry has routinely deceived, and continues to deceive, their clients, the public, the media, and government agencies, that these vaguely defined problems are in fact illnesses with known neural pathology. The classic example of this is the chemical imbalance theory of depression – a blatant hoax which was pushed so heavily by psychiatry that it has now become “common knowledge”.  And the most noteworthy aspect of this is that although the hoax has been exposed repeatedly – (most recently by Terry Lynch in his book Depression Delusion), psychiatry has taken no concerted steps to correct this misinformation, and indeed in many quarters is still promoting this fiction as established medical fact.
  1. Psychiatry has blatantly promoted drugs as corrective measures for these illnesses, when in fact it is well-known in pharmacological and psychiatric circles that no psychiatric drug corrects any neural pathology. In fact, the opposite is the case.  All psychiatric drugs exert their effect by distorting or suppressing normal brain functioning.  It is also well known that the adverse effects of these products are often devastating and permanent.
  1. Psychiatry has collaborated and conspired with pharma in the development of a vast body of fraudulent research, all designed to “demonstrate” that psycho-pharmaceutical products are safe and effective. The methods by which this fraud has been perpetrated include:  the routine suppression of negative results; the use of ridiculously short follow-up intervals; over-stating of marginal results; suppression of adverse effects; etc., etc.
  1. A great many psychiatrists have shamelessly accepted large sums of pharma money for very questionable activities. These activities include the widespread presentation of pharma infomercials in the guise of CEUs; the ghost-writing of books and papers which were actually written by pharma employees; targeting of captive and vulnerable audiences in nursing homes, group homes, and foster-care systems for prescription of psychiatric drugs; etc., etc…   Two glaring examples of this kind of venality are:

In this context, it should be noted that Dr. Biederman and Dr. Frances are among the most eminent and prestigious psychiatrists in the US.

In addition, 70% of the DSM-5 task force members had received funding from the pharmaceutical industry.

  1. Psychiatry’s labels are inherently disempowering. To tell a person, who in fact has no biological pathology, that he has an incurable illness, for which he must take psychiatric drugs for life, is an intrinsically disempowering act which robs people of hope, and encourages them to settle for a life of drug-induced dependency and mediocrity.
  1. Psychiatry’s “treatments”, whatever transient feelings of well-being or tranquilization they may induce, are always destructive and damaging in the long-term. Neuroleptic drugs cause tardive dyskinesia.  Extended use of antidepressants produces a state of chronic joylessness.  Benzodiazepines are addictive.  High-voltage electric shocks to the brain erase memories.  Psychiatry’s notion that one can solve people’s problems by tinkering irresponsibly with their brains, betrays a degree of arrogant naivety unequalled in other professional groups.
  1. Psychiatry’s spurious and self-serving medicalization of every significant problem of thinking, feeling, and/or behaving, effectively undermines human resilience, and fosters a culture of powerlessness, uncertainty, and dependence. Powerful, time-honored concepts such as the need for critical self-appraisal, and personal improvement through effort, have been systematically marginalized by psychiatry’s expanding list of “illnesses”, and ever-flowing supply of drugs.  Relabeling as illnesses, problems which previous generations accepted as matters to be addressed and worked on, and harnessing billions of pharma dollars to promote this false message, is morally and professionally repugnant.
  1. Psychiatry’s primary agenda over the past four or five decades has been the expansion of its list of “illnesses”, and the assignment of these illnesses to more and more people. It has now become routine practice to prescribe neuroleptic drugs to elderly nursing home residents who become “unmanageable”, and to young children for temper tantrums!

This is the profession that Dr. Gold chose to enter and now chooses to defend with patronizing platitudes.

. . . . . . . . . . . . . . . .

