So What is Mental Disorder? Part 1: Reasoning and Meaning

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So if mental disorders are not bodily diseases, as I argued in the last blog, what are they and how should we understand them?

I realised while trying to write this and the next two (and last) blogs how much more difficult it is to set out a positive notion of what mental disorder consists of than critiquing standard ideas. My thoughts on this are very much a work in progress.

I think both Szasz and Wittgenstein would suggest that looking for the essence of mental disorder is a mistaken pursuit. As Wittgenstein pointed out, we do not understand mental states through describing a private world or mind, we understand them through publicly manifested behaviour. Szasz famously described mental disorders as “problems in living,” or, elsewhere as “enduring patterns of human behaviour” that others find “troubling or undesirable.”1. It may be that the only definition that can be given of mental disorder is the sorts of problems that mental health services end up trying to address.

However, concluding that mental disorder is not a disease raises some important questions that bear on how we, as a society, should respond to the problems we refer to as mental disorder. Firstly, we need to ask whether the behaviour we characterise as mentally disordered is fundamentally the same or different from other sorts of behaviour. In other words, is there a case for special arrangements for some or all people who are deemed to have these sorts of problems?

To explore this question I will look at the sorts of mental disorder where there is the strongest case for there being a difference: what would nowadays be referred to as ‘psychosis’ or ‘severe mental disorder’ and in the past would have been called ‘lunacy’ or insanity. The definition of psychosis is usually a loss of contact with reality, but in the past people referred to the loss of ‘reason’ as the characteristic of such situations.

Jeff Coulter referred to the behaviour we label as mental illness as breaking norms of ‘intelligibility’(see my previous blog).2 When people are mentally ill they do crazy things, but more than this, their reasons for doing them are sometimes not based on the principles that human actions are usually based on. There is something different about the way the world is appraised and the manner in which that appraisal guides action. Take the following example:

A young man went to a police station to report that intruders had entered his house and injected him with poison. Although he had not noticed any signs of a break-in, he was quite sure this had happened because he had woken up with a headache. He also pointed to some ordinary spots on his skin as evidence of the injections. He was not able to offer any suggestions about how people could have entered his property and did not appear concerned about how this might have happened.

It seems as if this man is not using the same standards or types of reasoning that most people would use in this situation. He interprets ordinary things (headache, spots) as having special significance, and is not concerned about the sort of evidence that most of us would look for (how intruders might have entered the property).

There are two philosophical views on the nature of the impairment of ‘reasoning’ associated with psychosis or madness. The view that was dominant in the European Enlightenment is exemplified by Hegel and sees madness as a loss of rational, intellectual capacities and the re-emergence of a more primitive side of human nature dominated by ‘the passions’ (see my previous blog). In contrast, psychologist Louis Sass draws on Wittgenstein’s critique of Cartesian philosophy to describe ‘schizophrenia’, in particular, as a form of hyper-rationality, in which individuals become overly self-conscious and detached from the everyday world. People who are in this state become conscious of automatic mental and physical processes that we are unaware of most of the time (such as those involved in walking, for example). This detached or ‘objective’ attitude is a hindrance when we apply it to our own consciousness. According to Sass, therefore, “madness … is the end-point of the trajectory [that] consciousness follows when it separates from the body and the passions, and from the social and practical world, and turns in upon itself.”3

Using Heidegger’s terms, Sass’s view is that psychosis is a detachment from our primordial experience and knowledge. It is loss of the unconscious ‘knowing how’ attitude, our familiarity with the world around us that enables us to function on an everyday level, and its replacement with the ‘knowing that’ form of knowledge, the objective, self-conscious gaze or attitude. The latter is important for solving problems in ordinary life as well as in science, but it is founded upon and always presupposes the former. It is this more basic and implicit form of knowing that is fundamental to our ability to interact with the world and other people.

One of the inherent problems of a project like the DSM, or any attempt to classify psychiatric complaints, is their huge diversity. Different analyses are therefore unlikely to capture every individual’s experience of madness. Hegel’s views of the dominance of the passions might illuminate the situation of someone who is what we might call ‘manic’, whereas Sass’ descriptions might fit some people with a diagnosis of classical schizophrenia, but the majority of situations involve varieties in between and around these two stereotypes. Nevertheless, both positions suggest that some forms of mental disorder involve an alteration in the shared orientation to the world that forms the normal basis of thought and action, and that acts as the grounding of mutual understanding among human beings.

