Robert Whitaker Refutes Jeffrey Lieberman; But Is Psychiatry Reformable?


On May 5, 2017, Donald Goff, MD and seven other psychiatrists, including the very eminent Jeffery Lieberman, MD, published an article in the American Journal of Psychiatry. The title is: “The Long-Term Effects of Antipsychotic Medication on Clinical Course in Schizophrenia.”  Here’s the abstract:

“Concerns have been raised that treatment with antipsychotic medication might adversely affect long-term outcomes for people with schizophrenia. The evidence cited for these concerns includes the association of antipsychotic treatment with brain volume reduction and with dopamine receptor sensitization, which might make patients vulnerable to relapse and illness progression. An international group of experts was convened to examine findings from clinical and basic research relevant to these concerns. Little evidence was found to support a negative long-term effect of initial or maintenance antipsychotic treatment on outcomes, compared with withholding treatment. Randomized controlled trials strongly support the efficacy of antipsychotics for the acute treatment of psychosis and prevention of relapse; correlational evidence suggests that early intervention and reduced duration of untreated psychosis might improve longer-term outcomes. Strategies for treatment discontinuation or alternative nonpharmacologic treatment approaches may benefit a subgroup of patients but may be associated with incremental risk of relapse and require further study, including the development of biomarkers that will enable a precision medicine approach to individualized treatment.”

Note the concession:

“Strategies for treatment discontinuation or alternative nonpharmacologic treatment approaches may benefit a subgroup of patients…”

But, such strategies

“…may be associated with incremental risk of relapse…”

This is standard psychiatric scare-mongering, though the word “may” suggests less certainty in this regard than psychiatry has formerly expressed.

“…and require further study, including the development of biomarkers that will enable a precision medicine approach to individualized treatment.”

So these eminent psychiatric experts need biomarkers to identify those individuals to whom they should not give neurotoxic chemicals, but they don’t need biomarkers to maintain the practice of giving these neuroleptic drugs (forcibly if necessary) to everyone whom they label as schizophrenic.

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

Here are the article’s conclusions (p 6-7):

“Results from many randomized clinical trials strongly support the benefit of antipsychotic drugs for the initial treatment of psychosis and for the prevention of relapse. While naturalistic studies suggest that a small number of patients may recover from a first episode of psychosis without pharmacologic treatment or may discontinue medication and remain stable for extended periods of time, we do not have clinical measures or biomarkers that allow us to identify them prospectively. Because relapses and delays in the treatment of psychosis have been associated with poorer outcomes, there may be risk associated with withholding or discontinuing medication. Evidence from preclinical animal models is mixed regarding whether antipsychotics have ‘neuroprotective’ compared with ‘neurodegenerative’ effects, and it is not possible to conclude from available clinical imaging studies whether the brain volume loss observed during the course of illness is attributable to antipsychotics or to the underlying illness. More research is needed to clarify long-term effects of antipsychotics on brain volume and their consequences. Existing clinical evidence for a negative long-term effect of initial or maintenance antipsychotic treatment is not compelling. Patients and their families should be made aware of the strong evidence supporting antipsychotic efficacy and of the side effects that vary between drugs. Additional research is needed to help quantify the risk-benefit ratio associated with continuation compared with discontinuation of antipsychotic treatment and to identify predictive biomarkers in order to facilitate shared decision making and a personalized medicine approach.”

In other words, despite the caveats, all is well in the realm of psychiatry. Its drugs, in this case neuroleptics, are safe and effective, which has always been their contention, and concerns that have been expressed in this regard, particularly on the long-term effects of these drugs are “not compelling.”


Five of the eight authors disclose extensive conflicts of interest. The other three authors, Peter Falkai, MD, Jingping Zhao, MD, and Jeffrey Lieberman, MD “report no financial relationships with commercial interests.” However, on May 12, 2017, a week after the publication of Goff et al, Dr. Lieberman reported the following disclosures on Medscape:

“Jeffrey A. Lieberman, MD, has disclosed the following relevant financial relationships:

Served as a director, officer, partner, employee, advisor, consultant, or trustee for: Clintara; Intracellular Therapies

Received research grant from: Alkermes; Biomarin; EnVivo/Forum; Genentech; Novartis/Novation; Sunovion

Patent: Repligen”

Alkermes, Novartis, and Sunovion are manufacturers of neuroleptic drugs (Risperdal, Clozaril, and Latuda, respectively). As the Goff et al paper is essentially a defense of neuroleptics, it is difficult to reconcile Dr. Lieberman’s denial of a conflict with the above information that he posted on Medscape a week later.


On May 12, 2017, Columbia University Psychiatry Department issued a press release publicizing the paper. Here’s the opening paragraph:

“An international group of experts has concluded that, for patients with schizophrenia and related psychotic disorders, antipsychotic medications do not have negative long-term effects on patients’ outcomes or the brain. In addition, the benefits of these medications are much greater than their potential side effects.”

Note the contrast between the above assertion that “antipsychotic medications do not have negative long-term effects on patients’ outcomes or the brain,” and the much more cautious wording in the Goff et al conclusions:

“Evidence from preclinical animal models is mixed regarding whether antipsychotics have ‘neuroprotective’ compared with ‘neurodegenerative’ effects, and it is not possible to conclude from available clinical imaging studies whether the brain volume loss observed during the course of illness is attributable to antipsychotics or to the underlying illness.” [Emphases added]

The issue here is brain shrinkage, but the press release denies any negative effects on the brain. In fact, it has been known since 1954 that neuroleptic drugs cause permanent brain damage (e.g., tardive dyskinesia), and warnings to this effect have been included in product information for all neuroleptics for decades.  For the Columbia Psychiatry Department to state publicly that these drugs “…do not have negative long-term effects on . . . the brain” is a new low for a profession that is already steeped in deception and other ethical lapses. Incidentally, the very eminent Dr. Lieberman is the chairperson of Columbia’s Psychiatry Department.

The press release was picked up by various news outlets, including UPI, Science Daily, and Medical News Today, all of which repeated the Columbia assertions more or less uncritically.

In addition, on May 12, 2017, the illustrious Dr. Lieberman posted a Medscape video of himself, dressed in an immaculate white coat, announcing two pieces of “good news.”

The first piece of “good news” is the formation of a steering committee which would update the DSM on a continual basis (as opposed to every ten or fifteen years). Dr. Lieberman expresses “some degree of pride” with regard to the formation of this committee because in the period leading up to its last update, the DSM was “the target of vicious criticism” led by “antipsychiatry critics.” Dr. Lieberman describes these critics as:

“Individuals who were traditional nonbelievers in mental illness or the efficacy and scientific competence of psychiatry, like Scientologists or just rabid ideologues, to individuals that were anti-medical model, antiscience.” [transcribed from video]

Dr. Lieberman’s second piece of good news was, of course, the publication of the Goff et al paper affirming the safety and efficacy of neuroleptic drugs in the “treatment” of people labeled schizophrenic.

“The second thing which I’m very happy to say is a positive development, and the beacon of the good and the fidelity to what really underpins the medical profession and all of like sciences: a commitment to research and the discovery of knowledge and truth based on evidence…” [transcribed from video]

Dr. Lieberman’s elocutory skills are not stellar, and coherence in the spoken word is not his strong suit, but I think what he’s trying to say here is that the Goff et al paper is really great; like a beacon… or something?

Dr. Lieberman tells us that he had the “privilege” of participating in the article which was occasioned by:

“…the fact that over the years despite the triumph of psychopharmacology reflected in mood disorders, anxiety disorders, psychotic disorders, attentional and cognitive disturbances, there are continual critics, again, coming largely from various constituencies in the antipsychiatry movement, who have assailed the efficacy of these treatments…” [transcribed from video]

These critics, Dr. Lieberman continues,

“…who really gave rise to this notion, that antipsychotic treatment was adversely affecting long-term outcome, were sowing seeds of untruth, misleading ideas, and were ignoring entirely, in their pursuit of some ideological goal or need for self-serving acclamations, the harm that they were causing many people who would unwittingly accept these as credible statements and follow their guidance.” [transcribed from video]

Poor, poor Dr. Lieberman, striving valiantly to do the right thing, but beleaguered on all sides by cads, bounders, rabid ideologues, and self-promoting acclamation-seekers. Oh my!

