Researcher Acknowledges His Mistakes in Understanding Schizophrenia

Shannon Peters
121
20976

In a new article, published in Schizophrenia Bulletin, psychiatrist Sir Robin Murray reflects on the history of ‘schizophrenia’ research and mistakes made. Murray, a professor at the Institute of Psychiatry, Psychology, and Neuroscience in London, states that he ignored social factors that contribute to ‘schizophrenia’ for too long. He also reports that he neglected the negative effects antipsychotic medication has on the brain. Murray states:

“Amazingly, such is the power of the Kraepelinian model that some psychiatrists still refuse to accept the evidence, and cling to the nihilistic view that there exists an intrinsically progressive schizophrenic process, a view greatly to the detriment of their patients.”

Robin Murray, a Scottish psychiatrist and professor of Psychiatric Research at the Institute of Psychiatry, Kings College in London

Murray, who began his work as a psychiatrist in 1972, describes the shift in U.S. psychiatry during the mid-1970s “from being wholly psychoanalytical to almost wholly biological.” Since this shift, there has been an increased focus on the role of dopamine and genetic factors in ‘schizophrenia.’ During the 1970s, ‘schizophrenia’ came to be understood as a neurodegenerative disorder. This theory was supported by a study that found enlarged ventricles in the brain for individuals diagnosed with ‘schizophrenia.’ Murray regrets that he and many others ignored another study published around the same time, which noted how long-term use of antipsychotic medication can result in persistent brain changes, mainly in the sensitivity of dopamine receptors, which can result in tardive dyskinesia.

It was not until 2008, when a newer study showed the effects of antipsychotic medication on ventricular volume, that Murray began paying attention to the long-term effects of antipsychotic use. He states, “So, in 2016, it is clear that high-dose antipsychotics contribute, not to the subtle brain changes present at onset of schizophrenia, but to the subsequent ‘progressive’ changes thereafter.” Murray also reviews the neurodevelopmental theory of ‘schizophrenia,’ the idea that the disorder is caused by issues during birth and early development. Now, Murray refers to this theory as an “overstatement” of the evidence.

Murray also discusses dopamine supersensitivity, that long-term antipsychotic treatment can result in an increase in dopamine receptors, which increases the sensitivity to dopamine and decreases the effectiveness of antipsychotic medication. He states, “We raise the possibility that antipsychotic medication may make some schizophrenic patients more vulnerable to future relapse than would be the case in the natural course of the illness.” Murray believes in the use of antipsychotic medication to treat schizophrenia, but has become more cautious in its long-term use, saying:

“There is no doubt that antipsychotics are necessary in acute active psychosis. But do (we) have to continue to prescribe them in some patients because we have rendered the D2 [dopamine] receptor supersensitive to the excess dopamine released? I, and indeed most investigators, have neglected this vitally important question.”

Murray states that he expects the concept of ‘schizophrenia’ as a discrete disorder to become obsolete, just like “dropsy.” He writes:

“In the decades following 1976, I spent more time and energy than I like to recall, trying to find what caused the brain changes in schizophrenia. Sadly, I did not realize that the effects of risk factors such as adverse obstetric events, on brain structure and function, which can be readily seen in nonschizophrenic samples, are obscured in people with established schizophrenia by the effects on antipsychotics and other nonspecific factors.”

It is significant to have a prominent psychiatrist admit psychiatry’s mistakes and call for more research on environmental factors and epigenetics. Perhaps it signals a shift in the field of psychiatry if others follow Murray’s lead. He concludes,

“If I had the chance to have a second career, I would try harder not to follow of the fashion of the herd. The mistakes I have made, at least those into which I have insight, have usually resulted from adhering excessively to the prevailing orthodoxy.”

****

Murray, R. M., (2016). Mistakes I have made in my research career. Schizophrenia Bulletin. Advance online publication. doi:10.1093/schbul/sbw165 (Full Text)

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121 COMMENTS

    • Yes. “Perhaps it signals a shift in the field of psychiatry if others follow Murray’s lead”
      It always amazes me that whenever one of these psychiatrists state any “wrongdoing” people believe that a change will come.
      I remember that during DSM-5 discussions two of them Robert Spitzer and Allen Frances made numerous critics and proposed that DSM should end.
      DSM-5 is alive and kicking.
      We need a revolution in medicine as a whole and in psychiatry… start from scratch.
      What about listening to patients?
      That would be a great start. How can DSM be done – it is all about statistics, isn’t it – when the word of the patient is “anecdote evidence”?
      This stats are made based on what?
      On the clinical practice described by doctors? Oh, the word of the doctor is also anecdotal evidence… Hmm…
      How can the fourth phase of clinical trials – surveillance after the drug is on the market – can be done without listening to patients?
      lol
      It would be funny if the consequences were not that tragic.

  1. It’s a bit strange to hear Robin Murray say this,

    “Murray states that he expects the concept of ‘schizophrenia’ as a discrete disorder to become obsolete, just like “dropsy.”

    And then for him to speak the whole rest of the article as if schizophrenia were still a bonafide, carved at the joints, separable “disorder”. The severe end of the spectrum of extreme distressed (traditionally labeled “schizophrenia”) should not be called a singular term at all. There is one “it” there. For some people severely distressing experience is temporal and short-lived, for others medium and for others much more severe and long-term. Much depends on how the environment responds to the distress.

    On another listserv, I wrote about this issue of “Murray’s mea culpa” in this way:

    I thought some people might like to see British psychiatrist Robin Murray’s reflections on his regrets from a career in psychiatry, especially the part quoted below:

    https://www.dropbox.com/s/ej5kv57sybbxwum/Schizophr%20Bull-2016-Murray-schbul_sbw165.pdf?dl=0

    “I Ignored Social Factors for 20 Years” – Robin Murray

    Quote: “So almost by accident, I got into epidemiology, and then was confronted by the evidence that one of the most con-sistent epidemiological findings in the United Kingdom is the high incidence of schizophrenia in the African-Caribbean population. Having excluded genetic and other biological causes, we were forced to look at the role of social factors such as migration, social isolation, and discrimination.19

    It is odd that it took me until the mid-1990s to take social factors seriously as component causes of schizophrenia because when I trained in the 1970s, social psychiatry was predominant at the Institute. Indeed, one of the first researchers that I worked for was Jim Birley who, together with George Brown, had demonstrated the importance of adverse life events in schizophrenia.20

    However, by 1990 the predominant view, including my own, posited that schizo-phrenia was a brain disease influenced by aberrations in developmental genes20 and early environmental insults.21,22Social psychiatrists, including our local experts such as Paul Bebbington and Julian Leff, confined themselves to say-ing that social factors contributed to relapse. Indeed even as late as 1998, we took a sociologist, Rosemary Mallet, to the winter workshop on schizophrenia in Switzerland. Unfortunately, she was miserable because she didn’t ski, and apart from her own poster, there was no mention of social factors in the whole conference!

    In the last 2 decades, it has become obvious that child abuse, urbanization, migration, and adverse life events con-tribute to the etiology of schizophrenia and other psycho-ses. This has been a big shift for me! Indeed about 5 years ago, after I had given a lecture on the subject of social factors in schizophrenia, one listener stood up and said “Professor Murray, I last heard you talk abut social factors in schizophrenia in 1982. Then you were against them, now you are for them.” The audience fell about laughing! I splut-tered that one must change one’s mind if the data change. However, the truth was that my preconceptions had made me blind to the influence of the social environment.

    I never had a proper epidemiology training—but a suc-cession of younger fellows in my group spent a year at the London School of Hygiene and Tropical Medicine. There theylearnt how to use epidemiological techniques to exam-ine risk factors for psychosis, whether they were social or biological. So, for example, Peter Jones and Mary Cannon were interested childhood hazards be they infection or abuse, David Castle and Nori Takei studied effects of urbanization, Jane Boydell and Craig Morgan researched migration and ethnic minority status, while later Marta Di Forti examined the effects of cannabis.

    Jim Van Os in particular taught me, and then European psychiatrists as a whole, that it’s oversimplistic to regard schizophrenia as just a brain disease. Asthma may be a lung disease but it is one which can be precipitated by environmental toxins (eg, pollution) and allergens. Just as the lungs process air, so the brain processes external stimuli; consequently, its healthy function can be harmed by noxious factors in the social environment such as childhood abuse or adverse life events.”

    ———-

    Haha what a concept that last sentence is! Too bad it took decades to realize this idea, which seems not to have crossed the Atlantic yet. Apparently, leading American psychiatrists still don’t understand this concept.

    To me people like Sir Robin still sound like aliens studying humans a if they were another species, failing to appreciate the subjective, lived experience of those they write about. The people they write about sound like automatons or machines, without agency or volition.

    Lastly one has to wonder if Murray has ever done intensive psychotherapy with real clients, or if he is just sitting in a university classroom “studying” people from afar.

  2. I’m encouraged by Sir Robin Murray’s admission actually. I mean the alternative is another doctor/professor who after so many years in the field doesn’t have the slightest clue that any mistake might have been made. I’ve endured a system in which it is nearly impossible to speak of doing things differently because of custom, habit, and general group-think. The Neo-Kraepelins have to be directly responsible for much iatrogenic death and damage, that is to say, they with the drug companies have blood on their hands, and they are still pretty much the predominate presence in psychiatry today. Every time there is something of a defection, due to health concerns and the facts, that has to be an improvement. It’s time we had more doctors who were not in the business of destroying health in the name of health. If you have one psychiatrist speak out on the subject, it is possible that others may follow.

    However, if “schizophrenia” is bunk, and no longer a discrete disease entity, the following sentence makes absolutely no sense: “There is no doubt that antipsychotics are necessary in acute active psychosis.” Doubt, much doubt. If I had been a compliant mental patient, I would UNDOUBTEDLY, according to the odds, be dead today. The notion that the answer to “acting out” so-to-speak is a chemical intoxicant is behind the many of the mistakes he is alluding to. Prescribing a dose, invariably, among psychiatrists, seems to lead to prescribing further doses, and doing so, is not bucking the orthodoxy in the slightest.

    • Also…

      ” Sadly, I did not realize that the effects of risk factors such as adverse obstetric events, on brain structure and function, which can be readily seen in nonschizophrenic samples, are obscured in people with established schizophrenia by the effects on antipsychotics and other nonspecific factors.”

      Is it not possible that he is missing the effects caused by neuroleptic drugs themselves, and that adverse obstetric events are not so much a problem as he would imagine them to be? I kind of think “brain dysfunction” a too readily available explanation for aberrant behavior than it should be, especially if unproven. There can be little doubt that psychiatric drug use is contributing greatly to the increased mortality we are seeing, and that’s not a little thing by any means. I am sure that this increased mortality is not the only problem exasperated by this excessive over reliance on potentially toxic chemicals.

      The point I’m trying to make here is that if Sir Robin Murray has defected from the orthodoxy, apparently he hasn’t defected nearly sufficiently enough. One has to acknowledge the damage being done by standard practice if one is not to be complicit in it.

      • This is a good article acknowledging the profound effects stressors in childhood and in the everyday environment can influence the brain. But there are a few things here that the author is missing:

        1) High-dose neuroleptic use is listed here. Standard of care and evidence shows that you get a person with a diagnosis of Schizophrenia down to the lowest possible dosage as quickly as possible. And this is born out in studies. A recent Observational study in Sweden looking back at 21,492 people with the diagnosis of Schizophrenia and found that patients on antipsychotics, especially low doses, had a 15-40% decreased overall mortality than untreated patients. “Mortality and Cumulative Exposure to Antipsychotics, Antidepressants, and Benzodiazepines in Patient with Schizophrenia: An Observational Study” Tiihonen et al. That is a powerful finding. The same study shows the opposite of Benzos. Don’t give moderate and high doses of Benzodiazepines to these people (or anyone).