Back to Dr. Gold’s paper:

“Dear future and past patients: I. COMPLETELY. GET. IT. Nothing about being on a psychiatric ward is typical, even for a medical setting. But I (and every nurse, social worker, psychologist, occupational therapist, physical therapist, nursing assistant, and physician I have ever worked with) also really want to help you. That is why I chose a career in medicine, and even more true of the reason why I chose to specialize in psychiatry. I worry the images you have of inpatient psychiatry scare you and prevent you from seeing me as an ally. Even when I tell you that I am here to help, I can see the skepticism in your eyes and hear the fear in your voice. I am trained to observe, after all.

It is not surprising, then, that when I read descriptions or see my job portrayed as forceful or horrific, I want to take the time to correct them. I am not doing this simply because I want to protect my profession, but am actually doing this in defense of and in support of anyone who might need mental health help in the future. Stigmatizing attitudes toward psychiatric illnesses already exist; fear of psychiatry and seeking care do not need to be added to the equation.”

In recent years, the psychiatric survivor movement has grown, both in numbers and in the volume of output.  Survivors are writing about the mistreatment they have received, often for decades, at the hands of psychiatry.  But Dr. Gold dismisses these protests as erroneous and misinformed over-reactions.  Psychiatry’s so-called patients:  “lack insight” into their illnesses; do not understand “the necessity of hospitalization”; do not understand “the therapeutic benefit of engaging in conversations with others on the unit”; don’t realize that the psychiatrists who authorized the forcible injection of akathisia-inducing drugs “really” want to help; etc..

And Dr. Gold is taking the time to correct these misperceptions, not simply because she wants to protect her profession (Heavens, no!), but rather in defense and support of anyone who might need psychiatric help in the future.  How noble!

“Maybe people will always fear psychiatry, mental illness and what they do not know…But maybe those attitudes can be changed and as mental health advocates, we need to do everything we can to assuage those fears. Unfortunately, even well-meaning former patients perpetuate those fears, whether inadvertently or because of the limited lens through which they viewed their own hospitalization.”

To which I might respond:  Even well-meaning psychiatrists perpetuate these fears, whether inadvertently or because of the erroneous and destructive disease-focused lens through which they view their “patients” and their “treatments”.

The rationalizations and self-justifications continue:

“I’ve been screamed at, cursed at, rushed towards, demeaned and have seen patients and nurses get seriously injured.  Even still, I do not make these decisions lightly or lead a conversation with a needle.”

The great irony here is that the neuroleptic drugs that psychiatrists routinely use to control aggressive behavior frequently produce a condition called akathisia, which in turn is a known precipitator of suicide and violence.  Crowner, Douyon, et al, conducted a short study of this matter in 1990.  Here’s a quote from their paper:

“Akathisia is a common side effect of neuroleptic drugs that may present with behavioral disturbances. There have been preliminary reports on the association between violence and akathisia. We report the first observational study of this relationship. Patients studied were from a special unit for violent patients. A closed-circuit television camera was installed in each of the corners in its dayroom. Incidents of assault plus the 5 minutes preceding each assault were recorded on videotape. Participants and bystanders were rated for the motor component of akathisia. For each of nine incidents, we compared the akathisia scores for participants and for bystanders. Both victims and assailants were akathisic before about half of all incidents; bystanders rarely were. The classification of the movements we rated and the implications for further studies are discussed.”

It would be interesting to know how many of the individuals who screamed, cursed at, rushed towards, and demeaned Dr. Gold were experiencing akathisia as a result of neuroleptic or antidepressant drugs that she had prescribed for them.  It is also interesting that no major follow-up of the Crowner, Douyon, et al study has been undertaken by psychiatry.

. . . . . . . . . . . . . . . .

“Given the responses to our career selection in casual conversation, it is probably not shocking that I (and my peers) can sometimes hesitate to say my medical specialty, despite having no shame or regrets about my decision. Knowing now that hiding my profession only further contributes to its stigma, and without a voice or a face, psychiatrists and their patients will always just be a part of a power struggle…, I will never again shy away from it:

I am a psychiatrist-in-training. My job is complicated, weird, unique, fun, fulfilling, and challenging… but that’s what makes it beautiful.”