Dr. Lieberman concludes by praising the composition, scholarship, and rigor of the review, which he asserts

“…comes to a very clear and definitive conclusion, that we all should take note of, apply in our clinical practices, and use where needed in the education of patients, and the refutation of individuals who are really trying to create mischief for their own nefarious purposes.” [transcribed from video]

As we’ve seen earlier, the study did not come to “a very clear and definite conclusion.” The abstract was deceptively optimistic concerning the continued use of neuroleptic drugs, but the actual conclusions section contained several caveats:

“…there may be risk associated with withholding or discontinuing medication.”
“…it is not possible to conclude from available clinical imaging studies whether the brain volume loss observed during the course of illness is attributable to antipsychotics or to the underlying illness.”
More research is needed to clarify long-term effects of antipsychotics on brain volume and their consequences.”
Additional research is needed to help quantify the risk-benefit ratio…” etc. [Emphases added]

But, as is well known in medical circles, a great many (probably most) physicians read only the abstracts.


As I studied Goff et al, I was struck by the fact that the paper contained several serious flaws and omissions, and I decided that I should write a rebuttal. However, as happens increasingly with my advancing years, the willingness of the spirit was eclipsed by the weakness of the flesh. The days passed in the inexorable way that they do, and nothing was getting written.

And then on May 21, Robert Whitaker, founder and director of Mad in America, posted a superbly comprehensive critique of the Goff et al article. Robert’s post is titled “Psychiatry Defends Its Antipsychotics: A Case Study of Institutional Corruption,” and it is truly a brilliant piece of work.

The “evidence” and interpretations presented by Goff et al in support of their positions are meticulously analyzed, and shown to be distortive of the facts and selective of data. Mr. Whitaker presents his conclusions in a section headed “All is Well in the Land of Psychiatry”:

“What can be seen here, in this deconstruction of the review by Lieberman and colleagues, is that they presented information, time and time again, in a way that protects guild interests and their current protocols for prescribing antipsychotics.

  • They never provide data from the studies showing that 60% or so of first-episode patients may recover without the use of antipsychotics.
  • They always dismiss the better outcomes for unmedicated patients in cited studies, arguing that it is an artifact of an unequal comparison for some reason or another (Schooler, Rappaport, Harrow, and Moilanen).
  • They report no data from modern longitudinal studies that tell of much better long-term outcomes for the unmedicated patients.
  • In their discussions of drug-induced brain shrinkage and dopamine supersensitivity, they fail to discuss information from the larger body of scientific literature essential to assessing whether these drug effects could explain the poor long-term outcomes seen in the longitudinal studies.

Having reviewed the literature in that guild-protective manner, Lieberman and colleagues then drew these conclusions:

  • There is ‘little evidence’ that initial use of antipsychotics or maintenance treatment with the drugs have a ‘negative long-term effect.’
  • There are just a ‘small number’ of patients that may ‘recover from a first episode of psychosis without pharmacologic treatment or may discontinue medication and remain stable for extended periods of time.’
  • Randomized clinical trials (Leucht) and drug-withdrawal studies ‘strongly support the efficacy of antipsychotics for the acute treatment of psychosis and prevention of relapse.’

They were an ‘international group of experts,’ and they had come to a comforting conclusion for the guild: The drug-use protocols the profession has been using for decades are just fine.”

Under the heading “The Harm Done,” Robert writes:

“In his video, Lieberman talks about critics ‘sowing seeds of untruth’ and how such ‘untruths’ can cause harm, and I have to agree that sowing seeds of untruth can cause harm. We can see it so clearly in this case of institutional corruption.

The studies that tell of 60% of unmedicated first-episode patients recovering, and of better long-term outcomes for unmedicated patients, speak of an opportunity for psychiatry to grasp: they could change their protocols and give a chance to people who suffer a psychotic episode to recover and get on with lives unburdened by the many adverse effects of antipsychotics. There is an ‘evidence base’ that tells of new possibilities for people so diagnosed.

But Lieberman and colleagues did not present that possibility in this review. Rather they hid it from view. That is an action that does harm to millions of ‘patients’ and their families, and thus to all society. We will continue to live in a society organizing its care—and its laws regarding psychotic patients—around a false narrative, one told to serve guild interests, rather than the best interests of patients.” [Emphasis added]

And under the heading “The Challenge for Our Society”:

“In a study of institutional corruption, the ultimate goal is to present ideas for solving the corruption. Lisa Cosgrove and I admittedly struggled with this section of our book [Psychiatry Under the Influence, 2015]. While problems in psychiatry have become well known to our society, societal focus has been on curbing pharma’s influence over psychiatry. But how can the influence of its guild interests be curbed?

I really don’t know. The problem is that the power lies with the guild and its academic psychiatrists, who pen articles such as this one. They have the standing in society as experts; their papers are published in ‘medical journals’; and they have access to the press. Mad in America is meant to serve as a forum for critiquing that conventional narrative, but I am pretty sure that psychiatrists in Iceland will not soon be talking about the ‘untruths’ sowed by Lieberman’s article in the American Journal of Psychiatry.”

“But I do have one wish. I wish that all psychiatric residents would familiarize themselves with this controversy, and read the research articles that have been cited, and then ask themselves: Is this published report, the ensuing press release, and Lieberman’s video the work of a medical profession they are proud to join? Or are they the work of a medical profession that needs to be thoroughly remade, with this remaking to be their gift to the mental health of people everywhere? That could be quite a legacy for a new generation of psychiatrists.”


In his final paragraph above, Mr. Whitaker expresses the hope that psychiatry will reform itself.

Calling for reform, and inviting the profession’s new recruits to spearhead such endeavors, seem like eminently sensible and appropriate initiatives. But they ignore a fundamental reality: that psychiatry is inherently unreformable because its primary thesis is false. The central assertion underlying all psychiatric activity, and embodied unambiguously in DSM-III, IV, and 5, is that all significant problems of thinking, feeling and behaving are illnesses — real illnesses just like diabetes — which need to be addressed by medically qualified specialists, using medical-type diagnoses, and medical-type treatments.  And this central assertion is simply false.

Psychiatry could certainly pursue some reforms. They could sever their corrupt ties to pharma. They could stop publishing spurious, self-serving research. They could start getting honest about the adverse effects of their so-called treatments. The illustrious, white-coated Dr. Lieberman might even manage to gain an age-appropriate measure of control over the intemperate rants that he routinely directs towards psychiatry’s critics. But psychiatry can’t turn non-illnesses into illnesses. Once psychiatrists begin to acknowledge the illness falsehood — which is the underpinning of their entire structure — then their very reason for existing evaporates. As the mental illness hoax becomes increasingly exposed, it becomes commensurately clear that the psychiatric “treatment” of these non-illnesses is nothing more than drug-pushing, differing in no essential respect from the street corner variety. What psychiatrists provide is a temporary, chemically-induced feeling of comfort, control, docility, etc., at the expense of long-term damage. No psychiatric drug corrects any biological/neurological malfunction. In fact, the reverse is the case: all these drugs produce their effects by distorting, and in many cases, permanently damaging, normal functions.

And this is emphatically not an academic issue. Physicians are trained in the medical disease-centered model. This approach, which is extraordinarily effective in the treatment of real illness, is proportionately harmful when applied to problems of thinking, feeling, and behaving. The critical difference here is that real illnesses have a very large degree of homogeneity with regards to their origins, etiology, course, outcome, and appropriate treatment. By contrast, the kinds of life problems that psychiatry purports to address do not have this homogeneous core. Pneumonia is caused by germs in the lungs and the treatment consists essentially of eliminating those germs. The causes of depression and other forms of “psychiatric” distress, however, are as varied as the individuals who experience them. The notion that one can develop guidelines for the “treatment” of human distress analogous to those for real illnesses is a fundamental error. Shoe-horning the vast complexity of human problems into psychiatry’s invalid and unreliable “diagnoses,” and using these labels to justify widespread drugging and electric shocks, is arguably the most destructive hoax in human history. And as long as the illness thesis is retained, there is no possibility of reform. But if the central thesis is abandoned, then psychiatry loses the reason for its existence, and psychiatrists will have to find honest work. And that is the critical issue: for psychiatry this a death-struggle.

Through the persistent efforts of the antipsychiatry movement, psychiatrists have already lost the chemical imbalance theory of depression, one of the main supports of their house of cards, and they recognize that the writing is on the wall with regards to their other so-called neurological illnesses. When the neuroleptics-are-necessary-to-treat-schizophrenia myth falls, psychiatry is finished. And that is why Goff et al was produced: a desperate attempt to maintain its position by a profession that is truly on the ropes.

The way forward is to continue to expose the hoax, and to discredit psychiatry to the point where it can no longer attract new customers or new recruits. They have vast resources and lobbying power which they are using to fight back, but like a sand-castle, they have no substance, and the tide is coming in.