        2) This idea of social and environmental factors weighing in on health is a double-edged sword because a lot of opponents of Psychiatry point out the WHO studies that show that people with the diagnosis of Schizophrenia in the third world do better than people in the first world (where the access to all the medications are). But what is becoming clear hear is the bigger the evolutionary-environment mismatch, the bigger the stress on the health of the person. Comparing Joe in the Amazonian jungle is completely different than Joe on the streets of New York City.

        3) Again, you would be hard-pressed to find a doctor who believes Schizophrenia is a distinct disease entity. We are probably looking at 30 or 40 different biological processes that look roughly the same on examination.

        4) His statements are really a reflection on the change in Psychiatry over the past 25 years, to a more holistic model, embracing epidemiology and trauma and wishing he had spent more time on this nexus in his career. This is not news to the scientific community.

        5) Neuroleptics can make some people worse. Absolutely. But I’m citing the study above to make the point that in by no means is the scale weighted against neuroleptics. If you get someone who cuts out his eye because he thinks the FBI has put something in it, a guy cuts off his leg because he thinks its rotting, or a teenager kills his mom because she is not who she says she is (all cases I’ve seen), and you don’t prescribe an antipsychotic? You are grossly negligent.

        • Shook, you made an extremely good point and one that many patients have been shouting from the rooftop for years. The problem is not with the patient, the problem is with society. If an Amazonian (or African) or whatever tribal culture you point to does better than Joe in NYC, obviously, environment has a lot to do with healing. The answer is to change the unhealthy environment, not disable the patient. Westerb medicine blames the patient for altered states due to stress instead of blaming the entirely unnatural ways we live.

          I disagree entirely with the mental states where you say it would be grossly negligent not to medicate. This belief is exactly why I will never tell another mental health provider when I am experiencing distressing thoughts. Never ever. Providers like you can’t be trusted not to forcibly medicate us. Feelings are transient. disabling someone because they are honest about how they are feeling should be criminal. It is this attitude that keeps people from seeking the treatment they need.

          • I think you misunderstand my meaning. Those patients actually did those things. Again, Schizophrenia describes a heterogeneous population of probably 30 or 40 discrete disease processes. It can be much more severe than I think most people realize. I’ve met people who never took medications and the disease process was so severe that they were constantly preoccupied with voices and paranoia. They didn’t talk or interact with anyone, including their own family. Do you know what happens to those people? Look to the streets.

          • Shook,
            Your comments remind me of the “good, modern” treatment that I witnessed at a very respected hospital. The biggest problem I have with your comments (and the treatment at that hospital) is the lack of humility and uncertainty that leads to justification for forced medication. You cite extreme examples of horrific behaviours which also could have been prevented by providing other kinds of support or ‘forced safety’ (eg. humane confinement). Prescribing antipsychotics without informed consent, when it is not known whether or not it will worsen someone’s condition, is negligent.
            We heard this kind of faulty reasoning repeatedly. (e.g. medication is not proven to work, but if the patient gets worse than we have to use the medication (that is not proven to work). We was similar faulty reasoning that worked to always protect the idea that’current best practice’ is best. (e.g. “people get sicker in the hospital after being medicated because the disease is progressing” etc.
            You also say “I’ve met people who never took medications and the disease process was so severe that they were constantly preoccupied with voices and paranoia. They didn’t talk or interact with anyone, including their own family. Do you know what happens to those people? Look to the streets.” What about also “looking to” state hospitals where people like that,drugged with neuroleptics, sit and ‘don’t talk or interact with anyone, including their own families”?” Dr. Torrey talks of these patients in his books. I think the medical community refer to these people as ‘treatment resistant’, yet they keep them on neuroleptics anyways, probably killing any chance they have of getting better in the future.

            Some people who are in a severe state do seem to get better after a number of years and finding the key to how to improve the chances for more and more severely distressed people, is going to require the humility and openness that most psychiatrists seem to lack. In 25 years from now, what parts of ‘current best practice’ will the more thoughtful psychiatrists be apologizing for? Given all the uncertainty of treatment, the best ‘good’ psychiatrists can do at this time is to provide information about the uncertainty of treatment, provide full consent for treatment, fight against the current coersive aspects of ‘treatment’ that exists in the system and work with the wider helping community to ensure safe, humane spaces for people in extreme distress to be until they can move forward.

        • I have to disagree with you, Shook, on points 3 & 4 you would make above. Psychiatry still doesn’t know what it’s looking at, and “30 or 40 different biological processes” says as much. Psychiatry adopted a more biological approach to treatment in 1980 with the publication of the DSM-III, and I don’t think things have changed appreciably since then. Did more psychiatrists have a change of heart such as Sir Robin Murray did, that would be a very good thing indeed. Although there is talk of holistic treatments, etc., I don’t think we’re anywhere close to the situation that existed before the release of the DSM-III. Are we headed there? I would say it’s too early to say, but it’s certainly not too early to be hopeful.

          • Sa, again, these actions have happened. This would be the scenario: a man comes to a psychiatric ward from medicine stabilized after gouging his eye out with a pencil in his home. He is actively psychotic, stating there is a transmitter in his eye and the government has him under surveillance. He is aggressive towards staff. I cited a study up above done by an entire country finding antipsychotics lower all-cause mortality in people with the diagnosis of Schizophrenia.
            Again, there are degrees of sickness here that I think are just not appreciated and perhaps can’t be appreciated unless seen first-hand. Antipsychotics decrease the length of psychosis. This guy is getting an antipsychotic. I’m not locking him in a room and waiting for the psychosis to go away. You can argue two points here: Antipsychotics decrease the length of psychosis and they decrease all-cause mortality in people with Schizophrenia, but I would challenge you to cite those studies.

            Frank, as to your points, there have been some real breakthroughs in 2016, especially with the genetics of Schizophrenia. It is early, but I think we are headed there.

          • @shook

            “Frank, as to your points, there have been some real breakthroughs in 2016, especially with the genetics of Schizophrenia. It is early, but I think we are headed there.”

            I think a lot hass been written about those “breakthroughs” on this site.

            I’m not sure why you’re citing genetic research as an example of getting where we’re supposed to be though. It’s the opposite.

            P.S.: Some food for thought regarding genetics and schizophrenia….What the Nazis did in in Germany:

            “If a nation murdered and sterilized an estimated 73% to 100% of its diagnosed schizophrenics, yet a generation later that nation had a higher rate ofincidence of new cases of schizophrenia than did surrounding nations, shouldn’t we have questions about the claim by the mental health establishment that schizophrenia is highly heritable?”

            https://www.madinamerica.com/2013/01/what-happened-after-a-nation-methodically-murdered-its-schizophrenics-rethinking-mental-illness-and-its-heritability/

          • Shook,

            You state with confience that “Antipsychotics decrease the length of psychosis.” However, you provide no evidence to support this. Studies by Harrow, Wunderlink and others show the opposite – short use or no use of antipsychotics is associated with shorter length of “schizophrenia,”even if short-term use does decrease psychotic symptoms.

            You also clam that they reduce mortality. However, the mortality rate among the “chronically mentally ill” is MUCH higher than the general population, 25 or so years earlier, often due to medication-induced diabetes and heart disease. I think you’re believing what you’ve been told, but not looking at the totality of the evidence showing that long-term use of antipsychotics has very negative consequences that outweigh the benefits more and more significantly as length of use continues.

        • this comment is in response to shook,

          “This would be the scenario: a man comes to a psychiatric ward from medicine stabilized after gouging his eye out with a pencil in his home. He is actively psychotic, stating there is a transmitter in his eye and the government has him under surveillance. He is aggressive towards staff.”

          this is a pet peeve of mine; members of the establishment report events in a way that make the sufferer look totally ridiculous. it’s disparaging, cruel and unfair.

          i’m okay with what he believed.

          he stated there was a transmitter in his eye. STOP. instead of deeming him psychotic (and whatever else) exert some effort to try to understand the meaning behind his description. he was obviously distressed over something about his eye but he lacked precise knowledge and so he had to rely on conceptualization. our eyes ARE transmitters (they’re also called a gate or gateway). it seems to me he was having intrusive images flashed into his visual field but he couldn’t understand the cause or source. some support and understanding really would have benefited him but nobody would be capable of providing support and understanding if people maintain the prejudice belief in so-called mental illness. he likely gouged his eye after suffering the distress for far too long (driven and pushed beyond intolerance). people DO break.

          he said the government had him under surveillance. that’s true; the entire world is under surveillance (it’s quite invasive). what anyone can know, and should know, is that he was experiencing violation (he felt violated, and that was real for him no matter what or how or why). it would help if people just admit that they don’t know how to respond to a violated person. you don’t know what a violated person needs. hell, you can’t even diagnose him as VIOLATED.

          he was aggressive toward staff because he knew the enemy state of being. he was already greatly mistrusting of government (which is probably based on experience and if so would be acceptable, and not wrong or mentally ill) and so he likely saw staff as the enemy. i don’t doubt that he has had the rotten experience of needing help but not receiving it. in other words, he knew the people he was dealing with.

          it’s a big, unnatural world out there http://www.globalresearch.ca/on-the-need-for-new-criteria-of-diagnosis-of-psychosis-in-the-light-of-mind-invasive-technology/7123

          • My general critique and agreement of Whitaker’s take on things is more eloquently stated by another here:
            http://www.huffingtonpost.com/allen-frances/do-antipsychotics-help-or_b_9131376.html

            Antipsychotics in acute psychosis:
            Delayed-onset hypothesis of antipsychotic action: a hypothesis tested and rejected. Agid O, Kapur S, Arenovich T, Zipursky RB

            The first link is a pretty cool debate response by Allen Frances who is no friend of the establishment — especially with his scathing attacks on big pharma and the DSM-5. But he sees right through Whitaker’s sleight of hand. If you read Anatomy of an Epidemic, Whitaker cites Harrow’s following of 60 or so patients on antipsychotics and then makes a huge generalization about causation and medications. This is not a placebo or randomized controlled study. You can’t make any conclusions about meds from Harrow’s study. In a follow-up paper they admitted as much. Correlation is not causation and it is that leap that is made throughout that book again and again.

            I also cited a paper way up above that shows people with the diagnosis of Schizophrenia live longer on antipsychotics. It was a country wide study (Sweden) that also showed how dangerous Benzos are. It is really hard to argue with those findings.

            The genetics testing led to a finding that the histocompatibility complex that modulates the immune system was found to be a major player in people with the diagnosis of Schizophrenia. There is now active research to try and figure out if the immune system is attacking dendritic cells in the brain at the time of second phase pruning in adolescence (a time when a majority of first psychotic breaks happen).

            A tiny minority are housed in state hospitals. Our biggest mental healthcare provider is the prison system.

            Sorry, this post answers several posts.

          • That is an interesting approach, career, but it would not get you anywhere. Meanwhile you are exposing staff and patient to the threat of violence. You are making so many assumptions in your armchair analysis that it is difficult to know where to begin.

          • to shook,

            nonjudgmental care and compassion for a distressed sufferer certainly is interesting, yes. it’s practically novel! and i think you’re right, it would definitely go far in hollywood but not at all in the real world.

            as for the violence, i simply explained the motive behind his aggression. it serves the purpose of understanding. most people would think of a person’s aggression as a symptom of a disease (maybe sometimes it is) but aggression very much can have other causes. when you know and understand why somebody behaves a certain way you’re better enabled to respond in a supportive, healing and less consequential way. the standard course of response from those who serve the establishment is to CONTROL people. controlling somebody isn’t an act of helping them. controlling somebody isn’t an act of healing them. it should be common knowledge that trying to control somebody will make them rebel (e.g. aggression). yes, it is my assumption that he was severely frustrated but my assumption is based on decades of experience and observation. i’d say it’s more of an obvious conclusion than assumption.