Well all of this is nice to know, but in my view, psychiatry is neither fun nor fulfilling for those on the receiving end, especially in the long-term..

. . . . . . . . . . . . . . . .

The reality is that psychiatry is not something good that needs some minor corrections.  Rather, it is something fundamentally flawed and rotten; a wrong turning in human history, trailing death, disability, and disempowerment in its worldwide wake.  No amount of rationalization or platitudinous exculpations can mitigate this reality.  Psychiatry kills people every day, and adamantly refuses to recognize this reality and take appropriate action.

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

***

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74 COMMENTS

  1. As usual great artical. Always find myself not only agreeing so much, but so impressed by your ability to convey it, and unapologetic honesty. This line was very telling “It is not surprising, then, that when I read descriptions or see my job portrayed as forceful or horrific, I want to take the time to correct them” What part is not surprising that, she is portrayed as forceful, when she writes an artical that defends force? However, is it just me, or on some level does she realizes this is horrific, because she seems to connect the two.

    She has been screamed at? All she did was lock patents, and take away their belongings, and admitted it ‘felt like prison to them’. She get’s it though? ‘Psychiatry is there to help, and the past patents are just misguided’ If she trusts this field so much, how about she goes to a mental ward, and asks to be admitted for an evaluation? How would she know if doesn’t lack ‘insight’ into a potential ‘illness’? Doubt she would, and she’s trained into what words not to say, because she probably knows how subjective this is. She would probably even find it scary…

    Getting new patients… Is the goal. Hence all the focus is making her seem less ‘scary’. Wonder why their is a fear of mental patients? Could it be she says “I’ve been screamed at, cursed at, rushed towards, demeaned and have seen patients and nurses get seriously injured”. Only to justify forced injection. Also minimizes any potential responsibility. Making them sound irrational, and violent…

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  2. As always I thoroughly enjoyed your blog Philip. I’d just like to add that although psychiatry may be the worst offender, expansion of the list of “illnesses” is rampant throughout our health care system. I’m thinking of such diagnoses as low sex drive, pre-diabetes, pre-hypertension, and the push to put huge numbers of healthy adults on statins. All of this is driven by the pharmaceutical industry with the help of its medical collaborators. It is aided by journals that accept ads and by medical associations that depend on pharmaceutical funding.

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  3. Phil,

    Thanks for this article. I like the 10-point list.

    It’s interesting to think that if she read this, the author of the article being reviewed (Dr. Gold) would probably only be able to respond by denying, minimizing, and avoiding many of your points. The motivations for such responses are obvious – the first is financial. One would not want to give up a career path one has already embarked upon that would lead to an income of somewhere between $200,000-300,000 a year, or more, at Stanford University where this psychiatrist works. The second motivation would be status-based; once one starts developing a professional identity, it becomes a part of one’s self-esteem and has to be protected, even if the scientific underpinnings of one’s profession are very weak.

    And perhaps another motivator is that a form of “treatment” which uses drugging, coercion, and “illness management” for distress is easier and less disturbing for the professional than to explore possible social causes like trauma, neglect, and poverty, and to encounter the terror, rage, and despair that can accompany these experiences.

    I actually wrote an email to the author (Gold) sharing my story of recovery outside the system, and my response to my own hospitalization. And I referred her to ISPS (http://www.isps-us.org), a group which has alternative primarily non-medical approaches for people in extreme states, and which includes some psychiatrists.

    I do this type of outreach often; professionals rarely respond, which is probably understandable given that my views are a direct threat to their model of diagnosis, understanding distress, and treatment.

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    • Matt
      Thank you so much for contacting Dr Gold!
      That is what is needed!
      I would love to have her in a MIA round table FB discussion
      Dr Hickey is a great advocate but it is so clear he hasn’t been on a locked unit
      Akenthesia my foot- sorry Philip
      That is a normal fight response from a person who is or has experienced trauma
      And trauma is a locked unit!
      However thanks for pointing her article out and let’s do a round table live!

