This article also appears on CounterPunch.
In any society that prioritizes economic efficiency, productivity and order above life and all of life’s varieties, people experiencing altered and extreme emotional states will be seen as defective and as burdens—monkey wrenches that disturb the societal assembly line.
To be clear, contemporary American society is not Nazi-German society when it comes to treating people labeled with “serious mental illness,” as it is taboo in American society to directly murder this population as was done in Nazi Germany. But in the United States in the earlier part of the twentieth century, there was widespread compulsory sterilization of those diagnosed with serious mental illness; and from the 1970s through the early 1990s, dehumanizing experiments that ignored the Nuremberg Code of research ethics were administered on this population by prominent American psychiatrists. And today in contemporary American society, apparently it is acceptable for this population to die, on average, 25 years prematurely without challenging the authorities in charge of treating them. More later on psychiatry’s blame for this premature death rate.
When a society becomes so fanatical about machine-like efficiency, productivity and order that ethical injunctions against murder are thrown out the window, Nazi Germany—and societies that admire it—emerge. In 1934, ten years after Virginia passed its 1924 sterilization act, Joseph Dejarnette, superintendent of Virginia’s Western State Hospital, noted Nazi Germany’s increasing rates of sterilizations and lamented in the Richmond Times-Dispatch: “The Germans are beating us at our own game.” And that year, Leon Whitney, executive secretary of the American Eugenics Society, said of Nazism, “While we were pussy-footing around . . . the Germans were calling a spade a spade.”
Adolf Hitler closely followed the American eugenics movement and admired its sterilization policies. This competitively propelled him, in his efforts to rid Germany of “defectives,” to move beyond sterilization to murder. In Nazi Germany’s T4 Program, involving virtually all of German psychiatry, Hitler created a mandate to kill anyone deemed to have a “life unworthy of living,” which included people diagnosed with serious mental illness. Lack of economic productivity was the major criterion for inclusion in T4, and the Nazis referred to the program’s victims as having “burdensome lives.”
When human beings are viewed as defective and as burdens, they come to be seen as less than human, and so we really shouldn’t be surprised by American psychiatry’s recent ignoring of the Nuremberg Code of research ethics established after the horrific human experiments by doctors in Nazi Germany, a code which states that medical experiments on human subjects “should be so conducted as to avoid all unnecessary physical and mental suffering and injury.”
Specifically, from the 1970s through the early 1990s, leading figures in American psychiatry at close to a dozen leading medical schools explored the biology of “schizophrenia” by conducting experiments on more than 2,000 patients in which certain drugs were administered and others withheld in the expectation of worsening symptoms. Patients diagnosed with schizophrenia were given psychostimulant drugs with the expectation that these drugs would be “psychotogenic” (induce symptoms of psychosis), and this deterioration in fact occurred. In 1987, Jeffrey Lieberman, who later became the American Psychiatric Association president from 2013-2014, conducted a study in which patients previously diagnosed with schizophrenia but who had stabilized were given methylphenidate (Ritalin) until psychotic symptoms reappeared. In another 1990 study co-authored by Lieberman, the introduction states, “In order to examine the relationship of psychotogenic response to psychostimulants and acute treatment response in treatment-naïve, first-episode psychotic patients, we administered intravenous methylphenidate to first-episode patients.”
Some Americans today are embarrassed by early twentieth century enthusiasm in the United States about sterilizing people diagnosed with serious mental illness. Most Americans are ignorant of the late twentieth century psychotogenic experiments. And few Americans challenge current psychiatry authority that continues to be in charge of treating people diagnosed with serious mental illness despite that authority having a record of abuse and failure.
Psychiatry’s Blame for Current Premature Death Rate
“On long-term prospective evaluation, risk for death in schizophrenia was doubled on a background of enduring engagement in psychiatric care” was the conclusion of a 2003 Psychiatry Research study done in Ireland, where psychiatric treatment is quite similar to that of U.S. psychiatry.
In 2011, the director of the National Institute of Mental Health (NIMH) reported that still another major study found, on average, Americans diagnosed with major mental illness die 14 to 32 years earlier than the general population. While establishment psychiatry publicly laments this, it is in no small way responsible for this premature death rate.
The NIMH director noted antipsychotic medications’ association with obesity is part of the explanation for premature deaths. And according to the American Family Physician, antipsychotic drugs’ “life-shortening adverse effects” include diabetes, postural hypotension (especially deadly for patients with fall risk), cardiac arrhythmia, and sudden cardiac death.