If this is the case, if madness involves a loss or failure of shared reasoning that places the individual outside of the community of immediate and implicit human understanding, does this mean it is without interest or meaning? Ordinarily, human activity can be understood as having a goal or purpose that reflects and responds to its unique social and historical context. People do things for reasons, and most of the time other people can understand those reasons, even if they would not act in the same way. Behaviour is meaningful.

The behaviour of people diagnosed with severe mental disorders often does not make much obvious sense, however. This is why it can be tempting to think of it as driven by a biological process or disease. But does the fact that thinking processes are altered or impaired render it completely devoid of meaning; lacking in any purpose?

Another way of putting this question might be to ask whether madness is part of the individual’s ‘self’ or whether it should be regarded as something separate. We can understand ourselves as unique individuals with various goals and desires, sets of beliefs and emotional inclinations, all of which have been moulded by our individual history, interact with each other and are in a constant dialogue with the world around us. Some aspects of our nature are likely to be determined by our biology (e.g. some aspects of temperament), but these are intertwined with everything else to make us the individual we perceive ourselves, and others perceive us, to be.

Many writers have tried to illuminate the meaning of madness by showing how even the most extremely incomprehensible-seeming behaviours can be related to more familiar forms of experience. This implies that we should see these states as intrinsic aspects of the self, even if they are temporary.

RD Laing, for example, suggested that schizophrenia can be understood as a form of withdrawal in the face of overwhelming ‘ontological insecurity’.4 Laing compares this to the tendency to dissociate ourselves from immediate reality in order to cope with more familiar forms of anxiety. Szasz also proposed that a psychotic state can be a “solution to the meaning(lessness) of … life.”

I find parallels with addiction to be useful too, as elaborated by Richard Lewis. Addiction can be understood as a coping mechanism for dealing with unwanted emotions that “gets stuck in the on position.” Drugs can bring immediate relief from negative emotions, but they can become a self-reinforcing and damaging habit that closes down opportunities for learning other coping mechanisms. Psychosis could be thought of as having a similar function. Although it can be a rewarding experience in some circumstances, there is no doubt that for many people being psychotic is distressing and frightening, which makes it difficult to understand how it can be considered purposeful. The comparison with addiction, however, suggests that initially retreat into an internal world might reduce anxiety and negative feelings; for some it creates a life of colour and excitement that replaces a dismal or painful reality. But it can become a self-destructive tendency that can be difficult to break out of.

Many other writers have grappled with the meaning of psychosis and other extreme and perplexing behaviours we label as mental disorder. In terms of helping people, what all these analyses highlight is the need to relate to people as people undergoing extreme and frightening human experiences, rather than as bearers of disease. As Laing put it when describing a particular patient’s behaviour: “one can see his behaviour as signs of a disease; [or] one may see his behaviour as expressive of his existence.” The film Mad to be Normal documents Laing’s time at Kingsley Hall, the therapeutic community he founded for patients and ‘professionals’ to live together. His idea was that only by enduring people’s psychosis alongside them could others really understand the experience.

The Soteria project was also established to reflect the view that psychosis is a ‘way of being human’.5 For its founder, Loren Mosher, this required that staff adopt a “non-intrusive, non-controlling but actively empathetic relationship” with clients, which he characterised as “being with.”6 The more recent Open Dialogue movement also reflects this approach, and the move to involve people with lived experience of psychosis or severe mental disorder in these and other services is also a recognition of the importance, but also the difficulty, of relating to some people’s experiences.

Conclusion

It seems that when we are thinking of severe mental disturbances such as psychosis or ‘schizophrenia’, we are referring to behaviour that is not just different from usual, but is characterised by the impairment of usual forms of reasoning. This contrasts with other types of behavioural deviance, such as typical criminal behaviour, for example, where intentions are usually transparent and the basis of actions understandable.

Recognising that reasoning may be compromised in psychosis does not necessarily mean that the associated behaviour lacks meaning or purpose, however. Meaning is more difficult to discern than usual, which the numerous attempts to illuminate such behaviour testify to, but this does not mean it is absent.

In some sense, therefore, states we might refer to as madness or psychosis are distinct from ordinary experience, in that people can become detached from our everyday understanding of ourselves and our world. Yet they can still be regarded as meaningful patterns of behaviour — ones that have a purpose, albeit an obscure and often objectively self-defeating one.