          • Well, you should know your guy’s likely to have the feeling of being watched much of the time. Don’t be surprised if he also wonders about folks on the street talking about him- he may have the audios. I’ll want to know how well he’s slept recently. I’ll ask about his eye, how he knew it had to go, and about other sensations he’s experiencing. If I’m someone like a psych resident, I’d better find out if my new acquaintance is having anticholinergic hallucinations (e.g. bugs crawling under the skin) lest my bungling lead to devastation of patient, ward and self- no neuroleptics, please.

          • i wouldn’t be surprised if he encounters random strangers popping off at the mouth saying things that are too personal and hit too close to home. it happens to countless people. it’s a spiritual matter. but psychiatry denies spirit (totally lacks knowledge and understanding). do you know what an oracle is? do you know what prophet is? people are conduits or channels. when the spirit is at work the host is not speaking; a spirit is. not all spirit is the holy spirit. there are unclean spirits and demonic spirits (demons are known for the private knowledge they couldn’t possibly have about you, but they do). because people lack spiritual knowledge they call the phenomenon “gang stalking” and identify themselves as “target individuals”. it’s negative spirituality at work. not all spirit is light and love. there is dark (and it is very dark).

            if he feels bugs crawling under his skin he needs to elevate (he’s too low). the body is a temple and we’re supposed to keep it holy (most people don’t). when the body is not a holy temple it can become a prison of terrors and horrors. oh, there are things the body can do that will cause the inner being to want to jump out of their skin. he very much could be a lost soul or a prisoner soul or a victim soul, needing salvation.

            psychiatry’s unholy eucharist, those anti pills, will never be the remedy for the spirit, soul OR the body.

        • Shook said: “A recent Observational study in Sweden looking back at 21,492 people with the diagnosis of Schizophrenia and found that patients on antipsychotics, especially low doses, had a 15-40% decreased overall mortality than untreated patients.”
          I’ve heard of this study -Ronald Pies refers to it in a piece he wrote for Psych Central. I’d like to read the full text of the study, but I can only find the abstract. The full version costs $35. Do you know if there is any way of accessing it for free? Here’s the link to the abstract…
          http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2015.15050618?journalCode=ajp&

          • Oracles are those who cover their statements in such a way their pronouncements can’t be false- “if Croesus goes to war with Cyrus, a mighty kingdom will surely fall.”

          • bcharris,

            what a funky thread this is (i had a hard time locating your comment). i googled your quote and learned about the oracle of delphi’s test: tortoise and lamb. i think in today’s world such a being would be called a psychic.

            in regard to the so-called gang stalking phenomenon, it is greatly misunderstood by those who experience it. they believe there is a concerted effort of people who live for no other reason but to torment and torture them but many of the “perps” are unconscious oracles (mediums). in other words, those deemed to be perps lack cognitive awareness of what’s happening. but that’s not to mean that there are never cognitively aware gang members who do know exactly what they’re doing. there sure can be. there’s no doubt that it is a dark spiritual ordeal. the holy spirit would never torment or torture.

        • @shook: it’s interesting you criticise whitaker for supposedly claiming causality from a naturalistic study and then make causal assumptions from an observational study. a study by the same group of people is well debunked here: http://behaviorismandmentalhealth.com/2015/06/01/neuroleptic-drugs-and-mortality/ i guess they used the same data and just added benzo to publish a second article. there are also other problems with the study if you look closely. just one, but a major one: The identified schizophrenia patients were categorized into 4 DDD groups; (1) no antipsychotics during the follow-up, (2) small doses of antipsychotics or occasional use (0 DDD/ day–0.5 DDD/day, noninclusive), (3) moderate doses of antipsychotics (0.5 DDD/day–1.5 DDD/day, inclusive), and (4) high antipsychotic doses (>1.5 DDD/day).” [Emphasis added]

          So the individuals in the study were categorized – not by cumulative lifetime exposure to neuroleptics, but only by exposure during the five-year follow-up period. For example, a person who had been taking neuroleptics for decades, and came off the drugs in December 2005, and died in January 2006, would have been recorded as a mortality in the zero neuroleptic exposure group.

          wonder why they did it like this. hmmmmmmmmmm

      • Shook,

        IN your part 5 you made an argument for short-term use of tranquilizers.

        However, it’s important to point out that strong evidence supporting use of long-term drugging for improving outcomes beyond 1 year is lacking. This was discussed in Sohler’s study here:

        http://psycnet.apa.org/?&fa=main.doiLanding&doi=10.1037/ort0000106

        So the scale might or might not be weighted against tranquilizing over the short-term (if one defines “effectiveness” as making a person more compliant and less able to feel rage and terror), but long term there is much more doubt.

        Importantly, we want to clarify that antipsychotics drugs are basically tranquilizers that limit the ability to sense and feel disturbing thoughts/feelings. They are not medications treating a specific disease. With this in mind, it’s more clear why their long-term use does not promote a return to functioning and relating well in many very severely distressed people, since drugging cannot address the environmental and psychological factors underlying chronic long-lasting terror, rage, and distrust.

        It’s also important to note that intensive psychotherapy has had a lot of success with people labeled “schizophrenic” that is underreported, and that this can be achieved in many cases without the use of drugs.

        http://psychrights.org/Research/Digest/Effective/BGSchizophreniaMeta-Analysis.htm

        Reviewing 37 studies of psychotherapy for people diagnosed as “schizophrenic”, William Gottdiener said,

        “There is a long-standing controversy about the use of conjoint medication in the psychotherapy of people with schizophrenia. For many years psychotherapists were reluctant to employ antipsychotic medication as an adjunct to psychotherapy because they thought it would disturb the therapeutic process. However, since at least the 1960s most therapists that treat people with schizophrenia have used antipsychotic medication in conjunction with psychotherapy. Most therapists think it is indispensable. However, between 40% and 75% of patients do not take their medication (Perkins, 1999) and there are many for whom medications fail to work (see above Hegarty et al., 1994). For these patients and for therapists who choose to offer treatment with little or no adjunctive medication, it would be important to know if such treatments work…

        It is surprising that the proportion of patients that were likely to improve without conjoint medication, is similar to the proportion of patients that were likely to improve with a combination of individual psychotherapy and antipsychotic medication. This finding is contrary to most therapists’ clinical expectations. The finding that individual psychotherapy can be effective without medication is not new (see Karon & VandenBos, 1981). However, it is important because it suggests that individual psychotherapy alone might be a viable treatment option for some patients who do not improve from treatment with antipsychotic medications, for some patients who refuse to take medications, or for patients who are treated by therapists that choose to use little or no adjunctive medication.”

        To me, as someone who once took these drugs and discontinued them against my psychiatrist’s advice, this finding that improvement can occur without the drugs is not at all surprising. And given that up to three-quarters of people choose to stop taking their drugs, it certainly merits more research into non-drug treatments for those psychotic people who do not want to use the drugs long-term, which is probably most.

        • Good points. The data for long acting drugs could definitely be better. I agree.
          There are better studies to back up your claim on psychotherapy (Cognitive Behavior Therapy for People with Schizophrenia by Morrison et al is one). The meta analysis you cite is on very old studies and the fact they didn’t do a number needed to treat analysis is troubling as the people who drop out of the studies are going to skew to the frustrated or the non-responsive in my opinion, despite their claims to the contrary.

      • One thing neither the conventional shrinks nor many MIA bloggers seem to do is consider the bio-physical environment as a potentiating factor in episodes of “mental” illnesses. Whenever I read about extreme states, the writers always seem preoccupied with social factors when bringing up hostile environments, neglecting physical elements that can contribute to psychological distress.

      • Frank,

        I think it’s good that Dr Murray acknowledges the Damage. I believe the “withdrawal syndromes” are what keep people trapped in Psychiatry.

        In The Maudsley Hospital/Kings College in 1980 and I didn’t see one person, that I would relate to as ‘psychotic’ – just youngish people describing (themselves in extreme terms) in need of Psychotherapy.

        My own doctor at the Maudsley invented ‘Auditory Hallucinations’ for me through a misinterpretation of normal social thought (going on inside my head).

        I think “Mental” Research at Universities like King’s College London UK (and NUIG, Galway, Ireland) should be viewed in combination with the “cooking” of Records (and Diagnosis) – for the sake of making money!

        (‘Galway’ between 1980 snd 1986 “doctored” my own Adverse Drug Reactions on my Records, to drugs they were promoting).

  3. The more fundamental question is about whether there is a relationship between “mental distress” and “enlarged ventricles” and the implications thereof. I understand the skull to contain the brain and ventricles (air pockets for cushioning against impact). To say that someone has “enlarged ventricles” seems like a funny way of saying that a person has “decreased brain volume.” Decreased brain volume seems like a logical result of depression. Depressing experiences cause depression- emotionally painful hopelessness; hopelessness causes a radical reduction of thinking and behavior. Physiologists contend that “use it or loose it” is the motto for every body tissue; long-term depression causes nervous tissue atrophy- a natural “decrease of brain volume.”

    “Enlarged ventricles” can be explained with elemental physiology; it is unfortunate that psychiatry’s neuroscience ignores basic physiology theory while trying to explain their erroneous medical narrative.

  4. Thanks to the author for sharing this article. I am particularly interested in this kind of mea culpa because I have enlarged ventricles I believe as a direct result of years of antipsychotic use. This is particularly upsetting to me because I have never had a provider suggest that I needed these meds for any kind of psychosis at all. Even my “manic” reaction to antidepressants has been couched in terms of hypomania – bouncy and excited but completly connected to reality. I have never been disconnected from reality, no random sexual hookups, no outrageous spending, no gambling, never thought I was invincible, I’ve never had so much energy I stayed up all night. My insomnia that was thought to be mental in nature turned out to be sleep apnea. I’m having a hard time calling this kind of prescribing anything other than malpractice. So it helps when I read doctors who are publicly admitting to being so very wrong for so long.

  5. Glad to see his honest self reflection. However, I know that his assertion that, “There is no doubt that antipsychotics are necessary in acute active psychosis.” is not true. I have known several family, friends and others who have fully recovered from psychosis without neuroleptics and with alternative support including dialogic connection. Unfortunately, we don’t give most people experiencing psychosis this option.

    • Yeah that is just BS from Robin Murray. You have to wonder if this guy is aware of the Open Dialogue’s 3 studies in which about 75% of the people never used antipsychotics even initially, and most recovered to become functional. And the WHO studies where many, many people in lower income places who couldn’t even access the drugs still were able to improve and become quite functional with prolonged communtiy/social support. What kind of echo chamber must Murray be in to not be aware of or to deny these things and cling to drugs being necessary for all.

      • I’m not gonna defend Robin Murray. But I did follow the link posted in a comment above, and read the ENTIRE original article this piece was taken from. I read just a bit more of his Bio. I don’t think it does us any good to blast him here, and risk losing a potential ally. He’s clear about being primarily a research shrink, and globe-trotting in Academia. I doubt he has any real, first-hand knowledge of the human carnage that the pseudoscience drug racket of “psychiatry” has done. So why don’t we ease up a bit on him, and see if we can further recruit him into the human side of things. Maybe MiA will be Murray’s first real, first-hand exposure to the VICTIMS.
        Let’s give him a chance. Maybe we can turn him to an ally. That’s all I’m saying. ~B./

        • Bradford, in case some have forgotten- here is just one example of US drug case settlement as a reminder of the impact or to further inform of “first-hand knowledge”: BILLION dollar settlement for Johnson & Johnson’s INVEGA drug.