Psychiatry, self-servingly wedded as it is to the medical model, is not only unnecessary in this area, it is an effective barrier to genuine help. It is simply not reformable. Psychiatrists, as human beings, could, of course, become genuine helpers, but only if they abandon their spurious diagnoses and their destructive “treatments.” At which point, they would cease to be psychiatrists. And the venerable Dr. Lieberman would even have to surrender his white coat!


My disagreement with Robert Whitaker on the reformability, or otherwise, of psychiatry should not be interpreted as a criticism of his deconstruction of the Goff et al paper. His deconstruction of this document is simply superb, and I encourage readers to read Robert’s paper in full, and to disseminate it as widely as possible. Send links and/or paper copies to local politicians, mental health centers, GP’s offices, local newspapers, etc. Goff et al is out there right now in cyberspace and in print, spreading its self-serving and destructive message. Please do what you can to offset this deception with some genuine facts and analysis.


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


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  1. Dr. Hickey,

    Completely unrelated to this article, I wish to ask you:

    1.) You are so old now, that your loss will soon be inevitable. This would be a loss for many of us. Do you have youngsters who have been trained in your school of thought?

    2.) What do you think of the increasing support of pro-psychiatry in the “skeptic’s movement” and how the resistance of psychiatric BS is slowly being pushed into the same corner as the belief in tooth fairies?

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    • Registeredforthissite,

      Thanks for coming in.

      1. I think there are a great many young people active in the antipsychiatry movement who will, I feel confident, carry the struggle to a successful conclusion.

      2. Antipsychiatry has always been an uphill battle. At present , it’s doing better than ever, so-called skeptic movement not withstanding.

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  2. “When the neuroleptics-are-necessary-to-treat-schizophrenia myth falls, psychiatry is finished.” I hope so.

    In the short term, the neuroleptics/antipsychotics can actually create what appears to the psychiatrists to be the negative symptoms of “schizophrenia,” via what is actually neuroleptic induced deficit syndrome.

    And the neuroleptics/antipsychotics can also create what appears to the psychiatrists to be the positive symptoms of “schizophrenia,” including “psychosis,” via what is actually anticholinergic toxidrome.

    In other words, today’s “schizophrenia” treatment itself can create what appears to the psychiatrists to be both the negative and positive symptoms of “schizophrenia,” but the psychiatrists don’t seem to know this since neither of these neuroleptic induced illnesses is listed in their scientifically invalid DSM.

    As to Lieberman’s comment, “While naturalistic studies suggest that a small number of patients may recover from a first episode of psychosis without pharmacologic treatment or may discontinue medication and remain stable for extended periods of time, we do not have clinical measures or biomarkers that allow us to identify them prospectively.” I have a suggestion as to whom to wean off the antipsychotics.

    Since “antipsychotics do not cure child abuse concerns,” and today “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012).” I would recommend weaning all the child abuse victims, who are crime victims not brain diseased people initially, thus people who were mislabeled by the psychiatric industry, off the neuroleptics. An explanation by a psychologist of how of this is happening:

    Turning child abuse victims into the “mentally ill” with the psychiatric drugs is a form of aiding and abetting child molesters, which is illegal and detrimental to society as a whole. I very much hope the psychiatric industry will get out of the business of covering up child abuse en mass soon. Our society should be arresting the child molesters instead.

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  3. Thank you for the article Philip Hickey.
    If you compare the psychiatric drugs to chains, the persons that chains the slave will of course say the chains are helpful in controlling the behavior of the slave.

    I found one error ” But psychiatry can’t turn non-illnesses into illnesses. ” under the heading “BUT… IS PSYCHIATRY REFORMABLE?”

    I was diagnosed schizophrenic at age 19 I am now 49 and have rejected the psychiatric drugs as much as I can because I like my brain and think it functions fine.

    Friends I have known since we were in hospital(jail) together when we were 19 (we made friends there) think that I am (now) a genius. In fact, I have average intelligence but I do accept their compliment.
    They tell me I am smart because otherwise (if I was average) then they would be stupid, and no one wants to think of themselves as stupid. I wonder what their brain volumes would look like in a MRI scan after the thirty years of drugs they have consumed.

    The long term use of psychiatric drugs does make illness in its subjects. The long term use of psychiatric drugs damage the brain, and when it does so it fulfills the prophesy of the psychiatrist that the person is ill.

    If or when my friends discontinued the drugs over the thirty years they would have withdrawal symptoms. Symptoms like insomnia and “strange” thoughts. In addition they were never given/taught skills to handle their emotions of anger and such, so they always went back on the drugs. They were successfully taught to fear their emotions, that their emotions were diseases.

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  4. “…There are just a ‘small number’ of patients that may ‘recover from a first episode of psychosis without pharmacologic treatment or may discontinue medication and remain stable for extended periods of time.’…”

    I rejected medication at the beginning.

    I had 4 years of disability and suicide attempts on the medication, and I now have more than 30 years of established wellness off the medication. My Psychiatrist at the time was on the examining board of the Royal British College of Psychiatrists but he was incapable of telling the difference between the side effects of his own medications and genuine mental illness.

    Ultimately he ended up on the Irish Medical Council …

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  5. IMHO, psychiatry is not capable of reforming itself. It will never happen if left up to them; just like abolition of slavery would never have happened in this country if it had been left up to slave owners. They have too much invested and at stake to change now and insurance companies are not going to pay for any kind of real therapy so what incentive do they have to reform and change themselves?

    And as to the claim that the neurotoxins do not harm people over the long term, Dr. Nancy Andreasen put the lie to that when she did studies to find out what was shrinking the brains of people being dosed with the neurotoxins. Her studies, and she’s a very methodical person when it comes to studies and she is the matriarch of the Bio-Bio-Bio group of psychiatry, showed that people’s brains are shrinking because of the drugs and not because of the “schizophrenia”. She even redid her study because she didn’t believe the results of the first but after the second came up with the same results she finally decided to publish.

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  6. The study featured above is whitewash and BS. It doesn’t take much to figure that out. Within the system drugs are so much the “norm”, talking about not taking them is frowned on, very seriously. I imagine someday the science will sink it, I’m still waiting for that day. I know, for one thing, they aren’t serious when they say the following:

    “Strategies for treatment discontinuation or alternative nonpharmacologic treatment approaches may benefit a subgroup of patients but may be associated with incremental risk of relapse and require further study, including the development of biomarkers that will enable a precision medicine approach to individualized treatment.”

    They aren’t interested, while suggesting there is a subgroup, in supporting the notion that anybody improves without drugs. They’re more serious concern is what they call “precision medicine”, which might be more appropriately called, designer drugging. This is sort of like saying if you’ve got a drug that makes you feel bad (has a lot of so-called adverse “side effects”), not to worry, we’re developing drugs all the time, and we must have another one that will do you good. Problem: some of the psych-drugs with the least overt adverse experiences can be among the ones doing the most harm. All neuroleptics are harmful, at least potentially. The mortality rate for people in treatment for the most devastating of psychiatric diagnoses, gleaned from other studies, speaks for itself. Curiously, notice of this high mortality escaped the attention of the group of doctors behind the above study, and no wonder, you can’t sell drug maintenance effectively by highlighting the damage they wreak. Of course, the advertisements present those adverse effects as a long series of brain numbing stats to be glossed over by the person desperate for quick-fix help. In the end, there is a moral to all this nonsense: buyer beware, psychiatry is a hoax.

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  7. excellent article. psychiatry most certainly cannot be reformed. at the same time, I do not think psychiatry will ever die unless society changes, at a number of levels. My hope is that as the costs associated with all things Mental Health, Inc. continue to increase–the costs of disability, of the drugs, of “treatment” that is never, ever supposed to end, as long as the “patient” is alive–perhaps that alone might be enough to begin destroying psychiatry (and other parts of Mental Health, Inc., too; all of it tends to be oppressive and is based in lies…).

    Honestly, my concern right now and for the near future is that Mental Health, Inc. will respond in a reactionary manner and emphasize more drugs, more “diagnosis,” more of what lies at the core of Mental Health, Inc.–that is, force, fraud, and coercion.

    Again, I enjoyed the article.

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  8. Thank you Phil for the kind words, and for another keenly argued post.