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  4. I find it ironic and almost humorous how clueless shrinks are! She goes into great detail explaining how dangerous and stupid (lacking insight) her patient/victims are–thus promoting stigma. Then she goes on to worry about how the nasty stigma existing out there (for no conceivable reason people fear the mentally labeled! Can you imagine?) will prevent people getting the “help” they so sorely need. 🙂

    Earth to Dr. Shrinkenstein! If you stay away from Shrinkenstein you avoid the stigma. Seems like the only ones lacking insight into human behavior are the “soul-doctors.”

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  5. Another terrific post Dr. Hickey.

    I’m astounded by this doctor’s blog post.

    “Our field is somewhat unique, however, in that sometimes patients with mental illness lack the needed insight to recognize this advocacy. I have never enjoyed a situation where a person is legally required to remain in the hospital or take medication against their wishes, and despite popular belief and imagery, physical restraints are very much a last resort.”

    Emphasis added

    She’s lying through her teeth. If this statement were true, Dr. Gold would quit, and go into private practice. I don’t imagine agonizing to be keeping her in her post.

    “Given the responses to our career selection in casual conversation, it is probably not shocking that I (and my peers) can sometimes hesitate to say my medical specialty, despite having no shame or regrets about my decision. Knowing now that hiding my profession only further contributes to its stigma, and without a voice or a face, psychiatrists and their patients will always just be a part of a power struggle and a scary amusement park ride, I will never again shy away from it….”

    Hopefully, once she is no longer “in-training”, she will see the error in her ways, quit, and go into private practice. Psychiatric hospitals are prisons, they aren’t hospitals, and no amount of double talk is going to change that situation.

    Psychiatrists and their patients are a part of a power struggle although I don’t see any eternity in it. We know who holds the keys. Win the power struggle, and she’s out of a job anyway. Given where she now stands, that would be a cause to celebrate.

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  6. With such propensity for self, as well as “patient” deception,
    With such breathtaking arrogance and painful naivety,
    “Professional success” would appear to be guaranteed.

    No hope here of a future psychiatrist who has any knowledge, awareness, understanding, diagnostic capability or clinical management efficiency to help the multitude of people in whom she will induce AKATHISIA.

    Zero hope of any academic, true knowledge, skill and awareness in psychopharmacology.
    Only pharma plus guild propaganda.

    This primary delusion which she calls Psychiatry cannot and will not begin to understand and recognise the appalling iatrogenic suffering of AKATHISIA.
    To do so would be to admit to the reality of the Fantasy Psychiatry which this doctor sanctifies.
    More a second Axis of Evil than anything to do with medicine?

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  7. Excellent article, Philip.
    When I first read the book Mad in America, I took it to my psychiatrist and wanted him to read it. I was excited about it and somehow thought he would greet it with open arms and change his ways. By the time I read Anatomy of an Epidemic I had wised up and knew it was pointless to try to get any entrenched psychiatrist to even consider having his mind opened.
    Dr Gold seems to be very naive. Being admitted to a psych unit is demoralizing and dehumanizing, and that is the intent. It is like being sent to prison for something you didn’t do without due process. She calls that “scary”. I can see her becoming more stubborn and resistant in the future, burning out early and then just becoming a mediocre, status quo, 15 minute appointment shrink like all the rest.
    She is also arrogant and engaging in a power struggle where she always wins, because when a “patient” screams at her or attacks her physically, she is still the one with the good salary and title and the “patient” is the one wearing a gown and begging staff to make a phone call.
    The most offensive sentence in her article was I. COMPLETELY. GET. IT.
    OH. NO. YOU. DON’T.
    Because if you did, you wouldn’t be a psychiatrist in training. You would be doing something more worthwhile with your MD degree. You would choose a specialty based on real science and helping cure real illnesses and relieve suffering instead of causing it.
    Obviously, Dr Gold has no insight into her own behavior and the delusion that psychiatry is scientific and not a hoax.
    This is “for your own good”, Dr Gold: Don’t sell out.
    Too late. You already have.