          “Johnson & Johnson

          2001

          Fraudulent Pricing

          $3,750,000

          2013

          Off-label Marketing

          $2.2 Billion

          NP (2007-2012): $4,858,000,000 (Risperdal) + $424,000,000 (Invega) + $441,000,000 (Natrecor)

          J&J and its subsidiaries, Janssen Pharmaceuticals and Scios Inc., paid $2.2 billion to resolve criminal and civil liability arising from allegations relating to the prescription drugs Risperdal, Invega and Natrecor, including promotion for uses not approved as safe and effective by the Food and Drug Administration (FDA) and payment of kickbacks to physicians and to the nation’s largest long-term care pharmacy provider. In addition to monetary sanctions, this settlement placed J&J under a five-year CIA.”
          (still in effect)

          …linked here, are other offenders, in this credited article from Emory Law:

          http://law.emory.edu/ecgar/content/volume-3/issue-2/essays/failure-remedies-case-big-pharma.html

      • He’s likely also unaware of his profession’s history. Being a Brit, he might not know squat about the 19th Century Moral Treatment, which had about a 50% recovery rate of patients in their facilities, but was American. You do realize he’s been an inhabitant of Psychiatryland, a place where ordinary reality is forbidden, for a 40+ year career in psychiatry.

    • I absolutely agree with Truth in Psychiatry’s point here. In addition given that antipsychotics can increase sensitviity – using antipsychotics during brief acute stages may well be changing a ‘brief psychotic attack’ into a more severe psychosis for some people.

  6. It is significant to have a prominent psychiatrist admit psychiatry’s mistakes and call for more research on environmental factors and epigenetics. Perhaps it signals a shift in the field of psychiatry if others follow Murray’s lead.

    What possible “shift” would make an iota of positive difference other than psychiatry voluntarily dissolving itself as a purported field of medicine?

    I notice that while the author puts “schizophrenia” in quotes, Sir Robin does not.

  7. I am grateful that you can both see and admit to mistakes about how you understood schizophrenia, and the damage caused by antipsychotics.

    To me the next obvious obligation would be for you to try and ‘undo’ some of the damage caused by the misguided beliefs of your profession by speaking out against forced treatment, and by speaking for ‘informed consent. ….Will you? People in acute states can be kept safe without forcing them to take antipsychotics. No person should be forced to take drugs that have such terrible side effects and have not been proven to be more effective in the long run.

  8. I am glad that someone like Robin Murray is seeing the error of his ways yet I cannot help but also feel a sense of skepticism. Especially when people have dedicated their lives to the biological model and fought every inch of the way to deny the effects of childhood trauma as playing a significant role.

    As recent as 2012 Robin Murray was still denying the overwhelming evidence of the effects of childhood abuse playing a predominant role in becoming ‘schizophrenic’ later in life. However by 2012 John Read et al and many others had published so many articles on the correlations between childhood abuse and ‘schizophrenia’ that that could no longer be denied. So what does Robin Murray do? He blames the child.

    “Therefore, the possibility cannot be ruled out that a child destined to develop schizophrenia may show characteristics in childhood that increase the risk of abuse.” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372572/)

    This has I admit has always been particularly offensive to me when psychiatrists and psychiatry blame the victim for what others do to them. So pardon me if I remain skeptical for a while longer with regards to Robin Murray’s turn about.

    • “Therefore, the possibility cannot be ruled out that a child destined to develop schizophrenia may show characteristics in childhood that increase the risk of abuse.”

      I agree, this is disgusting “blame the victims” garbage, in reality the psychiatric industry should get out of the business of profiteering off of covering up child abuse, by way of turning child abuse victims into “schizophrenics” with the psychiatric drugs (for example via neuroleptic induced deficit syndrome and anticholinergic toxidrome).

      • Yeah, I just love that one. The child simply provoked the poor parents into abusing them! This is also a disingenuous “explanation” for why abuse is more common in homes with kids diagnosed with “ADHD” (by a significant margin, BTW – diagnosed like 4-5 times more frequently in foster kids). The kid was so obnoxious it increased the odds of the parent abusing it because it HAD “ADHD.” Makes me sick. I’ve also heard it said that soldiers who develop PTSD must have something “different” (AKA wrong) about their brains, because not everyone who fights in a war develops PTSD! Pretty outrageous stuff, but if you need to believe something, you’ll come up with a way to justify continuing to believe it.

  9. Everyone here, including the psychiatrists, psychologists, commenters etc., keep saying “Trauma, trauma, trauma”. What is this “trauma” we are talking about? Car accidents? Floods? I presume we are talking about harmful actions perpetrated by a human on another human.

    In that case, this turns into an issue of criminal justice. How do we do anything to provide these people justice?

    Psychiatric terminology is easily abusable and prevents the implementation of justice.

    For example, if a person A harasses person B to the point where person B starts behaving strangely and ends up being labelled with X disorder by one psychiatrist and Y disorder by another; then it becomes all the more easier for A to get away with what he has done to B by simply saying “B suffers from X and Y disorders”. You can look up court statements in whichever country you are from, which have the aforementioned themes.

    So, how do lawyers learn to defend B? How can we get B justice? How to prevent psychiatrists from making the lives of people like B even worse than they were to begin with?

    The usual themes here are drugs, labels etc. But we need more legal information and legal cases here too.

    • I think it’s important in addressing these things, at least in this venue, to shift from a focus on “blame” to a focus on understanding. There are places to address questions of guilt. But MIA, ideally, is about understanding. This does not preclude a redress of past harms, at all; it’s just that MIA is about getting there by way of inviting an “open dialogue.” To that end, for instance, it’s about seeing that there are traumas in life, and this can lead to experiences and behaviors that are sometimes called “psychotic.” This doesn’t mean it’s the only possible result of traumas, nor does it mean traumas are the only “cause” of “psychosis.” Just that there IS a connection, and it’s worth understanding it. And one kind of understanding, the one MIA is at its best when it’s about it, involves setting aside guilt and blame in favor of seeking understanding; the fact that traumas happen without anyone consciously intending them. They happen, sometimes, because it’s all people have known; they don’t know another way to live, so traumas continue. The problem with having arms is that they have elbows; anytime we do anything, even something good, we run the risk of hitting someone in ways we didn’t mean.

      So, in answer as well to Olga’s comment above, I think it’s important to focus our skepticism on facts here, not on people. Robin Murray is acknowledging mistakes. His comments are revealing of how, on a systemic level, these mistakes happen. People can believe, fervently, that they are right and find out they were wrong. MIA is about facilitating that process, ideally. I’m not sure that it helps to be “skeptical” of a person who comes to this dialogue, if that means questioning motive. I think our goal here is to watch each others’ backs. As in; what are you not seeing? What does the fact that you don’t have eyes on both sides of your head mean you can’t see? I think the ideal spirit of MIA is to seek to respectfully help, and that means everyone who shows up at the forum, even if unwittingly or unwillingly.

      Murray’s acknowledgment of mistakes is huge. I think the best response if we are to see more like it is appreciation, respect and encouragement. I say this with awareness of Olga as someone I respect (and love) most in the world, both for her experiences and what she has made with them. As it happens, we met four or five years ago on the same day I met Robin Murray at the World Hearing Voices conference in Cardiff. The fact that Dr Murray was presenting there meant that he was already in the road to writing this paper. The fact that he walked right into the Lion’s den was, in my opinion, commendable. I didn’t agree with much of what he presented; I thought there were things he wasn’t seeing. But the fact that he was there suggested he was looking in the right places, and I was hopeful. He got good feedback there and, from the evidence, has continued down that road.

      That’s why it’s important to be skeptical of ideas, but equally important to have faith in people. When we do the opposite; put our faith in ideas, and treat people with skepticism, we are heading down a road we may not find we like being on.

      • Kermit,
        It is important that Murray said what he did. And I like your comment.
        On the other hand, skepticism of his intent is warranted too. He only came out like this once he was near the end of his career and the reputational / financial risk was presumably less due to having already had his career and made his money. That takes far less guts than it would have to do it much earlier.
        In this way, it’s similar to Allen Frances, who made loads of cash by promoting pills for antipsychotic drug companies and profiting from DSM 4, and then turned around and became a critic once he had his wagons loaded down with bags of cash. You have to wonder how genuine it is. Although I think Frances is a worse, more clearly hypocritical case than Robin Murray. Robin Murray’s admission is also important because it will affect current mid- and early- career psychiatrists and associated workers.

        The person with the most guts would leave thei field during their career, or speak out from within the field at professional risk to themselves during their career. But I haven’t seen anyone do that yet, except for perhaps one or two professional MIA writers who left the field to practice differently or work elsewhere. These latter deserve more credit than Murray, IMO, who via his biological reductionism over 30 plus years did great harm in my judgment.

        • You may not be aware of the people who have taken professional risks, and indeed they are few, but the reality is that they exist, and you do not know them because the universe took them up on their offer to risk it all, and they lost everything.

          It’s well and good to say what others should do, but the reality is that asking others to risk their livelihood, their home, their children’s future, when the people who will benefit are unlikely (at best) to be there to put out the flames when their world gets set on fire is somewhat hypocritical. It’s all very aesthetic to cajole people into heroism. But lives really, actually, truly do get ruined. And not just the person; their families.

          So I’m just saying; when someone is able to take such a public stand and say “I made huge mistakes, for decades,” it’s just good strategy to be appreciative and encouraging, rather than piling on. If there is judgment to be rendered and justice to be served, I think it should happen elsewhere. MIA is about cultivating the dialogue, not suppressing it.

          That is what I mean when I suggest having “faith” in people. Faith is not about evidence; it’s about aspiration. If it were about evidence, it wouldn’t be faith, and it wouldn’t get us what faith gets; the future realization of our hopes, rather than the grudging acknowledgment of what we feel is due us.

          Also, I have known people who looked back on careers they regret, and tried to do the right thing, and were just blocked and hammered. They died bitter. Other than some nice sentiments from the choir, they had little to show. It’s up to us to make speaking truth as positive as possible.

          • Are you talking about “blind” faith?

            It’s admirable when someone realizes the error of their ways and seeks redemption. But most people here who are the victims of these “errors” have lost far more than a lucrative career. So while someone’s willingness to forgive may be commendable, it should not be considered their moral obligation.

          • Kermit, thank you I generally agree with these wise comments. Yes, it’s very hard to take risks that may cost your job / ability to pay mortgage etc, when the payoffs are vague if even perceptible.

          • “I have known people who looked back on careers they regret, and tried to do the right thing, and were just blocked and hammered. They died bitter.”

            Hammered, blocked, and dying bitter simply from trying to infuse the “mental health” field with a bit of integrity? Sounds more like a cult than a professional field, and with vulnerable clients, nonetheless. How dangerous–and seriously ironic–is this???

  10. Matt

    I agree with your point here. We must be able to acknowledge both aspects of this development with Murray’s self-criticism.

    Yes, it is a very significant event and laudable that Murray has made these admissions, but we must also understand the context for these developments and also examine what may be the motivations for a psychiatrist to make these statements.

    First off it reveals some of the positive advances the anti/critical psychiatry movement has made in its challenges to Biological Psychiatry. But it also reveals some of the current defensiveness and self preservation that is going on in their profession. Some psychiatrists, like Allen Frances and others, are aware that the entire scientific foundation of Psychiatry is beginning to be shaken to its core by current challenges.