    There was a time that I rather naively hoped that psychiatry could reform itself. The hope arose from seeing other areas of medicine change their ways when studies showed what they were doing was harmful or of no benefit (although of course all of medicine can be resistant to changing practices; they are happy to say they are practicing “evidence-based” medicine when the evidence fits with what they are already doing.) And so I “hoped” (as opposed to believed) that the psychiatric profession, when confronted with evidence from its own research, that its drugs were doing more harm than good over the long-term, could be the spur for wholesale reform. After all, how could a medical profession insist on treatments that were worsening long-term outcomes? The profession also had to confront the fact that its chemical imbalance story had never panned out, and that decades of research had failed to validate any of its disorders as discrete diseases. But I no longer believe that psychiatry will reform itself and change its ways. As an institution, the profession has its belief system, and as you say, psychiatry’s current societal legitimacy–and its own self-perceived legitimacy–is wed to the disease model it has promoted, and if that model falls, then why do we need “medical doctors” residing over this domain of our live?

    But I do believe that a “critical psychiatry” perspective–which on its surface does suggest the hope that psychiatry can reform itself– helps promote, to the general public, an understanding that will lead more and more people to reject psychiatry as it exists today. It is a perspective that reveals that psychiatry has sold us a false narrative ever since it adopted its “everything is a disease” model with DSM III, and that the published articles in psychiatry said to support that disease model–such as Goff’s article, the recent article claiming that youth diagnosed with ADHD have smaller brains than normal–never hold up under close review. You and I had the same immediate response to the Goff article; we knew it would be filled with spin and biased reporting of the available data re long-term outcomes.

    Moreover, for me, I think a critical psychiatry perspective makes it harder for the defenders of psychiatry to brush aside such “deconstructions” of its science with the public claim that this comes from people with an animus toward psychiatry. Lieberman still makes such a claim, but he is such a ridiculous person, and so I think that in terms of generating public understanding of the problems with psychiatry, it is a useful perspective. It says to the public, can we please just look at the facts.

    And thus the hope I now have: that an ever-growing percentage of the American population will come to see psychiatry and its disease model as discredited, and simply turn elsewhere for leadership in this realm. And as you note, this is indeed happening, both in the U.S. and abroad. The recent United Nations Report by Danius Puras is an example of this growing societal rejection of modern psychiatry and its disease model, and I see it too in the affiliate Mad in America sites that are forming: Mad in America Hispano-hablante, Mad in Brasil, a Mad in Finland that is now being put together, and a possible Mad in Asia.

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    • and thank you, Robert, for all your hard work. That said, I have an obvious question. I agree of course that psychiatry cannot be reformed–but why do you go from there to “critical psychiatry” instead of “antipsychiatry”, when critical psychiatry largely rests of the basis that reform is possible?

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    • The general consciousness is definitely growing on many levels. I guess that since critical psychiatry rests on a mostly sincere (though objectively unsupportable) hope that psychiatry could somehow be “reformed,” those who follow such reform attempts with optimistic anticipation and “non-partisan” attitudes may learn valuable lessons from the disillusionment of seeing their hopes crushed. On the other hand it seems that real people will be damaged in these experiments when the conclusions are eminently predictable.

      It would also seem that the logical progression is from critical psychiatry to anti-psychiatry.

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    • Bob – Jeffrey Lieberman may indeed be a “ridiculous person”, but his global reach and influence is something else. Last year, Professor Sir Simon Wessely of the UK Royal College of Psychiatrists announced news of “substantial funding” from the Wellcome Trust and the Gatsby Foundation…

      “With this funding, we will be setting up a Commission that will review the current teaching of neuroscience in the specialist training of psychiatrists and will make recommendations for a new curriculum incorporating modern developments in clinical neuroscience. In so doing we are consciously following in the footsteps of the US National Neuroscience Curriculum Initiative (NNCI).”

      And who happened to be on hand to kick-start this venture? A very special guest indeed!

      “We are delighted to announce that this project will begin with a lecture by Dr Jeff Lieberman who will fly over from the United States especially to talk at the College on Wednesday 20 April 2016 at 6:00pm. Please join us for Jeff’s lecture, ‘The Notorious Past and Bright Future of Psychiatry.'”

      Wonder if he wore his immaculate white coat…

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      • Thank you AuntiePsychiatry the links you provided above reveal much and clarify what Lieberman and his followers are trying to do to the people .
        It seems obvious that Psychiatry’s leadership to gain total compliance to itself is looking to try and still establish within the minds of the population on top of Psychiatry’s “chemical imbalance ” HOAX an additional powerful HOAX this time with co-operating neurological departments , ( using their “new improved scanning image reading machines ” then the co-operating neurologists will make referrals to psychiatrists explaining variations in sizes of various parts of the brain (“as surely the undeniable physical evidence of “mental illness” requiring “psychiatric doctor care and treatments” . All the while the pharma toxic drugs prescriptions and applied high voltage electricity, are the huge factors in brain shrinking. Does it get even more diabolical ? Shouldn’t we put Much More Emphasis on the evidence of Organized Crime and Torture Against Human Beings, while posing as health care, that this is ? Or what else ?

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    • Robert,

      Thanks for coming in. My own reasons for adopting an antipsychiatry stance are two-fold. Firstly, psychiatry is so rotten, destructive, and disempowering, that it warrants nothing less than complete condemnation. Secondly, if we give them an inch, they will take a mile; if we concede the remotest possibility of reform, they will latch onto that, make some cosmetic changes, and continue as usual.

      And by the way, thanks for Mad in America, which has done so much to advance our cause.

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      • As a surviving former victim of the lies of the pseudoscience drug racket and means of social control known as “psychiatry”, I have to back Mr. Robert Whitaker’s “critical psychiatry” stance 100%. Bob, didn’t you start out as a journalist? So, being “CP”-“critical Psychiatry”, seems to me a much better position, for all the reasons you’ve outlined so clearly above. Plus, it avoids the “scientology”/CCHR slur that the apologists of psychiatry love so much to use against any critics. Besides, for years now, the psychs themselves have been re-positioning themselves as “genetic neuropsychiatrists”, &etc.,… This style of neologistic “label creep” is what they do with their bogus DSM labels. (The DSM is a catalog of billing codes). Soon, the psychs will have us flying cars, driving airplanes, sailing submarines, and diving down to the sea in ships. Linguistically, we live in a world where skating on thin ice can land you in hot water. *THINK* about what I’ve said here VERY carefully…. Psychiatry is nothing more than 21st Century Phrenology with potent neurotoxins. I’d much rather see Mr. Whitaker STAY as CRITICAL of psychiatry as possible. Besides, I think the label “antipsychiatry” gives psychiatry far more legitimacy than it deserves. You wouldn’t be “anti-Santa Claus”, would you? (So-called “mental illnesses” are exactly as “real” as presents from Santa Claus, but that’s another comment.) KEEP UP THE GOOD WORK, Mr. Robert
        “Critical Psychiatry” Whitaker! ~B./

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  9. Thank You Robert,

    I think we need to get a document together of 100 people that were diagnosed with “Schizophrenia” that can be substantiated to have gotten completely Well through non dependency on medication – to convince people that it’s possible.

    (I believe present day Psychiatry promotes non Recovery “across the board” – regarding “Schizophrenia” – and a lot of people “buy into” this).

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  10. Bonnie,

    There are several reasons for my adopting a “critical psychiatry” stance rather than an “antipsychiatry stance.”

    One, the very term “antipsychiatry” calls up an ideological opposition to psychiatry. I never had such an opposition. My whole thinking on this subject developed out of a simple desire to see if psychiatry and its treatments were “working” for people, and also if psychiatry was telling an honest story about its treatments. In other words, a critical–in the meaning of taking a close look at psychiatry’s story–examination of the evidence. I still feel that way about the subject; it is what is inside me.

    Second, I think psychiatry uses the term “antipsychiatry” to its advantage. It says to the public, there is an “ideological” group opposed to psychiatry, and so it can now present itself to the public as the “scientific” group, battling an “anti” group that is non-scientific.

    Third, a critical psychiatry perspective keeps the spotlight on psychiatry’s behavior and treatments: Has it validated the disorders? Do its drug treatments improve lives over the long term? Does it conduct honest trials of its treatments? Is it an honest in its presentations to the public?

    And that’s where I think the public focus needs to be. If the public takes a “critical” look at psychiatry, what will it find? In contrast, psychiatry uses the “antipsychiatry” label to dismiss criticisms as coming from a group with an unscientific antipathy toward the field. From the public’s point of view, psychiatry continues to wear the cloak of science in such debates.

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    • That sounds like a strategic answer not a sience or ethics based one. That is, strategically psychiatry is likely to be weakened by the use of critical psychiatry arguments and allieing to critical psychiatrists and other respected professionals.

      Where as I takea an anti-psychiatry viewpoint and am willing to seek allies from critical psychiatrists and other respected proffessionals. Oddly my position partly comes from reading Mad in America which details the history of USA psychiatry and from which I came to the conclusion that psychiatry has always done more harm than good, it is not just a modern phenoma.