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  8. Dear Philip,

    I always appreciate your Articles.

    It’s not just Psychiatry and the Medical System that’s Under Influence. The UK Information Commissioner’s Office would appear to be Under Infuence as Well. Below is an excerpt from a Complaint I made to my Public Representative concerning the UK ICO :-

    °°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°
    PROBLEM
    In the paragraph in italics, the ICO describes my GPs approach to my personal information in perfectly reasonable everyday terms – I object to this.

    Italics begin.
    “…..You have also raised concerns about the retention of information that you were previously advised had been removed. I understand from Ms H… that this matter has been discussed with the Practice Manager who has advised that the medical professionals feel that it forms part of your ongoing care and therefore that it is still relevant to your medical records and must not be removed. This is not a matter that we can challenge as we are not medically qualified and are therefore unable to challenge a view that the information is relevant to your care. This would be a matter that you would have to take up with N… Medical Centre. ….” Italics end.

    IN PLAIN ENGLISH
    My GP Surgery in October 16, 2014 gave me in writing (with supportive attachments) an assurance that they had removed an important Record (the 1986 Irish Record Summary) from my records; but at a later date March 18, 2016, acknowledged that they had not. My GP Surgery had seriously misled me.

    BRIEFLY: THE RECORD IN QUESTION
    In 1986 I wrote to doctors at G… Southern Ireland requesting Adverse Drug Reactions Warning concerning treatment I had had between 1980 and 1984 be sent to the UK (my long term recovery had followed my withdrawal from the offending medications). ‘G…’ in reply sent over an “adapted” Record Summary but without Adverse Drug Reaction Warning.

    (I do have a copy of my handwritten 1986 ADR Warning Request Letter – it was in the very back of my Irish (FOI requested) notes.)

    ABOUT ME
    I have been well and functioning since 1984. I have not taken a penny in sick pay in my 30 years in the UK and I have made little use of the ‘services’ (with no ill effects). I am also a net UK taxpayer.

    WHAT I WOULD LIKE
    I would like to receive a complete copy of my GP records and information in the UK, and I would like to be allowed the facility to investigate these records, and to attempt to clear them up.

    °°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°
    I was directed towards the Ombudsman…

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  9. If Dr. Gold thinks psychiatric hospitals are so wonderful, she should be required to spend two weeks on a locked ward without going outside. She should also agree to take an antidepressant, benzo, antipsychotic, and sleep med, and then be required to cold turkey off of them once her time in the psych ward is up.

    She should then write a follow-up blog entry in the Huffington Post stating her conclusions.

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  10. I read Dr. Gold’s article too. I liked it about as well as Dr. Hickey did. There’s one in a similar vein by a delusional-seeming Dr. Helen Farrell. If you care to read it, do not miss Dr. Pies’ contributions to the comments section.

    Exceprt:
    I met J in the Emergency Department. Dark red blood [there’s another kind?] was oozing out of self-inflicted deep lacerations to her forearms. [If they were deep, blood would do more than ooze.] The surgical team was consulted and the cuts were debrided, cleaned, stitched and neatly bandaged. [Is this the Martha Stewart take on locked wards?] J was patched up. [No she wasn’t. She was stitched up.] But she was not healed. Her wounds ran deeper than a surgeon’s instruments could access. [What do you mean? They were in her ulnas?]

    “Locked up?!” These are typical words expressed by patients who learn that they are going to be admitted involuntarily to the psychiatric unit. [No, it’s what they say when they learn they are not going to be allowed to leave.] When J heard this news, her own tear-stained face scrunched up in an expression of horror. After several minutes of pleading, she finally resigned herself to the plan. [I bet that’s therapeutic, being terrified until your will is broken. Sign me up!]