    As a result of these developments many psychiatrist are consciously, or unconsciously, trying to find a way to justify and protect the future of their profession. Therefore, they see the need to criticize the more extremist positions and most vulnerable practices and positions of their profession in order to preserve their existence as a medical entity, and not lose ALL credibility.

    To build a successful movement to radically change the status quo (of an oppressive “mental health” system) we must be able to both support and praise psychiatrists willing to criticize their profession, but also TARGET the LEADERS of Biological Psychiatry who are desperately trying to defend and preserve their overall oppressive profession with partial, or half baked critiques, that deny the reactionary essence of Psychiatry’s social and political role in society.

    Richard

    • Just to pick here — I still don’t get where “biological” psychiatry starts and the “other” psychiatry stops. Though he and I have had some differences about what constitutes the “medical model,” Steve Spiegel in his recent blog expresses a similar skepticism about the whole “biological” term — i.e. that all psychiatry is “biological” to some degree. Politically the problem with the term is that it encourages people to think that psychiatry is ok per se, just not the “biological” kind.

      many psychiatrist are consciously, or unconsciously, trying to find a way to justify and protect the future of their profession. Therefore, they see the need to criticize the more extremist positions and most vulnerable practices and positions of their profession in order to preserve their existence as a medical entity, and not lose ALL credibility.

      Very important point. I think this is called damage control, i.e. “cutting your losses.”

    • Yes Richard.

      Another interesting factor is that the exponential rise of connectivity via the internet in the past 10-15 years has enabled critics of the existing system to spread their ideas more.

      Before 2000, almost all discussion about “schizophrenia” was dominated by academics writing in journals and books, with critics unable to spread their ideas as counters or alternatives widely or effectively. Critics are still fragmented but now they are more visible and can find each other more easily. Whereas before most of the connectivity and organizing belonged to those who held the traditional reins of power, i.e. ability to publish and speak in journals and university settings.

  11. I don’t think it is enough to acknowledge that mistakes have been made. Those mistakes have been responsible for much disability and death. If Sir Robin Murray were remorseful, and out to correct those mistakes that have been made, but that’s just it, there is little acknowledgement, witting or unwitting, of wrong doing. I think Sir Robin has a long way to go before the thing he acknowledges translates into real people with real lives. He claims that if he were to be going into the field today, he might want to be engrossed in those pretty little brain scans. I say we don’t know if we’re looking at brain activity or drug activity when we view brain scans. It is very positive that he gets it about “dopamine super-sensitivity” however, for the rest, I’m thinking were he starting afresh, he’d be making a fresh set of mistakes. I’m still waiting for patients to be seen as human beings rather than broken mechanisms. Death and debility, it would seem, to him, are still a matter of statistics, not people. I guess what I’m trying to say is that I don’t think for Robin Murray and similar others the severity of the problem has ever sunk in. If it had, his critique would be sharper and more forceful. As is, he made some mistakes, and perhaps he thinks they are correctable. I, on the other hand, only see a fresh set of mistakes in the making. He is changing, surely, but are those changes going to be enough to correct a legacy of bad science. I don’t think so. Not until a few others have realized the same mistakes have been made and are determined to correct them. I don’t think you do so by talking “trauma” one moment, and then imprisoning a person, and feeding that person a toxic substance the next. Psychiatry is still in a state of denial about the harm it has caused, and I don’t think his admission quite the slap in the face that his profession in fact needs.

    • His final statement, that schizophrenia will go the way of dropsy, is HUGE. I worked in SZ research in the early 2000s and, when I said this, was dismissed with gentle bemusement. I did change my career path to residential work, hoping to replicate Soteria and draw from Open Dialogue. I’ve seen some results of which I’m very proud. I’ve also been hurt and seen others hurt worse as a result of my choices; I believe that overall this was justified by what I think would have been greater harms of the other approach, but I have to live with the fact that nothing is 100% and the greatest harm comes when we think that something is. I know the greatest harm my decisions resulted in is probably directly correlated with how certain I was when I made the decision.

      I’m not sure it’s appropriate to hold scientists responsible for what people do with their results. (Excepting, of course, cases like Joseph Biederman and many others who deliberately created industries and benefitted from bad research. For them, I do propose a special circle of hell.) But I think there needs to be room for forgiving, if not appreciating, people who find out they were wrong, and admit it. Science, and maybe human life, has no future without this. None of us is right about everything we believe. If we had eyes on the back of our heads, we wouldn’t need to watch each others’ backs. I think that maybe that needs to be part of the plan.

      • confession and repentance are the prerequisites to forgiveness. any and all are required to confess (admit) and repent (stop) and then must seek forgiveness. that’s the way it goes. there is no other way. there are no shortcuts (and there certainly are not any bitter pills or happy pills or magic pills that substitute for responsibility).

        • I don’t really see “forgiveness” as an issue. I see stopping the damage as an issue. That psychiatrists are human beings, and thus prone to make mistakes, only follows.

          His final statement is not so huge when you consider how many others have made similar statements, and have had little come of them, and then it becomes…another prestigious psychiatrist leaves the field to other psychiatrists.

          “I’m not sure it’s appropriate to hold scientists responsible for what people do with their results.”

          Somebody said hindsight is 20/20. You’ve got “scientists” working for the pharmaceutical industry. I think we need to hold scientists responsible for their actions, that’s ethics, and in that regard, it helps to anticipate the results of those actions, that is, the negative as well as the positive.

          Conflict of interest is very real, and you’ve got scientists working on all sorts of projects, projects that don’t always make complete sense, and projects that aren’t always in the best interests of the general public. Those scientists, as the mental health profession shows, aren’t always the people most adept at critical thinking.

          Funding is always a big problem, funding and oversight, lack one and you have no science, lack the other, and you’re getting away with murder. Funding sources are often less than disinterested, and that underscores the need for some sort of oversight.

          • forgiveness matters more than you think. if you’re facing charges and conviction, as psychiatry is, you are less likely to surrender but forgiveness allows for surrender. forgiveness absolves guilt.

            in order to repent and confess one must feel true sorrow. acknowledgment (acknowledgment is the opposite of ignorance) is self-conviction which leads to sorrow (sorriness) which then leads to steps toward forgiveness.

            you just have to be met by the one who has the power to forgive.

          • Again, I’m more interested in ending harmful mistreatment than I am in absolving guilty parties of guilt, although doing so may have some significance for the religious. Accountability is important, and not something that can just be dismissed. If they won’t quit willingly, then we will have to find a way to make them quit, through prosecution if necessary. I’m not out to save people for any world other than this one.

          • forgiveness IS the way to end harmful mistreatment. they will stop when they acknowledge the catastrophic harm and damage they’ve done (guilt) but that very guilt leads to ignorance, arrogance and unrepentance which obstructs and prevents forgiveness. to absolve the guilt one must value and believe in forgiveness. then, there can be acknowledgment and confession and repentance all of which produce the desired effect; ending harmful mistreatment.

            repent means STOP. one is not encouraged to stop doing something through accusations, witch hunting, charging, convicting. all of those things evoke defense and in effect maintain the wrongdoing. one is encouraged to stop doing something when there is hope.

  12. Shook

    This is my response to your response way above. The burden of proof of whether a treatment WORKS should fall on the doctors who force treatment. (We shouldn’t have to ‘prove’ it doesn’t work in order to not be forced medicated. ) Doctors should not be able to force treatment on people if it MIGHT make the recovery worse. (That is what informed consent is about.) Where is your proof that the use of antipsychotic medications shortens the length of psychosis as compared to say sleep medication, and being in a safe supportive environment? (eg. Similar to the ‘Soteria approach’ rather than the ‘locking them in a room’ scenario which seemed to be what you thought to be the only alternative to prescribing antipsychotic medication) Some people report good responses to antipsychotic medication in the short term, while others seem to have worsening symptoms and terrible side effects even in the short term (within the first few months for sure and maybe much sooner too). For a person who does not respond well to a low dose of antipsychotic medication, their fate seems to be to be given increasing dosages. There are many people who are not recovered, many who are severely ill who are left on antipsychotics. I wonder how many ‘brief’ psychotic attacks have been changed into chronic illness due to bad reactions or poor tolerance to antipsychotic medication. I noticed you did not address my point that you find the severely affected in state hospitals as well as on the street.

    • I think people should have a no drug option. They have no such option at present. If a person gets committed to a state facility they are going to be drugged. As far as I’m concerned all research on the matter shows not only that people don’t recover from long term drugging, but that they are injured physically, and that this physical injuring often ends in death. Even if a person is imprisoned in psychiatric prison, and even if it is done by a court of law (i.e is forensic), I think the person should be protected BY LAW from iatrogenic injury. Psychiatric drugs cause iatrogenic injury, and I don’t think anybody should be forced to take harmful drugs against his or her will and wishes. I don’t think injuring people through chemical substances should be a punishment for any crime either. If a crime has been committed, let confinement be the punishment, not chemically induced injury.

  13. It is obvious that psychiatry is outdated, and more a religion thriving on myth, than on science. That comes from someone who’s real traumas were ignored and belittled as he was forcibly committed to state and veterans’ hospitals for the crime of “schizophrenia”. It was hell, absolute hell.
    While the advent of the diagnosis of PTSD has helped, there is just no excuse for the continued existence of psychiatry, other than for the lifting of Big Pharma at the expense, and deaths, of the traumatized and lost.
    Hugh Massengill, Eugene Oregon

  14. ok, I am glad that he has changed his mind and I agree that this is good as far as it goes. So is he going to be writing and speaking for this new position? Is he interested in re-educating his peers in medicine and psychiatry and related types of jobs? Will he go to the African Caribbean community and tell them they have been discriminated against rather than what they have been told again and again about their inherent brokenness and biological deficits and being subhuman? What is the moral action required when one sees his whole career and views as wrong and perpetuating discrimination and harm from physicians? Looking forward to see him blogging about his change of heart on MiA and UK sites. Can he write as many articles for his revised views as he did to promote his biological views?

  15. Studies, studies and studies. Studies this and studies that. P-values, effects sizes, confidence intervals etc. etc.

    I, personally, am far more interested in individual cases. How such diagnoses, drugs etc. have helped or harmed the lives of an individual, which is what such fields are about. Helping one individual at a time.

    Which is why, we cannot ignore legal cases and the effects of these systems on particular individuals.

    Let me give you some examples from my country of India. You should just look at the way some of these psych. doctors write.

    In the case of Pankaj Mahajan vs Dimple (30th Septermber 2011)

    Dr. Paramjit Singh of Medical College Amritsar writes: “This disease is Bipolar Affective Disorder. I treated her during this period. She was admitted in Emergency because her disease was in quite serious stage. In this disease, the patient can commit suicide. When she came, she was aggressive and irritable. If the proper treatment is not given to the respondent then her aggressive nature can be prolonged.”

    Bipolar Affective Disorder (primarily a psychiatric label) is mentioned as a disease, with no reasons given as to why she experienced the depression or mania (who knows? It could be trauma that caused depression and iatrogenic reaction as a result of SSRI antidepressants that caused mania) that results in the label of Bipolar Disorder.

    Without such an explanation, the circularity is striking:

    Patient: Why did I experience depression/mania?
    Doctor: Because you have Bipolar Disorder
    Patient: Why do I have bipolar disorder?
    Doctor: Because you experienced depression/mania.

    In other words, it’s like saying a headache caused her head to hurt.

    “Her disease was in a serious stage” makes it sound like she has cancer which has metastasised to different parts of her body. “Suicide is possible in this disease”, however no information is given as to what her reasons for wanting to commit suicide were except a psychiatric label. What her aggressive nature is and her reasons for being aggressive are not mentioned except a psychiatric label which is descriptive.

