As trained mental health professionals and clinicians, we’re supposed to understand the importance of reflection, consider our biases, be open to another’s perspective, and, perhaps most importantly, listen. But when it comes to opening up to ideas or information that challenge your worldview or how you conduct your business, on the whole, you’re doing a pretty poor job with all of the above.
For instance, in an article that an Irish news source was brave enough to publish, a woman describes her experience of fighting back against the mental health system, the trauma she experienced through so-called ‘treatment’, the harm from diagnoses, and her own recovery journey supported by Intervoice and the Hearing Voices Movement.
Rather than listen, engage, and try to learn more, professionals flooded the comment section with threats to the editorial board. In addition to reactive defensiveness, most of the comments claimed that this article was a public health danger, and was irresponsible and “unbalanced” (apparently balanced means that every statement made by a person with a viewpoint other than the status quo must be followed or preceded by an ‘expert’ statement refuting the perspective).
This is standard practice — assuming that the “experts” must be right and any opposing perspective is ‘dangerous’ or ‘uninformed’. This would be an understandable concern if it were true. But do you ever consider the possibility that it just might not be?
Most people who enter the mental health field do so with good intentions. Plus, aspects of mental health treatment can be very helpful for many. This can be true at the same time as the fact that much about the system and standard operating procedures are extremely harmful and based on elitism, oppression, and lies.
Perhaps you might take a few moments to consider: What if everything you think you know isn’t quite so?
Condemning that which you do not understand is not “help,” no matter your intention.
It has been demonstrated that clients tend to lie about how much you are really helping them — they like to be seen as nice and agreeable, probably for good reason. Aren’t those the very qualities every therapist hopes for in a client? A nice, agreeable, thankful client willing to feed our grandiose visions of ourselves. If you think this is cruel or ridiculous, then ask yourself how you react when a client is deemed “difficult.”
Do you slap a personality disorder diagnosis on them? Tell them they are treatment resistant? Dismiss their concerns as projections or primitive defensiveness? Do you then pat yourself on the back for being so helpful with your diagnosis and interpretation?
A common response might be: “Well, there are at least some conditions that are clearly neurologically- or genetically-based, so it’s imperative to get a correct diagnosis.” This statement is not based on replicable or unbiased evidence. Even if one were to concede that there is some evidence pointing to neurological differences, these can easily be explained by the traumatic impact on the brain from the environment and do not necessarily indicate any causal effect on behavior.
Brain difference does not equal brain disease.
But, at least blaming the brain helps clients feel less stigmatized, right?
The bio model of disease and biological/genetic defect does not, in fact, lead to better outcomes, increased acceptance, or decreased stigma. Rather, medicalization of an individual’s emotional suffering is associated with increased need for distance, decreased therapeutic alliance, decreased hope and harsher treatment.
In other words, diagnosing and telling someone what is wrong with them in order to try and fix them, while perhaps comforting in the short term, is actually quite harmful.
In addition, rates of diagnosed mental illness and suicide continue to increase, despite record-breaking spending on mental health care. This might be said to be a result of spending on unnecessary treatment while those in need go ignored, but then why is it that there is a dose-response relationship between increased treatment and completed suicide? Why do societies who are less “developed” fare better? And why do people who are “non-compliant” appear to have better outcomes?
Rhetoric does not equal fact.
Asserting that mental illness is an illness like any other, akin to diabetes or cancer, does not make it fact, no matter how many times it’s stated or for how long. Stating that schizophrenia is a serious illness and requires lifelong management does not make it fact. Suggesting that people have chemical imbalances that drugs can fix does not make it fact. Quite the opposite: Evidence seems to defy each of these statements.
An illness like any other: There has never been any replicable study demonstrating identifiable pathology that is akin to diabetes or cancer, in the brain or elsewhere. We keep promising “one day,” but that day has yet to (and probably never will) arrive.
Schizophrenia is a genetic illness requiring lifetime treatment: Schizophrenia, as a concept and diagnosis, appears to describe such a widely heterogenous array of experiences and behaviors as to be almost completely meaningless. It lacks validity and reliability, making it unscientific as a medical entity.
People can and do recover from experiences labelled as schizophrenic. Some might use tautological reasoning and claim “Oh, well then they never had schizophrenia in the first place,” but this is not science, it is circular and illogical reasoning.
Further, just because we’ve been told for the last century that “schizophrenia” must be genetic, the evidence is scant, at best, and rife with biases and errors that make any conclusion, particularly one put forth with such certainty, to be an illogical and unethical error. The lack of replication or conclusive genetic findings can keep being blamed on small sample sizes (because somehow tens of thousands of participants is “small”). But maybe this elusive chase for “missing genes” can be put to rest once and for all and we can finally admit that something else is going on.
Mental illness is a result of chemical imbalances: There is no evidence to support the theory that there are chemical imbalances in the brain causing states like depression, mania, or anxiety. The chemical imbalance theory is a myth exploited by pharmaceutical companies to sell happy pills. Drugs are drugs, whether legal or not, and their “effectiveness” on making us feel better does not mean that we have some imbalance that they fix.
You are extraordinarily privileged.
Granted, many individuals who work within the mental health system have plenty of experience with oppression, poverty, discrimination, and pain. I am not speaking to you; I’m speaking to the doctors, to the folks with fancy letters after their names who hold the power and influence over everyone who works underneath them. You don’t get fancy degrees without privilege.