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    • yes, Robert, I can see what you get from identifying as critical psychiatry rather than antipsychiatry. At the same time, I think that there are things that you lose–the clarity that this is an area that cannot and must not continue, that we are not looking at something that has the chance of being made acceptable,

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      • I am just re reading your book, Psychiatry and the Business of Madness, and am struck by the section on form filling and how that effects the experience of inmates in hosptals. Whether there were drugs or not hospitals as they stand would still be a kind of soft prison with observations and locked wards and not a lot of getting to know and support people in distress.

        Today I performed at a Mental Health Arts Festival and afterwards someone said they were really glad I had written about psychiatric oppression in the programme notes.

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    • I think psychiatry uses the term “antipsychiatry” to its advantage. It says to the public, there is an “ideological” group opposed to psychiatry, and so it can now present itself to the public as the “scientific” group, battling an “anti” group that is non-scientific.

      It depends on who you’re trying to reach. Every time they mention anti-psychiatry to the “public” they stir interest in anti-psychiatry and make people curious about it (even if it sounds crazy at first, it’s still interesting and provocative). They can claim anything they want, as once we have the organized strength and internal analysis to make them put their mouths where their money is — i.e. put up or shut up — they will be exposed as charlatans every time. In many ways Lieberman, et al. have been doing our work by constantly screaming “anti-psychiatry” even where there is none — it shows the power of the term. We should not be defensive about being “anti” ANYTHING that is WRONG. That’s not ideological, it’s simply moral.

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    • Robert, first let me say again how much I appreciate not only your work but your incredible honesty and openness. at the same time, let me suggest that people who call themselves antipsychiatry proceed initially from the very same position as you do–that what history and science has shown is that psychiatry cannot be reformed and it harms people. The only difference is that we call for getting rid of it. If you are convinced at this point that it cannot be reformed and necessarily harms, why would you call for reform (as is the case with critical psychiatry) To put this another way, why would you call for the reform of an institution that you now believe cannot be reformed? Isn’t the strictly critical psychiatry position something that no longer fits your beliefs?

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    • Robert,

      That’s an interesting strategy, and may ultimately prove more successful than an overtly anti stance. However, I think psychiatry will be as dismissive of critical statements as they are of anti statements. Remember, Dr. Lieberman once referred to you as “menace to society”!

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  11. Fiachra,

    This is such an excellent idea. We have been talking about doing something like this –100 stories of recovery from a diagnosis of schizophrenia without medications–for a long time. We need to do this.

    Write me on my email, and let’s discuss how to do this.

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  12. The only way psychiatry will change is if the financial incentives that reinforce it are altered. It is very clear that psychiatry chose its current direction out of a desire to maintain control of the field and to assure that psychiatrists could make lots of money with less work. It is also supported by the “permanent disability” concept that keeps their biggest funders, the drug companies, making billions. No amount of data can overcome the greed and power drive that is behind the current psychiatric paradigm. It will only stop when it stops paying off.

    — Steve

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  13. This Q? jumped out at me from the abstract, and I hope either Dr. Hickey, or Robert W., or *somebody*, will have a good response…. The abstract talks about, in the last 3 lines, “require….the development of biomarkers that will enable a precision medicine approach to individualized treatment”….
    Similar language also appears in the “Conclusion”…. First, exactly *WHAT*, – in strict medical terms, *ARE* these elusive “biomarkers”? If “biomarkers” need to be “developed”, does that mean “invented”?….
    Seems to me, either “biomarkers” DO exist, or else they DO NOT….Which is it? Can’t be both! And, given that they do or do not exist, how can they be “developed”? Will we see something like this, in future: “Current biomarker development lacks the precision to make a more definitive diagnosis”, or some such nonsense? Has anybody ever explained exactly how these alleged “biomarkers” are “developed”?….
    Can they be grown in a test tube or petri dish? Can “biomarkers” be genetically engineered”? Are “biomarkers” GMO’s? I sure hope somebody can help me with these questions!….

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      • Thank-you, Philip. I’ve seen “develop (biomarkers)” used in many other pro-psychiatry contexts. I think the use of “develop” here WAS intentional. $$ Think about it, to “develop” biomarkers requires genetics labs, and medical labs, and LOTS OF $$$$$…. I don’t think they care, as long as they push the narrative, and keep the $$$$ money flowing in. BTW, it occurred to me to ask, regarding DSM “diagnoses”, if they were “DISCOVERED”, or *INVENTED*? If you think about it, how could they have been “discovered”? So-called “mental illnesses” could ONLY have been INVENTED. Same with the elusive “biomarkers”. The very word was INVENTED, not “discovered”…. So-called “biomarkers” either exist, or else they don’t. *IF* they exist, then they were either discovered, or invented. (Now, I’m not denying that there are many people in distress, of either emotional, psychological, “mental”, etc., but that does NOT mean that so-called “mental illnesses”, as in the DSM, were NOT INVENTED.)
        I don’t like FRAUD, um, I mean “Freud”, either, so I don’t like “Freudian slip”. **THINK** about what you’re saying when you use the term “Freudian slip”. What’s a “non-Freudian slip”? I hope you take my critique here to heart, Dr. Hickey. You continue to inspire and teach me, so let me return the favor! Let me here and now invoke the divine inspiration of the MOST pre-eminent Critical Psychiatrist, Mr. Robert Whitaker! *grin*….

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  14. Bob, Bonnie, and John

    Bob, thank you again for MIA and your willingness to be so open about your evolving political perspective on these vitally important matters.

    I do see some value in giving “critical psychiatry” a forum because it does expose more of the underbelly of Psychiatry and creates more favorable conditions for splits to occur within the institution. This will help set the stage for more people to eventually see Psychiatry for what it is in the real world and migrate towards becoming full blown “anti-psychiatry,” and for the institution to ultimately be dissolved of any medical or legal credibility in our society. This helps create the material conditions in the world for Psychiatry to be finally “abolished.”

    The anti-psychiatry movement, like any other radical movement in history, will be vilified and labeled with all sorts of discrediting descriptions. But, if it both scientifically and morally makes sense to abolish Psychiatry, then it must be supported, AND we must work hard to help people understand why this is a just political and moral position.

    It is up to us, through our painstaking work, to show that the anti-psychiatry movement is, not only, highly compassionate and ethically astute in its analysis, BUT also, consistently RUTHLESSLY SCIENTIFIC in its ability to apply science to deconstructing the Disease/Drug Based Medical Model. We will gain followers by always staying on this “high road” and never watering down our politics or falling into some form of reformism.

    As to whether or not “abolishing Psychiatry” is a reasonable goal given the way the world is currently constructed. Looking at the world 40 years ago, some type of “attrition model” of abolishing Psychiatry MAY have made sense and been possible to take place over the long term within the current Capitalist/Imperialist system.

    However, several important factors in the world that have occurred in the past 4 decades that now make this “attrition” approach not realistic or possible:

    1) There has been over 4 decades of one of the most complete and successful PR campaigns (involving several hundred billion dollars of deceptive propaganda) of political brainwashing in the history of the modern world. Biological Psychiatry’s “chemical imbalance” dominating, Disease/Drug Based Medical Model has now become so deeply entrenched among the masses that it would require major “Revolutionary” changes in society to uproot this way of thinking.

    2) The pharmaceutical industry is such a vital cog in the U.S. economy, and one of the most expansive and profitable, that it has become literally “too big and important to fail.” Psychiatric drugs have played a decisive role in boosting and expanding Big Pharma in this period, and helped it become such a vitally important segment of the U.S. economy.

    3) The world has qualitatively changed since 9/11, and it has become a more volatile and dangerous place to live and to maintain nation states and the various international alliances. And U.S. Imperialism has become increasingly more isolated and tenuous as the the #1 empire in the world.

    4) All this makes the role of Psychiatry, with its mass drugging, its misleading focus on its “genetic theories of original sin” as the central human problem, and forced hospitalizations/incarcerations etc. – such a necessary and important means and method of SOCIAL CONTROL throughout society. For obvious reasons they are targeting (with drugs and labels) those sectors of society that have historically been the most prone to becoming political activists against the System.

    5) For all of the above reasons, I don’t believe “abolishing” Psychiatry is possible within this current Capitalist/Imperialist system. But this DOES NOT MEAN it is an incorrect, or somehow a Utopian slogan and/or political goal to be raising at this time.

    Do people really believe that we can save the planet from environmental disaster WITHOUT major systemic changes in how our society is organized and governed??? The very same questions could be raised about ending racial oppression or women’s oppression on a global scale.