The NIMH director also lists cigarette smoking as a major cause of premature death, noting, “People with a mental illness are more than twice as likely to smoke cigarettes,” however, antipsychotic drugs actually increase the desire for nicotine. A 2009 study “Smoking and Schizophrenia” reports that, “Smoking may be an attempt by schizophrenic patients to alleviate cognitive deficits and to reduce extrapyramidal side-effects induced by antipsychotic medication.”
Antipsychotic drugs are the primary—and routinely the only—treatment by establishment psychiatry for people diagnosed with schizophrenia, and this monolithic approach has proved to be generally ineffective, often resulting in financial poverty. And poverty, caused by any means, is well-established as being associated with premature death. Investigative reporter Robert Whitaker in “The Case Against Antipsychotics: A Review of Their Long-Term Effects” offers extensive research to back up his conclusion that: “Antipsychotics, on the whole, worsen long-term outcomes.” While for some individuals, Whitaker notes, these drugs may provide a short-term benefit, there is a long line of research showing that antipsychotic drugs, “Impair functioning over the long-term.” Impairing functioning over the long-term is obviously going to result in increased poverty—and increased premature death.
Though establishment psychiatry rails against the “stigma of mental illness”—stigmatization being another source of premature death—it is responsible for exacerbating this stigma through its disproven “brain disease” explanations. Psychiatry’s promulgated “biochemical brain imbalance theory of mental illness” has long been scientifically disproven (this recently admitted even by some in establishment psychiatry) but continues to remain a societal belief. For the general public, the acceptance of brain disease explanations as the cause of serious mental illness is associated with a desire for a greater social distance from the mentally ill, reported a 2010 study in Psychiatry Research (and re-confirmed in a 2014 Psychiatry Research report). Social Science and Medicine in 2013 similarly reported that people who believe in biogenetic/brain disease explanations for mental disorders perceive these people as more dangerous and desire more distance from them. This stigmatization, which establishment psychiatry has exacerbated, results in not only unemployment, poverty, and social isolation but also “diagnostic overshadowing,” a stigmatization in medical care in which the physical symptoms of people diagnosed with serious mental illness are falsely attributed to mental illness, resulting in not receiving treatment for very real medical conditions—another cause of premature death.
Anti-stigma campaigns emphasizing biological explanations and brain disease, reported the Canadian Health Services Research Foundation (CHSRF) in 2012, “have not been effective, and have often made the problem worse.” The CHSRF concludes, “Biological explanations can also instill an ‘us vs. them’ attitude, defining individuals with mental illness as fundamentally different.” Alternately, the CHSRF concludes, “Presenting mental illness in the context of . . . psychological and social stressors normalizes symptoms, creating a healthier public perception of mental illness.”
Even more helpful in reducing the stigma of “serious mental illness” is eliminating this term “serious mental illness,” and instead using terms such as “altered state” or “extreme emotional state.” While these states can be frightening for society, family, and those experiencing them, depathologizing these states is one of the best ways to eliminate stigma.
The key to a community truly assisting people experiencing altered and extreme emotional states is for that community to believe that these states have meaning and value for the community. Once a society diseases and pathologizes these states as mere “illness” and “defect” without meaning or value, those people experiencing these states are seen as burdens on society.
In many indigenous and tribal societies, people experiencing altered and extreme emotional states do not create havoc but are seen in a positive light. This can be seen in Psychosis or Spiritual Awakening, by filmmaker Phil Borges, who has been documenting indigenous and tribal cultures for over 25 years. Similarly, the late ethnobotanist, Terence McKenna, who also studied indigenous and tribal societies, also concluded that our society does great harm by devaluing the gifts of this population who are instead told: “You are not of equal worth to the rest of us. You are sick. You have to go to the hospital. You have to be locked up.” Their “treatment,” McKenna notes, renders them “on a par with prisoners and lost dogs in our society,” and McKenna concludes: “So that treatment of schizophrenia makes it incurable.”
When people get treated as unwelcome burdens, they can become angry and agitated or, depending on their temperament, become passively dysfunctional.
In American society—just as in any other society that prioritizes economic efficiency, productivity and order over life and all of life’s varieties—people experiencing altered and extreme emotional states are seen as defective and as burdens. In the American economic system—just as in any other system that obliterates genuine community and creates extremely stressed families already struggling to find enough hours in the day to survive—people experiencing altered and extreme emotional states create havoc for families. And so, families are susceptible to resenting those in altered and extreme emotional states who need a great deal of attention, support and time; and families are vulnerable to acquiescing to any societally sanctioned authority who has taken charge of this population. And given the priorities of American society, an authority with a lengthy record of abuse and dismal failure is a good enough authority.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.