    Some of the tactics lawyers, doctors or the opposition use are the misuse of psychiatric labels.

    For example “The opposite party suffers from schizophrenia as a result of which she has paranoid thoughts” etc. So, here a label, instead of being used as a description, is instead misleadingly being used imply causation.

    This allows for particularly deceptive tactics. For example, taking a particular label, reading up the worst possible behaviours associated with that label and alleging the opposite party suffers from all those and that it is caused by the label. Since psychiatric labels can be somewhat vague and can refer to various things for which the person has been labelled, it is easy to play around with them and use them against someone to delegitimise what they say and to manipulate and distort facts and/or even lie outright.

    In such cases, having a bipolar diagnosis due to mania caused by SSRIs (like me), and having experienced spontaneous manias makes a difference.

    The patient has to hope and rely on the charity of his/her consulting psychiatrist or head of department to do the right thing. This makes one a beggar.

    And clearly, if you have gone to a number of these fools, you will have more junk and more labels in your files, which will only add to your misery.

    Yet another psychiatrist in the same case writes:

    Dr. Virendra Mohan (PW-3), M.D. Psychiatry writes:

    “She was diagnosed as a Chronic Paranoid Schizophrenic. There is no direct relationship in the stress or strain with the disease. Second time, she was admitted by her father Prem Kumar on 28.09.1999 and was discharged on 05.10.1999.”

    Yet another psychiatric label, this time, it’s schizophrenia. Is she bipolar or schizophrenic? This just confirms my suspicion that the more psychiatrists you go to, the more labels you get and the garbage written down about you in your files increases exponentially. Also, stress and strain has nothing to do with one’s mental state? Ridiculous.

    What would the average lawyer or judge understand of these things? Nothing. They will rely on the words of the “trained professionals” most of whom will not do something against their own interests.

    ***

    Individual cases need to be investigated. What these people do in clinical practice to particular individuals and how it affects those individuals needs to be brought to light.

    What the families of these individuals do needs to be brought to light.

    Yes, understanding and open dialogue is important. But that just ends up being debate, and the practices of people continue.

    I will go back to Szasz on this one:

    “A relationship of dependency is implicit in all situations where clients and experts interact. Because in the case of illness the client fears for his health and for his life, it is especially dramatic and troublesome in medicine. In general, the more dependent a person is on another, the greater will be his need to aggrandize his helper, and the more he aggrandizes his helper, the more dependent he will be on him. The result is that the weak person easily becomes doubly endangered: first, by his weakness and, second, by his dependence on a protector who may choose to harm him. These are the brutal but basic facts of human relationships of which we must never lose sight in considering the ethical problems of biology, medicine, and the healing professions. As helplessness engenders belief in the goodness of the helper, and as utter helplessness engenders belief in his unlimited goodness, those thrust into the roles of helpers whether as deities or doctors, as priests or politicians have been only too willing to assent to these characterizations of themselves.

    This imagery of total virtue and impartial goodness serves not only to mitigate the helplessness of the weak, but also to obscure the conflicts of loyalty to which the protector is subject. Hence, the perennial appeal of the selfless, disinterested helper professing to be the impartial servant of mankind’s needs and interests. “

  16. Reflecting back on my comments above regarding my skepticism towards Robin Murray and reading the many comments since then, I became interested in my own skepticism. Is it warranted? Is it just my personal experiences with psychiatry that create a filter across my eyes so that when a prominent professor says he “If I had the chance to have a second career, I would try harder not to follow of the fashion of the herd. The mistakes I have made, at least those into which I have insight, have usually resulted from adhering excessively to the prevailing orthodoxy.” I find myself skeptical? Is it because I want more hard evidence indicating Robin Murray really means it before my skepticism eases is that what I need? Or perhaps as someone who has been been in psychiatry and seen the horrors that exist in there my go to place is skepticism or even locking my heart to all who recant? Perhaps my anger which continues to burn and seethe inside prevents me from opening my door wide when ever somebody who has actively engaged in the system of harm that has damaged so many people I know and millions that I don’t know says I was wrong…

    I do remember that I too used to work in psychiatry as a nurse before becoming a patient of the self same system and it never ever occurred to me that such a huge worldwide industry could be based on pseudoscience oppression and lies. It was unthinkable then that what I was participating in was doing more harm than good and though I often thought there is something wrong here I could never put my finger on it because the lie was so massive that I failed to see it. To be fair to myself then, psychiatry was still able to completely shield its workers from the critic of the anti psychiatry movement so I would have had to actively seek it out. Sadly I never looked because it never occurred to me to look. I like to think that if then was today I would have acted differently but I don’t know.

    One thing is for sure I learned from an early age that words were decoration often sounding wonderful drawing you in filling you with hope and dreams but they only became real when the words were upheld by action. I still today get caught up in the power of words the beauty of an apology the dreaminess of futures planned through words but as yet unknown and find hope peaking through. So reflecting on my skepticism I can see that all is not lost though it can be seen as sounding negative even unwelcoming to someone venturing off the path of established psychiatry. Yet if you listen carefully there is a positiveness for I have not fully lost hope and shut the door completely. I still have hope, hope that words can lead to action that an apology sincerely meant can result in working actively to right the wrongs that have been and continue to be perpetrated within psychiatry. If Robin Murray really means what he says and actions follow he will have my support but he must earn it for words are just pretty decorations if all that follows is nothing.

  17. Olga

    I salute your skepticism and your willingness to bare your soul regarding your experiences both within, and with, this oppressive “mental health” system.

    This discussion reminds me of a lyric line from a John Gorka song when he sings “…where paranoia makes common sense….” Given the material circumstances we now face on this planet regarding the power of certain institutions, skepticism in the face of such enormous power is a very healthy way to view the world.

    Given the enormous power Psychiatry has gained in our society over the past 4 decades, we must reexamine all preconceived notions about what it will take to confront this beast. Especially, when we look at just how entrenched it has become within the fabric of societal forms of social control. I believe that those in power are becoming more and more aware of exactly what they have with an institution that can can so easily circumvent the Constitution and restrain and drug people at will.

    We must not forget that many of the people who are today most victimized by Psychiatry’s oppressive system are from the same social strata and groups of people who were the political rebels and creative agents of change in the 1960’s. In a newly “Trumped Up” world we should only expect this power to be exercised in even greater amounts, and perhaps even with unforeseen forms of control, in the not so distant future.

    I believe that the future of Psychiatry and the political and economic system from which it arose, (and now sustains it), are now inseparably linked. The rise and fall of this profit based capitalist/imperialist system and Psychiatry, now have the same destiny. It is up to us to put them both in the dustbin of history. Nothing short of that will lead us to a world free of such oppressive forms of power and control.

    For this reason we should expect there to be a group within the institution of Psychiatry to make apologies for the worst of their crimes. Some will have legitimate changes of heart, but others will be the kind of apologists who are trying to desperately preserve and protect this institution from a (hopefully) inevitable demise. We must do our best to sort out the genuine from the fake apologies as they develop in the future. But a HEALTHY SKEPTICISM will be one of our greatest assets in seeking future revolutionary change in the world.

    Olga, your words are filled hope and sanity in such an insane world. Carry on!

    Comradely, Richard

    Richard

    • Genuine or fake apologies? Who needs apologists? Psychiatry is quackery. There is no apologizing for that. You’ve got to get people doing something else. Remorse and acknowledgment of wrong doing are good when they lead to change of activities. When they don’t, they become meaningless. The problem is not just that psychiatry is quackery. The problem is that this quackery is responsible for a great deal of death and injury. We are not just dealing with a few relatively innocent fortune tellers. We are dealing with a whole industry full of scoundrels maiming and killing people by chemical means. This guy just got a quick glance of what’s in the mirror. Well, it’s a mirror that we need to be holding up to the entire misbegotten industry. You are supposed to be medical doctors! How can you do what you do? You are needlessly injuring and killing people. Don’t do what you do, and people will be healthier, lives will be spared. This is what the statistics tell us. The same statistics you are working with. Pay attention to them sometime.

      • Frank

        Apologies are not without meaning or importance in the struggle to end psychiatric oppression. Some members of the profession may actually stop practicing, or possibly devote their career work to helping psychiatric victims safely withdraw from their toxic drugs and cast away their labels. And most importantly some psychiatrists might actually start raising hell within all psychiatric organizations exposing the harm done and the faulty science propping up the entire institution.

        Any activity like I just mention could help to promote various splits and divisions within psychiatry. These kind of intense political divisions have historically always preceded the end of most oppressive institutions. Any and all splits within Psychiatry should be both welcomed and exploited by all anti-psychiatry activists. We should be encouraging and supportive to all those psychiatrists willing to apologize for harm done, AND for becoming active to end ALL psychiatric forms of oppression.

        However, the issue of “apologies” was not my main point in my above comment. You did not address my point about how at this time in our history Psychiatry has become such a vital part of how the current ruling classes can maintain their power and control of the masses.

        Psychiatry affords the status quo a vey effective and legal way to render potential rebels and creative agents of change ineffective through psychiatric labels, drugs, and incarceration in locked units. Also, the pharmaceutical industry has become a vital component of the entire U.S. economy, and psychiatric drugs are a major part of their profit portfolio. And for these reasons, MOST IMPORTANTLY, the future of Psychiatry is inseparably linked to the entire future of the capitalist/imperialist system – you cannot effectively fight or end one without targeting the other.

        Richard

        • “You did not address my point about how at this time in our history Psychiatry has become such a vital part of how the current ruling classes can maintain their power and control of the masses. “

          I assume this is addressed to me. I agree with you up to a point, and after that point we part company. I agree that psychiatry is a weapon the status quo uses for social control, and to neutralize, and disengage, potential threats to its authority.

          “MOST IMPORTANTLY, the future of Psychiatry is inseparably linked to the entire future of the capitalist/imperialist system – you cannot effectively fight or end one without targeting the other.”

          As I have said before, I don’t think it makes any sense to make abolishing psychiatry contingent upon social revolution. End psychiatry and you will still be waiting for social revolution. Have a successful social revolution, and you will still be waiting for the end of psychiatry. I feel I have to separate the two goals in the interests of achieving either one of them. I’m not waiting for a revolution to end psychiatry, and I know better than to think that the end of psychiatry will spell the end of capitalism.

          • “End psychiatry and you will still be waiting for social revolution. Have a successful social revolution, and you will still be waiting for the end of psychiatry.”

            i agree.

            take a look at the scope of services of this organization and see the wide array of human sufferings all bundled together under one proverbial roof,

            http://www.ctcounseling.org/ScopeofServices.html

            keeping in mind the vast array of sufferings, i’d like to see somebody dismantle and reorganize the house.

          • Richard’s main point, with which I agree, is that that strategically capitalism and psychiatry can’t be fought independently of one another. It’s like trying to defend oneself from an attacking beast by focusing on only one set of claws.

            This is not the same as saying that all efforts to fight psychiatry must include anti-capitalist rhetoric (though it’s hard to avoid). Substitute “corporate” for “capitalist” and most people will agree however.