    I believe that the movement to end all forms of psychiatric abuse, and ultimately abolish Psychiatry, can be a vitally important tributary in a world wide river of upheaval transforming the entire planet into a more humane and just place to live. So in the context of the above political analysis that I have sketched out here, to be “anti-psychiatry” makes perfect sense, and it is morally the only position I can live with in this “crazy” world at this time.


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        • I realize that it looks this way, Oldhead, and so I very much see why you ask what you did My own sloppiness here. No, I don’t agree that the attrition model is not longer “realistic or possible”. I think it is as vital as it ever was–and incidentally it is a model which came into being only about ten years ago and in part precisely because of the developments which Richard suggests. What I agree with rather is the concluding paragraph. That said, I should add, as a leftist and as someone with an intersectional analysis which very much includes class, I also agree that ignoring the monied interests involved would be a serious mistake. As such, correspondingly, when I write at length about the attrition model in book chapters (the only place where I can develop it at length) I prioritize such ways of eroding psychiatry as law suits, hardly something that gets rid of capitalism, but something that uses the leverage within the system in a way that could seriously detract from the huge profits made and in so doing, do its own job in eroding psychiatry.

          Thanks for asking for the clarification, Oldhead.

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    • Another strange development, with Bonnie’s approval.

      There are a lot of things wrong with the current system, and it is a system that desperately needs changing. Putting profits over people wreaks Hell on people.

      Let me just say I’ve always had a problem with those ideologies that make feasible change possible only through world revolution. Nor do I think it very viable that any sort of classless society should be achieved through dictatorship. The idea of waiting for revolution to relieve us of psychiatry just doesn’t sit well with me. I, and I’ve stated this before, just don’t have the patience for it.

      In this Brave New World we are stuck in, I’d give a little bit of credit to the resistance of the “reservation”. I simply think much of the impetus for change is not going to be able to wait for any resistance on a massive scale to bring down the present system, that is to say, I think we are going to have to forge our own non-oppressive ways of operating, or of an outside the system “within the system”.

      Those authoritarian revolutions that have taken place in the past, rather than “abolishing psychiatry”. have found it convenient to have Coercive psychiatry serve their own social control ends. In lieu of a massive populist movement against psychiatry, I see no reason this would not happen again. Psychiatry itself, through the reform of moral management, had the blessing of the revolutions associated with the enlightenment that took place in France and America. Segregation and detention in huge Victorian monstrosities in the country was shortly to follow as a direct result.

      What am I saying? I’m not arguing against change. Are you? I don’t think it is intellectually honest to betray one revolution for another. Defeatism is no answer. Rather than sabotage one’s own efforts to effect change, with theory or whatever, I see a great need to redouble efforts. It is not like, during the long course of history that defines the existence of institutional psychiatry, there haven’t been heroes and heroic struggles against it. I worry here, and a great deal in fact, about the wheels of progress grinding to a halt due to a proclivity, among some individuals, to becoming “lost in theory”.

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    • Biological Psychiatry’s “chemical imbalance” dominating, Disease/Drug Based Medical Model has now become so deeply entrenched among the masses that it would require major “Revolutionary” changes in society to uproot this way of thinking.

      Unfortunately none of the self-described “revolutionary vanguard” organizations currently in existence seem to have a clue about any of this — the farthest they go is talking about “over medicating”; and they have not a clue about the medical model, or the key role psychiatry plays in the current repression not only by drugging people, but by defining idiosyncratic resistance and non-cooperation as symptoms of illness. I don’t see any “revolutionary” orgs out there that aren’t a quarter century or more behind in their grasp of any of the issues we consider vital. So this is a major problem to say the least, and refusing to see it will hold back any genuine revolutionary progress until it is finally addressed by the so-called left, and clear-thinking people in general.

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      • While we’re at it:

        It is up to us, through our painstaking work, to show that the anti-psychiatry movement is, not only, highly compassionate and ethically astute in its analysis, BUT also, consistently RUTHLESSLY SCIENTIFIC in its ability to apply science to deconstructing the Disease/Drug Based Medical Model.

        Painstaking work? It’s not rocket surgery. How “ruthlessly scientific” does one need to be to recognize that abstractions (such as “the mind”) cannot have physical properties (such as diseases)??? No further “research” is needed, and that which is conducted anyway is playing into the illusions of “mental health”/”mental illness.”

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      • Oldhead

        You said: “Unfortunately none of the self-described “revolutionary vanguard” organizations currently in existence seem to have a clue about any of this…”

        For this we should not be all that surprised since this may be the last human rights struggle of great significance. As more radical activists from OUR movement link up with all the other tributaries of struggle, it will certainly bring to those struggles our thoroughgoing deconstruction of the Medical Model. And the bigger our movement becomes the less it will be able to be ignored and/or misunderstood.

        They will simply not be able to ignore or avoid dealing with these issues as the overall struggle against the System intensifies. Just as the women’s movement asserted itself during and after the 60’s upheaval.

        And if it continues to be ignored or downplayed as new Revolutionary changes take place, then there just may have to be a “revolution within the revolution.” Whatever the case, none of these obstacles should discourage us, or cause us to be defeatist or hesitant about doing what is historically necessary to advance our struggle against ALL forms of oppression.


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        • I’m not defeatist, I’m critical. There are any number of groups claiming to have the understanding, analysis and strategy to lead the masses. While we should make ourselves and our information/analyses readily accessible to all, it is not our obligation to plead with anyone; it is the responsibility of such formations to come to terms with their own glaring blind spots. ESPECIALLY if they expect people to trust them with their lives. A recognition of the impending psychiatric holocaust for what it is constitutes an essential part of any revolutionary analysis.

          I’m not arguing against any of your points here, simply emphasizing that your essentially accurate framing of the issues is not typical of any current organized revolutionary socialist organization, although it should be, or something like it.

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          • PS That’s sort of how I see this now, as a revolution within the revolution. Most people in the US are unfamiliar with all of this on every level however, as their concepts of revolution are based on cold war stereotypes fostered by the news media and popular culture.

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  15. Three cheers for Dr. Hickey! Dr. Hickey does it again! Thank you. Dr. Hickey’s analysis is simple and straightforward, clear and cogent. He declares the truth. The fact of the matter is that psychiatry, not antipsychiatry, is based on false philosophy, false ideology, and false science. Psychiatry is anti-truth, anti-science, anti-reason, and anti-liberty. Antipsychiatrists oppose psychiatry because they are pro-truth, pro-science, pro-reason, and pro-liberty. Just as it was moral and reasonable to oppose Great Britain in the American Revolution, to oppose slavery in the Civil War, and to oppose the Nazi’s in WWII, it is moral and reasonable to oppose psychiatry. Anyone who knows anything about the history of psychiatry understands that its founders and its foundations are corrupt. Anyone who knows anything about psychiatry understands that its history is riddled with stories of abuse, torture, drugging, and murder. Does it really make any sense to be merely critical of abuse, torture, drugging, and murder? Of course not. It’s probably better to be critical of these crimes than to endorse them. But reason and conscience demand that decent and honorable citizens embrace justice and truth while eschewing injustice and deception. In other words, to turn a common phrase on its head, Phil Hickey and the “antipsychiatrists” are on the right side of history. The arc of the moral universe is long, but it bends toward justice. Dr. Hickey is at the same time very merciful toward psychiatrists who, for the most part, simply do not understand the harm that they cause. There is nothing preventing psychiatrists or mental health workers from finding decent, honest work, perhaps laboring to repair the damage that they have caused. For instance, the could donate their means to Mad in America, or better yet, to survivors of psychiatry. Of course the general public currently responds better to critical psychiatry than it does to antipsychiatry, because the truth about psychiatry is hard to come by. Even after slavery was abolished it took many years for the Civil Rights movement to coalesce. But speaking the truth in love, and writing the truth without malice, is more important than pleasing a crowd. Great work Dr. Hickey. In the future, survivors of psychiatry and their posterity will pay tribute to those who dared to tell the truth about psychiatry. The names of Thomas Szasz, Phil Hickey, and perhaps a few others, will be had in remembrance and honored among those who love liberty, justice, and truth. Fortunately, there is still time for the villains of psychiatry to repent, and to reform themselves. Three cheers for Dr. Hickey! Hip hip, hoorah! Hip, hip, hoorah! Hip, hip, hoorah!

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  16. Phil,
    Good to hear your voice on here again.
    Of course I agree with everything you are saying here, no surprise.