    A nurse came into the room and took J’s phone. [That would be a theif, not a nurse, in common parlance.] She took her sweater, her belt and the laces from her shoes. [Now the nurse is a sexual offender, too.] J stripped down into a standard hospital gown. [We like that opening in the back, even though we don’t do surgeries in this ward.] It is common for patients to make one last plea and many have told me that they fear the psychiatric unit is analogous to prison. [Because it is. And you have a sick way of writing about terrified people’s behavior. If you didn’t enjoy it, you would do something else for a living. You like the tear-stained faces of young woman, and their pleas. Admit it.]

    J is representative of the many patients whom I treat on a day-to-day basis. She is a composite of those actual people who suffer from serious mental illnesses ranging from psychotic and mood disorders to personality disorders that require hospital level care. [You’re a composite of Stalin, Mao, Jack the Ripper, and Betty Boop.]

    Not Your Mother’s Psych Ward [Leave my mother out of this, Ding-Dong, unless you want to go a few rounds in the parking lot.]
    The days of psychiatrists wantonly locking up patients like J against their will are long gone. They have been replaced by a legal process called civil commitment that firmly puts patients’ rights first [even as it locks patients up against their will, or at the whim of a judge who knows nothing but what psychiatrists tell him]. Yes, J was being admitted against her will, but she would retain her power to make treatment decisions, summons legal counsel, and even have a hearing with a judge [unless she lacked insight or was declared non compo mentis. Because if her idea of treatment was telling you you’re a deranged creep and demanding that you stay at least 30 feet from her at all times, I don’t think she’d receive it. I think she’d lose every one of those powers you listed, just for requesting something that most people would find at least a little bit funny, not a sign of “mental illness.”] These safeguards apply to patients like J who are mentally ill and at risk of harm to themselves or others as a direct result of mental illness. [Did I miss something? Cutting her arms doesn’t mean J is “mentally ill.” It probably means something awful’s going on in her life that she either can’t escape or can’t articulate, to herself or anyone else. One thing she does not do is lock people up and drug them. That, my friend, is “mentally ill” even by your standards, if you’d stop and think about it. Except I’d just call it sadistic.]

    http://www.wbur.org/commonhealth/2015/05/15/upside-of-psych-unit

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      • OK speaking of liberal totalitarianism, I see that Huffington can print this shit with impunity unless you join facebook as that’s the only vehicle they accept for submitting comments. And everyone knows, or should, that facebook is primarily a tracking and profiling site collecting personal info, beliefs, attitudes, fears etc. for huge data banks which provide the info to business and government.

        Is there a way to get a group account & share the password, or maybe have someone get an account and transmit comments from people who don’t want their privacy trampled just to make a comment?

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        • You can do it, but be aware that the account would eventually get deleted because Facebook only tolerates individuals using their real names. They have eventually busted all my fake accounts. In the case of a shared account, they might have ways of detecting that logins are occurring from all over the country or world, and simultaneously. If everyone used a good VPN* service, and pretended to be from the same city, that would help. If you make an official “Page,” many people can administer it, but I don’t know that Pages can comment on off-site content.

          *VPNs are Virtual Private Networks. You login into their application before you commence using the web. They assign you an IP address from anywhere in the world you chose (among their offerings), so that your real IP address is not revealed when you view web pages. (Normally it is logged by the computer that is hosting the pages.) Your real IP address lets people pinpoint you to a city block, or to your home if your internet service provider is consulted. It’s like a calling card that you leave by accident. Or like you stepped in something and now you’re leaving tracks all over the internet.