It is nearly impossible to get through 5-10 years of training and graduate school without some history of receiving a message that you are smart, that you are capable, that you can succeed. You definitely cannot get through the process without money or a healthy sense of entitlement. Even with scholarships and stipends, one has to pay for rent, food, electricity, conference fees, travel, guild membership fees, books, supplies, etc., with little possibility of secondary work. The hidden expectation of one having the funds to cover the extraordinary expenses of graduate training is baffling at times. The idea that a student or young professional can’t afford it somehow is a laughable idea… for good reason: they almost always can.
Yes, you might have hundreds of thousands of dollars in student loans (or is that just me?), but to believe that you could even do such a thing in itself requires a certain level of privilege. People who grow up in poverty, discriminated against in school, or having to work at a young age just to get by do not tend to have the entitled belief that they can borrow such unfathomable amounts of money and actually survive. There are exceptions, of course, but this is certainly not the norm.
This is most important when considering the fact that most people who you are labelling as mentally ill, especially seriously mentally ill, have had very, very, very different life experiences than you. They tend to be poor, of a racial minority, of a sexual or gender minority, and/or severely traumatized. Of course, having any one of these particular experiences does not necessarily mean you have a clue what it’s like to experience some other form of oppression, nor does it mean that you are not still privileged.
And, dear mental health professional, you likely have experienced trauma yourself or been very close to someone who has. This does not mean that everyone must respond as you do or that adapting to society is the right way to survive.
Folks who get labelled as mentally ill also tend to be anti-authoritarian and do not accept the insane world we live in as one to be accepted or adapted to. They don’t quite fit in. To claim that not fitting in, refusing to abide by societal norms, or rebelling, even in the most unhealthy ways, against society is disease is actually, in fact, arrogance.
Being a family member of a person diagnosed as mentally ill is not the same thing as experiencing it yourself.
Most people who become mental health professionals and/or researchers do so because of their own personal experiences with extreme emotional distress; or, perhaps more specifically, close others’ experiences.
There is no doubt that when an individual is suffering that those around him or her also tend to suffer. Very few people harm others with the intent to create harm. In fact, people stuck in their world of pain and victimization are often acting from fear, not cruelty.
It can be hard to grapple with the complex emotions one might experience in response to a loved one’s suffering: anger, resentment, hatred, jealousy for the attention they receive, pain, awareness of the injustice in the world, sadness, helplessness, hopelessness, etc.
Rather than grapple with these emotions, society has created some abstract concept, “mental illness,” to direct all intolerable feelings toward. It is so much easier to be angry and resentful toward “bipolar disorder” than your father, mother, sister, or son. It makes sense. But it is an illusion.
Additionally, the destructive family dynamics that so often provide the context for so-called mental illness to develop in the first place too frequently go ignored or are deemed irrelevant.
This is NOT THE SAME THING AS BLAMING FAMILIES. Everyone suffers in their own ways, and having an identified patient who exhibits the symptoms of the family was once accepted as understandable. Everything exists within context.
Sadly, by telling someone that they are, in fact, defective (i.e., “ill”) and that the problem lies within them, you are, very directly, reinforcing the message of the family system and society. You are relegating trauma, oppression, racism, poverty, abuse, gaslighting and cruelty to the trash bin of a “trigger.” You are giving the message that “You need to adapt to this sick horrible society,” rather than acknowledging that suffering may, for some, always exist.
This will, of course, make people feel good — we all like to confirm our beliefs about ourselves, even when they include being bad, defective, or, well, just different.
You, as a family member, are just as likely to be reenacting your past and toxic patterns as anybody whom you diagnose as ‘other’.
You have been indoctrinated into an ideology.
Whether considering psychoanalytic ideas, cognitive-behavioral, medical, etc., each still is an ideology. These are frameworks and belief systems that help one have direction, provide a structure for making sense of the world, describe a philosophy of ideas about propriety and social norms, and speculate on ways to solve human suffering.
Just because it can be molded to provide a base for a randomized control trial does not inherently make it true or scientific.
At best, the mental health field is a pseudoscience providing a means for social control.
Say what you will, but no other word covers the educational process besides indoctrination. The process of obtaining a doctorate (medical or otherwise) requires submissiveness, idealization of professors, obedience, faith, and a complete intolerance for challenging of the status quo. Even as revered professionals, if someone dares to question or challenge the status quo, that person is censored and vilified. One must avoid any offense at a colleague or superior, lest they be deemed mentally ill themselves.
I have written about my own experiences struggling against this indoctrination process. Obtaining my degree required — quite explicitly — me to conform and stop questioning, to ignore a vast evidence base that refutes much of the distorted information being taught, and to violate my own integrity. Does this really seem surprising?
That is not science, that is religion. Which begs the question: Where is the line between ideology and delusion?
You are also delusional.
This statement doesn’t feel good, does it? Is your immediate reaction to recoil in anger and claim “I most certainly am not”? Might you find yourself doubling down on your beliefs in response to such a judgmental statement? So does anybody else who gets told this.
Everyone is delusional. It’s just those whose beliefs do not fit with societal norms that get labelled and drugged. Our belief systems help us defend against overwhelming existential anxiety — and we all have false beliefs that help us do so.
You have not figured out the meaning of life.
You might believe you have. The right drug, the right protocol, the right diagnosis, the right interpretation, and suddenly there’s no more suffering, right?
You just might be wrong.
And what then?
This blog is dedicated to Matt Stevenson, who always made sure that no one ever got too comfortable in their beliefs… myself most definitely included. Rest in peace sir. Rest in peace.
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.