    I was sad to read a psychiatric article last month (on another forum) by another group of psychiatrists arguing that even considering that “schizophrenia” could be treated without neuroleptics would be “unethical”, because it would be to deprive “patients” of “the only known evidence-based treatment for their illness”. It is scary to think about the massive distortion and self-delusion on so many levels that goes into making a statement like that – the lack of knowledge about what the “efficacy” and relapse trials of the drugs really show, the ignorance of the data about long-term effects of cognition, tardive dyskinesia, parkinsonism, brain atrophy, the lack of any understanding that severe terror and distress are not “treated” by antipsychotics, but people are merely numbed to what they are experiencing. Such psychiatrists are truly lost in a maze of self-confirming, but delusional perceptions about the people they are supposedly treating. The sad thing is, they are not actually bad people, and they could do much better, if they had accurate information about the nature of severe distress and the serious harms of neuroleptics.

    I agree with others here that critical psychiatry can be a useful forum for reaching the general public who are not ready for stronger messages. Also, not all psychiatrists are totally close-minded, and some are beginning to become more aware that there may be serious problems associated with long-term use of the drugs, as well as that environmental stress and trauma are much more heavily involved with what gets labeled psychosis than many used to think. Some of these people can and do care and can do good things in terms of raising awareness. So, it is not that psychiatrists are always harmful, although inadvertently many of them are.

    Phil, drink of the fountain of youth so that you can be here a while longer.

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    • Matt and others

      Matt, you said: ” The sad thing is, they [psychiatrists] are not actually bad people, and they could do much better, if they had accurate information about the nature of severe distress and the serious harms of neuroleptics.”

      A question is raise here: When do people who continue to do “bad” things even when they are increasingly exposed to knowledge that their behavior is doing “bad” things to people, finally get labeled as “bad” people???


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      • The best way to get to the Fountain of Youth is to ride your new bicycle.
        I’m serious, Philip. Go to a good bicycle shop, and buy a new bicycle. You know you can afford it. Then ride it every day. (Weather permitting, – no need to go hardcore too quickly….)…. Bicycling is the closest thing to a mechanical Fountain of Youth humans have yet invented. Don’t waste your time and money at Wal-Mart, or a “sporting goods store”. There’s gotta be a good bicycle shop near where you live. They would LOVE to get you started, and I’d love to see you get started. You can always get off and walk it, if traffic or steep hills are too much, but there’s nothing like coasting down a hill on a bicycle, to feel like a kid again! Good excuse to get out in Nature/the Country/Trails, also….

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  17. Great to hear from you Phil. The silence has been deafening. 🙂

    Members of the MIA community, the following statement could be quite effectively and legitimately inserted as a disclaimer prior to every MIA article which mentions “mental illness” or psychiatric “research”:

    “[P]sychiatry is inherently unreformable because its primary thesis is false.Once psychiatrists begin to acknowledge the illness falsehood — which is the underpinning of their entire structure — then their very reason for existing evaporates. As the mental illness hoax becomes increasingly exposed, it becomes commensurately clear that the psychiatric “treatment” of these non-illnesses is nothing more than drug-pushing, differing in no essential respect from the street corner variety.”

    Once the logical, scientific, and linguistic impossibility of “mental illness” is truly appreciated the discussion should end. Further “research” based on an acceptance of this incontrovertible falsehood — no matter how many millions of dollars back it up — is inherently flawed and meaningless, as it is based on demonstrably false precepts.

    The above is not a “good point” to be tossed around at gatherings of “progressive” professionals. It is an ongoing reality that is oppressing and killing millions of people.

    Thanks again, Phil!

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    • Oldhead,

      I know you are very militant about this and I completely understand your position. Only that it will never work except in loud proclamations on MIA.

      The public will NEVER accept that there is no such thing as mental illness. They will laugh in your face, and show you the “schizophrenic” that thinks that aliens are communicating to him via radio waves.

      Try these arguments on the sites of people like Steven Novella. You will be shot down immediately.

      I know you will respond in a militant manner to me again, and be harsh. But I’m just the messenger.

      P.S. Does anyone know what happened to Ted Chabasinski? He used to write here. Is he alive?

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      • Sadly, i have to agree that the vast majority of the public will not easily let go of the lie that there is such a thing as mental illness.
        Before the biological model, we had thousands of years of the devil model. What both have in common are the belief that the sufferer is a victim of something that has no logical connection to the person. The devil indiscriminately attacked people (because, after all, Christianity says that everyone is a sinner) and so too, “brains just go wrong sometimes.” Nothing about poverty, discrimination, social problems, unemployment… In other words, no sense of “here’s something society as a whole should address because if people are suffering, then it’s OUR fault too.”
        Likewise, NAMI which stands up for poor, suffering parents of “schizophrenics” and protects them from”unfair, totally unfounded” allegations that their poor parenting could in any way have something to do with what their children go through in later life.
        Why would anyone want to let go of a no-fault-no-blame theory and adopt a take-responsibility policy instead?
        And, by the way, that goes for the “mentally ill” as well. It’s so much easier to be a helpless victim. Whether you end up taking pills or not. Those who fight back and take responsibility for their lives and health are the tiny minority.
        Having written all that, it’s not all doom and gloom. We have a saying in the Talmud, that “a person who saves one life is like one who saves an entire world.” This can be interpreted on many levels. Even one person saved and given the hope that he can become a co-creator of his own life is an immense accomplishment.

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      • Registered — I don’t think it’s “harsh” to say that this is a defeatist stance. You also seem to confuse an argument being mocked, laughed at or otherwise attacked with it being “shot down,” i.e. credibly refuted.

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        • Well, if you say “mental illness” does not exist, they will say “fine, we will not use the term ‘mental illness’, we will use the term brain disorder”, for which there will again be protests. Then they will say “these antipsychiatry people are incorrigible and senseless. What about the man who believes there’s an alien implant in his skull and he’s trying to pull it out? What do you call that? How do you help him?”.

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          • registered, I am not sure why you are saying these things. It is not that you are not correct about how the majority of people have or will respond. You most certainly are. However, to not speak truth because the majority of people will begin by dismissing what you say and because you know how they will dismiss you has never been the way that progress is made on huge issues. There is a process here, and the process involves speaking the truth and speaking it relentlessly irrespective of how people respond. to quote Gandhi on this one, “first they ignore you, then they laugh at you, then they fight you –and then you win.”

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          • fine, we will not use the term ‘mental illness’, we will use the term brain disorder

            Good point. Which is why I also argue against the idea that there is a “something” of any sort which is simply looking for the right label. It does no good to put “schizophrenia” in quotes if the implication is that “it” exists but has been misidentified or “misdiagnosed.”

            I am in synch with Bonnie here, who has written about the “decontextualization” of experience; maybe she’d be interested in elaborating a bit.

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          • Why can’t we just call “it” emotional distress?
            Perhaps because being immobilized by distress is seen as pitiful and weak and to be condemned? Whereas being immobilized by real illness is seen as deserving of sympathy and assistance.
            Therefore, communicating distress is done via symbols and codes such as alien implants, CIA spying etc.
            Yet the fact that all the hype about eliminating “the stigma of mental illness” has been shown to be a sham – there is still the stigma, and perhaps it has even become greater – shows that deep-down, people know that “mental illness” is not the same as a broken leg (or a broken brain, even).
            Just as being highly sensitive is seen as a defect in most of the Western world, so too are the consequences of that sensitivity. We usually don’t value the depth that sensitive people bring to the world – we instead value the “get up and go” people who are the big movers and shakers and achievers.
            If we want to really help people in distress, we will have to learn to value their unique contribution. There are cultures who already do, and they are the better and healthier for it.

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          • You have to know the context in which that person thinks what they think. When you understand the context, you understand what they are up against, what they mean by what they say. Calling something either a brain disorder (which it is not) or a mental illness (which is nonsensical) eliminates the context that will help you understand what what the person is dealing with and instead substitutes an arbitrary label that you apply which is mistakenly called treated as causal.

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  18. The sad truth is that both psychiatrists, psychiatric nurse practitioners, and psychologists are so fully indoctrinated that schizophrenics and their families will never hear any option other than taking antipsychotic meds for the rest of their lives. Even though I was experiencing severe side effects from Geodon, I made the assumption that what they were telling my parents and me was correct and that they had my best interest in mind. It wasn’t until I ended up in the emergency room from the side effects that I first heard anyone say that what I was experiencing was caused by the meds. And she was just a regular nurse. I would also sadly have to point out that my ordinary doctor never warned me about any of the psych meds I was on. He didn’t prescribe them for me since they were prescribed by the psych nurse at the clinic, and he simply didn’t seem to care nor want to intervene with what the psych nurse was doing to me. So, you can’t expect any help from your family doctor. The ultimate weapon against them is the internet where you can enter Geodon and get all sorts of responses from various people who’ve had horrible side effects from it. I encourage everyone who has ever suffered from any psych meds to be vocal about it and warn others about your experience with the drugs. If everyone who has been hurt by psych meds would post their experience on various sites on the internet we could overwhelm psychiatry’s lies.