          Some people use a VPN to seem to be from a country that is allowed to access certain material on the web, if they live in a country that isn’t allowed to. Others use it for lightweight anonymity, because lot of bloggers keep track of the IP address that visit their blogs. If you’re stalking the enemy and don’t want to be recognized by your IP address every time you enter their turf, a good VPN is probably a good enough defense against being recognized, if you change up your fake location often. I doubt anything is NSA-proof, though.

          Good VPNs don’t keep any user activity logs, unless they have to by law, in which case they’re not all that good for people who do bad things on the net. Good VPNs don’t leak your real IP address. Bad ones do both.

          Leak what? Search for: lifehacker leaking ip address VPN.
          A lifehacker article on the topic of leaks will be the first result.

          Some VPN services are free, but always test for leaks and check their logging practices.

          I just searched for: best vpn
          The first site listed by Google gave high ratings to some good VPNs.

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  11. Or was J cutting her arms as a consequence of SSRI/other psychotropic drug induced AKATHISIA?

    It would be of compelling interest to know whether or not the “History of Presenting Complaint” section of her case notes, pertaining to her arrival in the Emergency Department, included fastidious documentation of all dates, drug-names, dose increase/decrease, drug add-ons, drug cessations: – prescribed during the days, weeks and months before this situation.

    It is only this process, in exact detail, –
    (plus of course an awareness and understanding of how iatrogenic akathisia can so often result in the humiliation, false judgement, deprivation of clothes, mobile phone, destruction of any residual self esteem, reduction of spirits to utter despair, and the incarceration in an anti-therapeutic environment for enforced highly toxic drugging) – that can differentiate a correct diagnosis of SSRI/SNRI/Psycholeptic drug induced AKATHISIA from the alleged, “diagnosis” of a “serious mental illness”.

    It would also be critical, in differentiating akathisia from an “SMI” to document any available observations from family and/or partner.
    Specifically, any changes in movement, mood, behaviour, agitation, aggression, flattening of affect, onset of “self harm” noticed (by those who know best) in close proximity to the dates of psychotropic drug changes.

    My own observations suggest that a history from relatives is unwelcome to the admitting psychiatrist.

    How many people with unrecognised, SSRI induced akathisia requiring urgent (proper) medical management of their acute, medical emergency are subject to the routine degradation, humiliation and destruction of self and soul, described so vividly in the “Care” of J?

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    • Far too many. And the MDs just eat it up, because then they can whip out the “mood stabilizers” and “antipsychotics,” and that means they have a patient for life. Like a spider wrapping another envenomated fly in spider silk and stashing him somewhere in her web, they accumulate wealth, one victim at a time.

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  12. You’re dreaming TRM. Even most regular doctors don’t think meds have side effects. And Dr. Farrell called the new psychiatric ones benign.

    Just so you know, I am ranting against psychiatry and not you. 🙂

    All rants aside, your posts make perfect sense. But then there is reality.

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  13. I would just love the day it becomes common household knowledge of the points brought out here by Philip Hickey.

    Point number 4 especially: where it for some can be an aid to have some natural responses dampened or numbed, it can be utterly devastating for others. Any intervention to the delicate balance of brain chemicals, such as Serotonin and other neurotransmittors, will cause, and have caused unwanted changes in human behaviour and demenor, general health and awareness. Physical as well as mental changes cannot be predicted by the prescriber nor the recipient.
    Ove.

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  14. I don’t get it. Is Dr. Gold not feeling well?

    This is a door and there is a lock on it. This is a key in the hands of Dr. Gold. We see no keys in the hands of patients. Is Dr. Gold not aware that she comes into work daily and unlocks the door to let herself in, and it locks behind her? Is she deaf, unable to hear the click of the door?

    Oh, she lacks insight. She sees a lock, but in her mind, she insists its treatment.

    Meanwhile, the commonly held belief is that this is a locked door, and this is a key.

    I think a few rounds of ECT, therapy, and drugs might fix her grand delusion. Of course she won’t be able to put a sentence together, but…..It’s treatment. Tell her that.