          • My point is that they must be fought independently of each other. Join them and the likelihood of succeeding at either diminishes to the extent that they are joined. There are leftists who aren’t with us, there are rightists who are with us. Psychiatry and capitalism simply aren’t joined at the waist in Siamese twin fashion. I can’t pretend that anti-corporate or anti-capitalist rhetoric is going to bring down the house of psychiatry, although it may help bring down the house of corporate capitalist imperialism. Left liberal Mother Jones magazine, with the Obama administration, publishes a piece playing the violence card, and blaming it on “mental illness”. This is what we are up against. There is no way in hell that I’m going to say you can’t be finished with psychiatry without first having been done with capitalism. I would be done with both, but each in its own time. I don’t think it helps to connect them like Siamese twins unless you aren’t serious about your objectives in the first place. As far as I’m concerned, we can be finished with one without being finished with the other. Capitalism and psychiatry are simply not a beast with two heads and one heart that can be dispatched so easily, and to pretend that it is is to lose sight of both objectives, and, in essence, to beat yourself up. I’m interested in diminishing the power of psychiatry and capital, but I don’t think treating them as synonymous is going to get us one iota closer to our goal. They are not synonymous, and treating them as if they were, gets us further away from the objective of abolishing either. I’m sorry, but I don’t think, on this issue, that impracticality is my strong point.

          • They are not synonymous, and treating them as if they were, gets us further away from the objective of abolishing either.

            Psychiatry will be adapted to support whatever power structure is in place. In this day and age that means capitalism. Not only is psychiatry used as a tool of domestic repression/”law enforcement,” the billions generated by pharma guarantee a symbiotic relationship which would be difficult if not impossible to disentangle. So no, they are not synonymous, but one is the enforcement arm of the other.

          • Remember Senator Joe, remember the blacklist, remember all that has been done to destroy the unions, at least, the most radical of the unions. I can’t forget where we come from. The same holds for psychiatry, the drug companies, the mental illness industry, and all the forces, in whatever condition, aligned against it. My thought: if you’ve got two armies to fight, you don’t want them combining forces into a single army that would be even more difficult to vanquish. Psychiatry is all about mental health policing, but it really doesn’t have the rule of law on its side. Mental health law operates by way of making a loophole in the law. Close the loophole, and there is no mental health law. As I see it, two small armies are easier to defeat than one large one. I’d keep that in mind if I were you.

          • Another reason, if you look at matters historically, “the trade in lunacy” in Great Britain, which had a great deal to do with the rise of institutional psychiatry, was a matter mostly of families of wealth trying to keep errant family members from squandering their fortunes, to keep the money in the family, when it wasn’t a matter of the unscrupulous conspiring to steal the wealth of the confused and naive. Poor people didn’t matter so much, they could be handled by poor houses and debtors prisoners, not mad houses so much. There was a great fear during the 19th century of gentlemen and ladies, people of polish and distinction, being whisked off the street and lodged in the mad house. Of course, this was before the mental health system became the run away freight train that it is today.

          • Hi Frank

            It is not a question of whether the struggle against Psychiatry and capitalism are “contingent” upon each other. It is more a question that, at this historical juncture, the capitalist system “needs” Psychiatry to maintain its existence for several reasons – both economic and political.

            For that reason, in the final analysis we will have to end a profit based capitalist system BEFORE we can fully end Psychiatry. And the struggle against psychiatric abuse on a broad scale can be a very important human rights struggle that can help expose capitalism and rally forces against ALL forms of oppression under the capitalist system.

            I believe remnants of Psychiatry will still exist after a social Revolution against capitalism. So yes, the struggle against Psychiatry (and all its forms of backward thinking about “mental health”) would necessarily have to continue after such a Revolution. But NOW, the material basis would exist for the people to finally isolate and expose Psychiatry in such a way that it would ultimately wither away and go out of existence.

            As Oldhead said in a previous comment, this does NOT mean that you can’t wage struggle against psychiatric oppression without always raising anti-capitalist rhetoric. But it does make sense to try to constantly point out the connection between these two entities. And especially, educate people how vital Psychiatry is for the future preservation of a capitalist system.

            Richard

          • I don’t think your premise here holds, that is, 1, I don’t think “the capitalist system ‘needs’ psychiatry to maintain its existence”, nor do I think 2. “we will have to end a profit based capitalist system BEFORE we can fully end Psychiatry.” Psychiatry serves capitalist interests, surely, but it is based upon fraud. I don’t think you have to get rid of capitalism before you can expose and dispense with fraudulent practices. The psychiatric hoax has been used to advance both socialist and capitalist agendas. It is the authoritarian nature of these systems, not their economic differences, that supports this hoax. I’m for equality, but I’m for liberty, too. Freedom from social control masquerading as medicine.

          • Frank

            I believe we should view our movement against psychiatric abuse (including the anti-psychiatry wing) as in the same type of position as the environmental movement. Both are life and death movements of great significance and consequence, but we cannot fully protect this planet from destruction under a profit first (by any means necessary) capitalist system.

            To think we can fully protect this planet without a Revolution is a delusion promoted by all those who believe that capitalism can be reformed to become a humane system. The same could be said about our efforts at ending psychiatric abuse

            In the capitalist “marketplace of ideas” anti-psychiatry is just one of a million political perspectives relegated to the back pages or to some 30 second sound bite on the television news. If this movement becomes too powerful it will be more viciously attacked by the very powerful institutions of Psychiatry and Big Pharma. They are clearly now viewed by the ruling classes as TOO BIG and IMPORTANT TO BE ALLOWED TO FAIL.

            I am not promoting a defeatist type approach here; I am just trying to be realistic as to what we are up against. All the “fraud” and human damage done that you point out that comes from the Psychiatric/Pharmaceutical/Industrial/Complex, this is exactly the fodder we have to work with. All this exposes the criminal nature of these institutions and presents the masses with enough reasons to lose faith in this capitalist system and the class of people that run and benefit from its existence.

            And yes, if and when a new socialist system comes into being there will need to be an important summation of past mistakes so all forms of totalitarian control can be once and for all eliminated. That includes all forms that have derived from “mental health” systems.

            Richard

          • I agree that we need to put people over profit (the opposite of what capitalism is all about), and that the anti-psychiatry movement in this sense is related to the environmental movement for that very reason. I’m not linking it to the fight against capitalism because I think in practical terms doing so is not going to get the best results, if it gets any results. It’s like this for me, psychiatry (medical fraud) is one problem you can work on a solution to, but if you link it to the problem of capitalism (political economy), you’ve got two problems instead of one, and you are even further from your goal than if you tackled the matter one problem at a time. Two problems demand two solutions. The bigger you make the problem the further away you get from a solution. Simplify, simplify, simplify. Henry David Thoreau said that. Sure, doctor complicity in drug company profiteering is behind hundreds of thousands of iatrogenic deaths every year, but this goes way beyond the field of psychiatry alone, and it does, perhaps, implicate capitalism. The thing is, when you get such in psychiatry, the very field itself is on trial because the entire industry is based upon an erroneous presumption of illness. We can do something about medicalization today. We can’t wait for socialism to do something about medicalization because there are no guarantees.

          • I don’t think it does much good contemplating which will go first. If psychiatry is eliminated as a support beam for capitalism before the system as a whole falls, that’s good. If the entire system crumbles all at once psychiatry will no longer be given state support and will crumble in its wake. I do believe that the system will collapse under its own weight, but we need to make sure it doesn’t fall on us.

            I believe that at this point capitalism does need psychiatry, desperately. They can’t keep the people down all by themselves, there are too many of us; they rely for control on the restraints we put on our own dreams and ambitions, and our conception of what is possible. The function of psychiatry is to enforce these “internal” restraints.

            These of course are analytical discussions which need not stand in the way of practical organizing, which needs to be done in a way which is accessible to all victims of psychiatry, not just those with a refined analysis. But we do still need a collective analysis that will point us in the correct direction and allow us to understand and confront the problems we face for what they are.

            I also think this thread has run its course, unless someone starts a new one.

    • Olga,

      I was quite sure at the start that the “medication” approach was nonsense and I told them. I had come to the Maudsley hospital expecting to talk to understanding Professionals with a view towards personal improvement.

      In the final analysis after years of psychiatric disability I was able to access suitable help and recover. So the Experts at King’s College/The Maudsley are “more harm than good”.

      I think in his acknowledgement that Dr Robin Murray is more or less acknowledging the complete failure of Psychiatry (but without specifically saying so). Kings College/The Institute of Psychiatry as far as I know is a type of ‘Pharmaceutical/Medical’ profit making enterprise.

  18. The core issue is not, as Dr. Robin Murray stated, allegiance to “the Kraepelinian model”.
    Far more core issues include (a) the massive desire of the medical profession for “schizophrenia” to be seen as – and found to be – primarily biological;
    (b) an alarming degree within medical researchers of bias against and ignorance of the complexities of human emotionality and psychology that play such a major part in creating and maintaining the experiences and behaviours that become collectively referred to as “schizophrenia”.
    With this level of bias and ignorance, these people – i.e. “typical”medical researchers – who have little or no training in understanding human beings – are not fit to be the lead directors of the profoundly important work of providing meaningful understandings of these experiences and their causes, understandings that are so urgently needed by so many, and by society as a whole.
    Governments urgently need to re-examine the un-evidence based assumption that, in relation to emotional and mental health, doctors know best. Most doctors are, in reality, quite clueless of the emotional and psychological subtleties of the experiences and behaviours that become collectively called “schizophrenia”. Yet governments given them power and dominance in global mental health.
    Little wonder that global mental health is in such a state of chaos – the blind, biased and largely ignorant leading the distressed.

    • Terry, Great response and critique of Murray’s “bonafides” thank you.

      This is the exact same arguments I make against people like Murray within the ISPS group. I argue that their work should not be respected or taken seriously since for the most part they do not know or work with real people, in the sense of getting to know them intimately and helping them recover. What they do is much easier – sit in the halls of academia making up poorly-evidenced biological and genetic theories about “schizophrenia”.

      • Hi Matt,
        I agree. The public have such a misguided view of the medical position in mental health, mistakingly assuming that, because they are doctors, they are THE primary source of knowledge, understanding and “science”.
        What a catastrophic error of judgement that has been, and what a price has been paid, by so many.

        • Dr Terry,

          I think everyone knows that misuse of a substance is likely to cause a more serious problem in the long run.
          The idea that continual tranquilliser use doesn’t cause anxiety and brain damage (supersensitivity) has got to be Medically Dishonest or Delusional.

  19. Matt,

    Last Thursday at the “Beyond Diagnosis” Event (in London UK) hosted by NHVN, I got talking to someone who had been disabled for years by “voices” – but had recovered completely with the help of HVN Peer Support.

    This individual was not a shell of a person – but very interesting and humane.
    The Answers are there and they don’t necessarily cost much!

  20. First, I would like to thank those who have read my article, and for the kind words from some (though not all!). I will try to respond to a few of the points made.

    Several commentators assume that I am defender of the status quo of psychiatric treatment. Not so, I was the Chairman of the UK Schizophrenia Commission which listened to views of patients and carers the length of the UK, and produced a Report that was extremely critical of standards of care; our 42 recommendations for change can read at .To give one simple example, we pointed out that one of the reasons why compulsory treatment was rising was because the conditions in many in-patients units had declined to a point that few would voluntarily agree to be admitted to such places.

    Sadly, what knowledge I have of the standards of mental health care for the poor in the USA suggests that it is worse than in most European countries, and that more ill people languish in prisons or on the streets. It is perhaps worth again making the point that the idea that there exists a deteriorating disorder termed schizophrenia is much more prevalent in the USA than in Europe where models emphysizing the role of social and psychological factors are much more prevalent. Perhaps this is a consequence of a health care system based on the profit motive since social and psychological therapies are necessarily costly.

    Matt wonders whether I have been involved in clinical care or have I sat in a university classroom “studying” people from afar. For 40 years I have worked in one of the most deprived areas of south London where poverty, unemployment, social disintegration and crime are rife. One cannot work in such an environment without being aware of the corrosive effects this has on people, ill or well.