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  19. People who are subject to Community Treatment Orders are forced to take ‘Antipsychotics’. ‘Antipsychotics’ are most correlated to Akathisia. Akathisia is NOT just a movement disorder, but the most horrific condition a human could experience without any ostensible physical harm, indeed it potentiates suicide/homicide ideation and completed suicide/homicide. And that’s just for starters. Only wish I could show you all on here, a reply I have from the General Medical Council of a complaint I put in regarding these drugs, CTO’s a psychiatrist and their analogy of patients subject to CTO’s. It sickened me.

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        • Streetphotobeing – do you have someone you can trust to help you with this complaint? I used to work as a volunteer advocate for a brilliantly run local advocacy group, and this was just the kind of thing we were able to help with. Unfortunately the shoestring funding we had from the council was pulled and handed over to MIND, so it has folded… but maybe there is a similar setup near to where you live…?

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          • Thanks for that. “but maybe there is a similar setup near to where you live…?”
            Unfortunately… nope.
            It’s as far as it can go re the psychiatrist but that one was not regards me in particular, how ever I have widened it to ask the question to the General Medical Council in view of what they say on their website :

            “We help to protect patients and improve medical education and practice in the UK by setting standards for students and doctors. We support them in achieving and exceeding those standards, and take action when they are not met.”

            I’ve also put my own complaint to the Parliamentary and Health Service Ombudsman – which has been going on and off for a good 6 months now – they say they will inform me late next week if they are going to further investigate the matter. At the moment I can not go into detail and not sure if I will after it either. Thanks to all the work of Robert, Philip and everyone who posts on here, I’ve been able to reference their work for my case.

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  20. I’ll post the question I’ve asked the GMC after they replied to me:

    “This is what it says on your ‘about us’

    “We help to protect patients and improve medical education and practice in the UK by setting standards for students and doctors. We support them in achieving and exceeding those standards, and take action when they are not met.”

    How would you protect patients who have been coerced or forced onto drugs (anti-psychotics) that cause akathisia (clearly stated in the literature to cause suicide/homicide ideation and completed suicide/homicide) from psychiatrists who do this, let alone GP’s prescribing children SSRI’s?

    Now I do not expect a clear answer, but do you not think it about time that this appalling situation be investigated ? And in the context that it is not a a rare condition. If you take an SSRI and then say Nytol (it has valerian which blocks Cytochrome P450) not uncommon if you have anxiety and insomnia, you WILL go into akathisia with in hours. Even black tea inhibits Cytochrome P450.”


    Just to be clear, I’m not on a CTO. I’ll ask the Ombudsman next week how much I can talk about my case.

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    • streetphotobeing – you said… “I’ll ask the Ombudsman next week how much I can talk about my case.” In addition to this, you might want to ask what action they would take if you do discuss it. I can understand restrictions due to confidentiality if the case is about someone else, but what can they do about you discussing your own case?

      Best of luck!

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      • I had tried to post a comment on the NHS Choices website, where you can rate a hospital with a comment but NHS Choices moderated it, when I asked why, they just said the Ombudsman had put a stop to it. The Ombudsman communicate via Egress Switch and classify all the correspondence – at least to me – as sensitive.

        And Thank you.

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  21. The Parliamentary and Health Service Ombudsman are going to formally investigate my complaint. It’s taken a long time and been very trying, grasping all the literature studies that are relevant. They are going to gather papers and prepare a case and they could still decide not to investigate or to change it depending on what they find. And again, thank you all on here, whom I have referenced. That’s all I can say.

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    • Thanks for the update. Well done for pursuing it this far – I know how much time and energy it takes, and I’m impressed by your tenacity. I hope you get some answers from them, and I have my fingers crossed for you. Be prepared for the long haul (I guess you know that already!) Please feel free to contact me privately by e-mail if you like, you can find my contact details at

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      • Thank you for that. With these people it’s all about facts – like a court case – the utter horrific hell you went through.. well it seems they expect you to accept an apology… it’s so much more than that when your identity is almost wiped out.

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  22. Suggestion of further research with focus on recovery

    I appreciate your constructive contribution: “Strategies for treatment discontinuation or alternative nonpharmacologic treatment approaches may benefit a subgroup of patients … More research is needed to determine whether some individuals may respond to alternative pharmacologic or nonpharmacologic treatments for a first episode of psychosis and if so, how to identify them.” (Goff et al. 2017: The Long-Term Effects of Antipsychotic Medication on Clinical Course in Schizophrenia).

    Based on:

    size of antipsychotics effects,

    increasing focus on recovery

    falsification of current paradigm (Treatment as usual) i. e. recommendation that all individuals with new-onset schizophrenia should receive acute and maintenance antipsychotic treatment

    further research is suggested with focus on recovery.

    Effects of Antipsychotics

    Antipsychotics are used to ease symptoms (Leucht et al 2009: NNT=6) and to prevent relapse (Leucht et al 2012: NNT=3) with evidence at the beginning of the psychosis for a minority of patients. There is no evidence that antipsychotics promote “psychosocial functioning, professional functioning, and quality of life” (Buchanan et al 2010 PORT Treatment Recommendations). Bjornestad, Larsen et al. 2017 admit that evidence of long-term maintenance medication is missing: “Due to the lacking long-term evidence base (Sohler et al. 2016) …” Current use of neuroleptics has been criticised. Studies show the advantage of a shift to lower doses for fewer patients over a shorter period of time.


    Recovery is used in several meanings and has gained attention and has now become mainstream. Both the United States, Canada, New Zealand, Australia, the UK and Ireland are building their national strategies on recovery. The Norwegian Government’s Strategy for Good Mental Health (2017-2022) “Mastering Life” is based on WHO’s Action Plan 2013-2020 and The European Mental Health Action Plan 2013-2020 and EU JOINT ACTION 2016. The Norwegian Mental Health Expansion Plan mentions the needs of the user/patient as a starting point, “mastering one’s own life”, “successful return to working life” and “entering into a social relationship with family and friends” (Ottar Ness 2015). Recovery rates decreased: «17.7% in studies between 1941 and 1955, 16.9% in 1956–1975, 9.9% in 1976–1995, and 6.0% in studies after 1996» according to Jaaskelainen et al. 2013.

    Wunderink et al 2013, Jääskeläinen et al. 2013 and Harrow et al. 2007 deal with recovery.

    Naturalistic studies of Open dialogue reported good outcomes looking at recovery, reduces schizophrenia per year and reduced disability benefit. The evidence in support of OD has been criticised being of low quality, and randomized controlled trials are required to draw further conclusions.

    Falsification of Treatment as usual

    Tomi Bergström, Jaakko Seikkula et al. 2018 compare FEP Open dialogue patients with all FEP patients in Finland over a period of 19 years. Open dialogue (OD) uses neuroleptics for 20% of patients in the beginning, standard treatment (CG control group) 70%. 97,3 % of the CG get neuroleptics at some point. At the end 36% of OD patients use neuroleptics, for CG it is 81%. Disability allowance, readmission and patients under treatment halves with OD, reflecting better recovery. This register study bypasses ethical and feasibility problems og long-term studies.

    This register study reflects reality/facts about Finland on national level. Treatment as usual is falsified as the most effective treatment. RCTs could give further information which of Open dialogues approaches e. g. reduction of antipsychotic medication, immediate help within 24 hours, social network perspective, dialogue etc. contributes to the good treatment results.

    Studies to find out why Open dialogue promotes recovery

    Scientific studies can only explain reality not disprove. Respect of reality could considerable improve treatment and health of patients. Therefore I have asked Norwegian research institutions in 2018 to do further studies on a shift of Paradigm: Can Open dialogue improve recovery rate, reduce schizophrenia per year and reduce allowance/sickness?

    Later a “Call for Studies to Find out why Open Dialogue Achieves better Results” to US National Institutes of Health, UK National Institute for Health Research Norwegian Psychiatric Society (NPF) and NORMENT: Norwegian Centre for Mental Disorders Research has been made: .

    Both National Institute of Health Research (NIHR) and The Institute for Dialogic Practice, Northampton MA already conduct research.

    Would research with focus on recovery on the basis of exploring promising treatment results of Open dialogue be the way forward to promote and improve patients health?

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