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  15. Dr. Gold,
    In case you are aware of this article and are reading these responses to try and better understand why people have the reactions to psychiatry that you describe, I thought I would add this comment. You seem like a well- meaning person, but you do not seem to understand the ‘humility’ and ‘uncertainty’ that is so necessary that would enable you to approach your patients in a truly helpful and respectful way, in a way that would ensure that you did not add any harm to very vulnerable people

    I will just use one example (from the many I saw) from your article, that demonstrated this lack of humility and uncertainty in regards to what is ‘best treatment’ for your patients. You write “And, without understanding the therapeutic benefit of engaging in connections with others on the unit, it can feel restrictive to have visiting hours and not be able to have a significant other or family member spend the night.” It is such an arrogant position that you take here, particularly given the very limited training in counselling that many psychiatrists seem to have. I think it is pretty established by now, that stress and fear (and lack of sleep) exasperate the situation of a person who is in extreme distress. You assume, from this statement, that the surface connections that a person might develop and engage in during the limited time of an inpatient stay, are more effective than the patient’s deep trusting relationships, to help him/her through such a terrifying, fearful time of troubling thoughts and strange feelings. I think you should let the patient let YOU know how he/she feels the most safe and what would be most helpful. I know when my loved one was experiencing very confused thinking, a terrifying night spent alone in an inpatient unit resulted in staying awake all night and a much worsened condition. The response from staff? “It is very common for people to get worse once they come to hospital”. (My thoughts about that response: “No Wonder”).

    I hope I have been able to clearly express to you, why, as a family member, I don’t think you ‘completely get it’. If you are serious about wanting to be an ally to patients, why not read the blogs on MIA of psychiatrist Sandra Steingard , who has worked for decades in this area and who advocates ‘slow psychiatry’. She is always responsive to emails from all, so I am sure you could get a lot of guidance from her.

    If anyone from MIA is posting directly to Dr. Gold’s article, could you let her know there are responses to her article over here on MIA?

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  16. I don’t disagree with your assessment of how people are treated in locked wards. It’s probably worse than I can fathom. However, I think you’re way off base when you state that the ‘general public’s negative perception of psychiatry…. is grounded in a realistic appraisal of psychiatry’s spurious concepts and destructive “treatments”.’

    This may be the reason in the circles you travel in including here but, no, it isn’t.

    The general public is afraid of people considered out of the ordinary, out of touch with reality, unstable, unpredictable and sometimes violent. Throw in a dose of judgement for others who are not able to support themselves and a disdain for those considered weak and to blame for their situation and that is gets you to the general public’s perception of psychiatry and psychiatrists (long considered as ‘crazy’ as the people in their locked wards).

    I suspect that I what I wrote sounds harsh, and in reality it is, but I don’t think it serves well to attribute an understanding to the public which they lack.

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  17. Philip,

    I am so late to the party, but… thank you for this article. It feels truly liberating and relieving in a strange way, to hear someone express exactly what you have here, with the forcefulness that is genuinely warranted. Thank you, thank you, thank you!!!

    I also hope I never meet this buzzfeed contributor in person.

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  18. So happy to see you writing again, Phil. Your work is always so insightful and searing. Dr. Gold has definitely “drunk the Kool Aid” of psychiatry as a benign and helpful profession. As for me, I will stay as far away from them as possible and advise my friends and family to do the same.

    A word about “pre-hypertension”—-I want to know why, with my blood pressure at 120/80 for as long as I can remember, my doctors used to tell me that was perfect…..and now it’s cause for alarm. I think it’s about drugging folks–lower numbers, more drugs.

    I told my doctor that I was “Pre-dying” as well.

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    • “Pre-dying!” I love it! It’s a condition we can ALL claim!

      The same happened with cholesterol, BTW. At one point, you had to be 160 or so before anyone got worried. Then for no real reason, they changed it to 120. Actually, there was a reason – to sell more cholesterol-lowering drugs!

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