    The trouble for a psychiatrist is that no matter how concerned one is about the living conditions of one’s patients, it is difficult to persuade politicians to care about them. Ellen raises the question of the African-Caribbean community and whether they have been discriminated against. I have no doubt that they have been. Indeed, much of our work has emphasised the role which discrimination has played in the high rates of breakdown among migrants and ethnic minority populations in the UK.

    BC Harris asks if I am aware of 19th century Moral Treatment. Of course I am since the origins of moral therapy were in France and the English Quakers played a major role in its development with the famous Retreat in York.

    Yes, I do know of the Open Dialogue approach. I look forward to this model being tested in the same scientific way that any novel treatment approach should be. Currently we are waiting tor the results of a randomized trial of another innovative treatment – avatar therapy

    Others question if I am aware of the views of patients. Fortunately, the Institute of Psychiatry where I work has for the last 15 years had a thriving “service users” department “SURE” which has carried out much important research . So I am lucky to have ready access to new insights from user groups including the Hearing Voices movement.

    In my view, societies can be judged by the extent to which they care for their less fortunate members. I sympathise with those who have been hurt by bad psychiatry, and look forward to better and more holistic care. We, psychiatrists and anti-psychiatrists alike, have much to learn about how to improve care, and we should not to be ashamed to change our minds when new information comes to light: that is the way progress is made.

    • Professor Murray,
      Thank you for your many contributions to our field and for your respectful engagement here. It is enormously helpful to have you share your reflections on your career. None of us are immune from having blind spots. As you know, the history of science and medicine is filled with instances where one area of certain “fact” gave way to a new paradigm.
      While the limits of human cognition may make it impossible to avoid these errors, we can decide how we respond to them. Some may hunker down and maintain their world view, while others have the courage and humility to admit to mistakes. You are clearly in this latter category.
      While I have no idea what influenced you to reconsider the data, I continue to believe that our shared profession is indebted to Robert Whitaker. Your paper can read as a synopsis of the chapter he wrote in 2010 in Anatomy of an Epidemic on the antipsychotic drugs. Sometimes, it takes an outsider to see what others have missed. Rather than be discredited, as he has been in some quarters of our profession, he also deserves our admiration and respect.

    • Thank you for your informative and respectful response here; in spite of having some critical reactions to your post.

      I have not heard of ‘avatar therapy’ and wonder if more about that will be posted on MIA.

      I really like your final comment about the importance of being able to change our minds in the face of new information, and I echo Sandra Steingard’s point that Whitaker should have been treated with great respect for being able to discover and bring such important new information to light; rather than be vilified, as he has, by so many psychiatrists.

      • as far as i remember from a talk by leiff which i attended, it’s basically talking back to a computer generated avatar of the voice you hear (that you can model to look like you want it to). the avatar is controlled by the therapist and you can make it sound the way the voice sounds, and the goal is to gain control over on befriend the voice or resolve the conflict underlying the meaning of the voice. it’s described here in more detail https://www.ncbi.nlm.nih.gov/books/NBK373172/ and in some other papers.

    • Robin

      As a person who is anti-psychiatry, I appreciate your willingness to respond to this intense discussion. I also appreciate your empathy for those harmed by psychiatry and your willingness to admit past mistakes.

      Given the current levels of harm perpetrated by the institution of Psychiatry throughout the world, I believe history demands even greater efforts at speaking out about those serious problems, and the willingness to take risks at disrupting “business as usual” within the psychiatric field.

      Robin, given your unique position and reputation within the psychiatric field, I believe your words and actions could have a very positive effect at bringing about change, if you are willing to take the necessary risks in doing so. I hope to read more in the future about your efforts at taking these type of ethical and moral stances against all forms of psychiatric abuse.

      Respectfully, Richard

  21. Some of the content of my prior posts may have been a bit harsh. But, I will respect Dr. Murray’s action of coming into the battle-zone and sharing his views in a decent manner. Please excuse the way some of us write sometimes, because we have our reasons for doing so.

    Hopefully, some good comes out of everything we say and do.

  22. Beyond Schizophrenia Diagnosis:-

    I attended a Beyond Diagnosis Event last Thursday 26 January 2017, promoted by The Hearing Voices Network and sponsored by the British Psychological Society at Amnesty International HQ London, UK.

    At the Event I got talking to a very interesting and enthusiastic person who had been disabled by “Voices” for years but had made complete Recovery through attending HVN meetings.

    The Answers are there and – they don’t necessarily Cost much.

  23. Human hormones are main reason for Schizophrenia and same is with any so called *Mental* Illness
    or disorders.Of course Psychologists and Psychiatrists,will never agree with me!Natural hallucinogenic
    substance(s) exists in brains of each schizophrenic.And this isn’t dopamine,because dopamine isn’t in
    group of hallucinogenic substances.

  24. Can we call these as illnesses ? An insight into the truth!!

    The truth is no one can read your mind or understand your thoughts. However, due to the events that is taking place or due to your own experiences your logical thinking mind will convince you surely that others must know your thoughts. A person who experience this will carry out their own thought experiments too to find out if others could really know his/her thoughts. Meaning at certain times if you are a person who experience this, you yourself would think of particular topics/things and see whether others would respond you and when this happens it will further convince you that others can read your mind or understand your thoughts.

    Only way to get rid of this way of thinking is to talk openly/directly with the people who you think that can read your mind. Asking this would be pretty odd to you but again trust me asking this and understanding that others are not actually aware of your thoughts but they simply respond to your thoughts without they even knowing will save your life. Things that they reply to your thoughts are coming to them out of the blue without they even knowing, they get thoughts (this is similar to thought insertion that schizophrenics are talking about) and they simply talk about it. However, these things always will have a meaning to your current thoughts or your actions, which is why your logical mind thinks that they somehow know your thoughts or understand your thoughts. They will sometimes, smile at you, laugh at you, give gestures etc… to convince you that they really know or aware of your thinking or thoughts. However, in reality they know nothing. These responses or the words coming out of their minds would align with your thinking, that’s why your logical mind always make you to believe that they know your thoughts. Even if you ask directly from them “if they know your thoughts” still you will face things/actions to convince you or they would respond in a way to convince you that they know your thoughts but they don’t acknowledge it or you might think they know your thoughts but they don’t like to direclty tell you so. The only way to get out of this way of thinking would be to talk to them and understand that they don’t actually know your thoughts, their actions, words are simply aligned with your thoughts/actions giving you an impression that they know your thoughts. However, this impression is so strong to create a belief in your mind, that you cannot get rid of.

    You will meet people who respond to you thoughts everywhere. Sometimes, this can be your neighbours, when you are in a coffee shop, in a library, people in television programs, radio stations, while you are shopping, in the streets etc… you name it. You will meet people who respond to your thoughts everywhere. So the bottom line is again they know nothing about your thoughts, these responses which aligns with your thoughts are coming to them out of the blue, which convincing you.

    This is not a coincident not everyone facing these experiences. Any person who face this experience will start having the thought broadcast delusion. It’s a highly advanced computer program built with artificial intelligence giving these experiences to us. You are a victim. Schizophrenia shouldn’t exist in this world. This is why you will not find thought broadcasting delusion prior to 17th century. James Tilly Mathews is the first person to complaint this technology at the end of 17th century but sadly no one thought that such a thing was secretly developed by the people who control in those periods.

    A person who do a proper research into the history would find out below strange events:

    Thought broadcast delusion was a recent delusion we cannot see any evidence of this delusion prior to 17th century. Delusions such as glass delusion are well recorded delusions. Therefore, if thought broadcast delusion existed during this period, these delusions would have been recorded too. However, that’s not the cast.

    http://www.bbc.com/news/magazine-32625632

    1797 WAS THE FIRST FAMOUS CASE OF SCHIZOPHRENIC:

    “James Tilly Matthews in 1797 and the name of the machine was called as the “Influencing machine”. His case claimed to be the earliest clear description of schizophrenia in British psychiatric writing.”

    From the beginning of the 18th century you will further see new mental illnesses coming to the surface one by one out of the blue. These are all due to this technology.

    We also don’t find any evidence of people hearing voices 24/7 (or throughout the day) prior to 17th century. Some people might argue saying that people heard voices and they would take examples like Joan of Arc. Joan of Arc never heard voices 24/7 or throughout the day. If any researcher do a proper analysis during the period of 8th to 16th centuries, you will not find any evidence of people in general public hearing voices 24/7.

    https://www.youtube.com/watch?v=rmkdEKazZnI

    This is the reason why some people in the history said the following

    https://www.academia.edu/18656936/Balzac_s_Louis_Lambert_schizophrenia_before_Bleuler

    “Hare [20] defend precisely this hypothesis, arguing that the scarcity of reports previous to 1800 indeed leeds to the conclusion that schizophrenia is a recent disease, and therefore, that it must have been triggered by a specific event around 1800..”

    On top of this, when it comes to delusions in schizophrenics, thought broadcasting and thought insertion are the primary symptoms and this is what they say.

    “Thought broadcasting is a part of Schneider’s first rank symptoms of schizophrenia. The presence of any of the symptoms is indicative of the illness. It should not be taken lightly as it may cripple a person’s ability to communicate with others and impair his or hers everyday life”

    Which means, since primary symptoms of schizophrenia, such as thought broadcast delusions and hearing voices was not there prior to the 17th century, schizophrenia itself must be a recent mental illness.

    If a person understand that thought broadcast delusion is not a mental illness, they should start questioning about voice hearing too! Cause there are so many that people start hearing voices after they going through this abnormal events, which is not a mental illness.

    Further, these voices itself has abnormal powers,

    http://www.hearing-voices.org/voices-visions/comment-page-2/

    “My voice gathers information from around the globe and gives me heads up months in advance for important events. Sometimes, it can be wrong in its deductions, but most of the time, my voice is right in its look-ahead exercises. I think my voice is telepathic across the collective voice. Family members, my husband, does not hear voices, he says, but they gave him schizo pills, cause he has a bit of paranoia. He saw the Japanese tsunami of 2011 in his dream, 5 months in advance. He reassured me that we were not in it. Thank God, it was true. I usually see the earthquakes and volcano eruptions.”

    http://hvn.forumatic.com/viewtopic.php?f=2&t=1203

    “I am now happy to say that I still do hear voices, yes… and we get along great (and will forever continue to do so). My voices really helped me to become a better, stronger person, and sometimes they still do the devil voice when they are in a joking mood. Actually, they can do any voice they want (man, woman, child, God, devil, British guy, Arnold Schwarzenegger, a Mexican, someone I know, etc.). It’s a skill they have that I’ve learned to appreciate, and I find incredibly entertaining.”

    http://www.intervoiceonline.org/about-voices

    “Hence the quite significant interplay on physical things especially the erotic…. but also sight (they see what you see), smell…. and for example, they don’t like me eating or having sex.

    they lie like hell… and try to give the impression they can put thoughts in your mind…. wich is all about power. having said that i have had several clear instances where they know things i don’t know…

    i’ve been woken up, and told to listen to the news… and it will be something related to what we were talking about the day before… they have also known things about to happen in the IMMEDIATE future…

    they have told me of a phone call from so and so…

    they can also sense when i am about to get an SMS on my phone…. they try and claim responsibility for making the person send it…

    They have also made a big show of moving my cursor on the screen on my laptop, while I had a witness! weird stuff cetainly,

    http://www.intervoiceonline.org/about-voices

    The voices are in multiple languages and have nearly always been positive. I am learning to cope with them and learning appropriate social skills to deal with them in social settings which is not very simple.”

    If these voices are coming from our own brain, how come voices are able to speak in languages that a voice hearer has never learnt?

    I hope this will open up your eyes and understand the truth behind these voices and mental illnesses.