The next blog will look at the implications of this analysis for concepts of autonomy, agency and responsibility and the final one will explore the nature of mental disorder from a social perspective.

Show 6 footnotes

  1.  Szasz T. The Untamed Tongue. Chicago: Open Court; 1990.
  2.  Coulter J. The Social Construction of Mind. London: Macmillan; 1979.
  3.  Sass LA. Paradoxes of Delusion: Wittgenstein, Schreber and the schizophrenic mind. New York: Cornell University Press; 1995.
  4.  Laing RD. The Divided Self. Pelican Books: 1965.
  5. Jenner FA, Monteiro ACD, Zagalo-Cardoso JA, Cunha-Oliveira JA. Schizophrenia: A Disease or Some Ways of Being Human. Sheffield: Sheffield Academic Press; 1993.
  6. Mosher LR. Soteria and other alternatives to acute psychiatric hospitalisation: a personal and professional review. Journal of Nervous and Mental Disease 1999;187:142-9.

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117 COMMENTS

  1. Thank you for writing your articles. I think it is important to be able to bring philosophy into the picture, and with it, to look at the definition of what we may be dealing when we say a person has a “mental disorder”, or “problems”, or “distress”, or is “traumatized”.

    I have to see this matter of madness or “mental disorders” from a historical perspective and, therefore, the thinker that I have turned to the most is Michel Foucault. History of Madness (2006, trans. Jean Khalfa), not Madness and Civilization, the earlier truncated translation of the same book from the 1970s, is really worth reading if anybody wants to go there.

    Foucault saw institutional incarceration of the mad beginning on any sort of scale to speak of with the advance of the enlightenment. The enlightenment was all about reason, and as madness was essentially unreason, something had to be done about the unreasonable, even if it meant the reasonable had to be unreasonable about it. Prior to the dawn of the enlightenment, a dialogue existed between reason and folly/madness, and locking them up was not any sort of priority. Afterwards, you’ve got the private madhouse business, and the asylum building frenzy. In this early book Foucault is studying this relationship to madness/folly/”mental illness” as a matter of social exclusion. Later, when he looks at correctional institutions, his concerns shift to that of power relations.

    I think as important as these definitions are, they exist within a historical context, and that it is important to look at it from that angle, the angle of the history of ideas, as well.

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  2. There are different types of “psychosis.” Most people dealing with today’s mental health industry are likely suffering from an antidepressant and/or antipsychotic induced anticholinergic toxidrome “psychosis.”

    https://en.wikipedia.org/wiki/Toxidrome

    This type of “psychosis” is evil and has incessant voices, although it does not prevent a person from doing their daily duties or functioning in society. To the contrary, since one of the symptoms of this type of psychiatric drug induced “psychosis” is hyperactivity, it means one tends to keep very, very busy. Although you do sleep way too much, and there are extreme memory and cognitive issues associated with this type of “psychosis.”

    Another type of “psychosis” is a drug withdrawal induced “super sensitivity manic psychosis.” This type of “psychosis” can actually be quite exhilarating, magical, staggeringly serendipitous, and it can function to equate one’s subconscious self with their conscious self.

    I’m sure there are other types of “psychosis” as well, but those were the two types of “psychosis” with which I personally dealt. It would be nice if the doctors some day would get out of the business of making people “psychotic” with the psychiatric drugs, since this is contrary to their promise to “do no harm.”

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  3. There seems to be a third characteristic of mental disorders as conceived by the popular imagination. Complete amorality or worse. Doing totally evil things for no reason at all.

    A recent article in The Blaze stated: They have discovered the motivation for the Los Angeles shooter. He was mentally ill.

    No matter how disjointed or odd his thoughts may have been, I don’t see the future shooter sitting down and thinking, “Because I am mentally ill I am going to go on a killing spree and die myself. It’s irrational and evil; therefore I must do it.”

    Why? Because I am a villain. Nyah ah ah!

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  4. The Batman Movie Shooter went on a killing spree because he had been diagnosed with bipolar. Even then “mental illness” was not the motive. He believed he was a monster–no longer subject to the laws governing humanity. Full of grief and bitterness and envy at the rest of humanity, he murdered a bunch of “normals” as a means of ending his own life. After all his psychiatrist had assured him he had a degenerative brain disease which would cause him to act irrationally and even amorally. The “meds” could treat it but he would always be a monster and his life would not amount to crap.

    He thoroughly believed his doctor. So you could say his “good insight” prompted the killing spree.

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    • James Holmes was a student majoring in neuroscience, and he was reading about psychiatry and “mental disorders”, and it must have affected him deeply. Just imagine, you have one of these horrible things these doctors are telling you about. What do you do?

      He sought “help” for anxiety, and received SSRI antidepressants. He even told his doctor about his murderous feelings, perhaps induced by the neurotoxins in his system.

      1. Maybe his professors could have been teaching him something else besides how bad they think “mental disturbances”.
      2. There’s a good chance the antidepressants had a lot to do with his killing spree.

      Yep, the “mental health” system is in danger of manufacturing many more such “monsters”.

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      • We here at MiA are thinking “logically”, and “rationally”. (I won’t attempt to DEFINE those terms, so let’s just assume for sake of argument that we agree what we mean by them….) But psychiatric drugs, such as the SSRI’s that James Holmes was taking, cause the brain to malfunction in ways that are irrational and illogical. While under the influence of these DRUGS, our behaviour becomes illogical and irrational. Because it’s inherently illogical and irrational, it can only be understood illogically and irrationally! So it doesn’t make sense to us! What I’ve just descibed is exactly how the pseudoscience of psychiatry creates the very “mental illness” which it then purports to treat!
        (I wonder how long it’s gonna take what’s-her-name to approve this comment before it appears?….)….

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    • Actually the Easter Bunny and Santa Claus exist–not literally–but as cultural archetypes. The fact that they are so popular and deeply rooted in our collective consciousness says a lot about our society.

      If nothing else Mental Illness is a cultural archetype. It may be a myth, but it must be meaningful to many Americans on a personal level; or fewer would embrace it. I’m not just talking about psychiatric workers or grateful consumers either.

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  5. Has anyone considered that criminals use insanity for the purposes of hiding their crimes, and destroying witnesses? The tools to distort reality and use psychiatry for legal defense are broad and widely available. And yet we continue to be more tolerant as a society about drugs and we are specific as to which people we advocate for in domestic violence.

    Understand that I live in San Antonio TX, the largest city for violent crime right now in America and we have massive problems with police dropped cases and a very low number of police officers on the street. In this environment, forced drugging and lack of police presence is shutting off a system that already has overcrowded prisons and no long term mental hospital system. It is getting so bad that unseen crimes are leading to “seemingly random” violence. The psychiatrist are apathetic to many and often over sympathetic to those who are into drugs. Give it time and we’ll be the next Detroit.

    If you want to know why it’s like this, it’s quite simple. Widespread access to drugs by street sources and over prescription has lead to the tools for psychiatric abuse becoming widespread. And yet, we’re asked to be tolerant.

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    • Just for the sake of clarity, only 1% of cases attempt an insanity plea. Of that 1%, less than a quarter are accepted. Those that are denied are much more likely to receive the harshest punishment so if it is being used by criminals to manipulate the system, their counsel doesn’t understand the system or they are very bad lawyers.

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      • You forget another reality, Deena. Most “public defenders” are actually *complicit*. I was charged with a bogus, fabricated criminal charge, partly because the female public defender was trying to create business for herself, and for the local “community mental health center”, and associated “mental health court”…. She actually tried to convince me that I have a “mental illness”, and that she was “helping” me. The prosecutor tried to get me sent to the State mental hospital. But, I rejected the shyster lawyer, and fought the prosecutor. I insisted to the Judge my right to represent myself “Pro Se”. I had to suck up the fraudulent conviction, but the Judge had no other choice but to side with me on the loony bin part. Point is, so-called “mental illnesses” are used as weapons against persons the local community finds inconvenient, annoying, or challenging. This reality is invisible in the cloistered, hyper-clinical ivory tower Dr. Moncrieff inhabits.

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        • This sounds like a very interesting courtroom experience. However, my comment was really intended as a response to the claim that criminals are using insanity pleas to get away with their crimes because of how easy and obtainable an insanity plea is.

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  6. Dear Dr Moncrieff,

    Thanks for the interesting article.

    You mention “schizophrenia” and anxiety, what I notice is that most “depressed” people seem to suffer from dreadful anxiety. I identify with David Letterman (below) when he describes his own torments.

    https://youtu.be/NxUVPmrMr0s

    When I tried to quit medication many years ago I was overcome with compulsive anxiety about everything.

    But my salvation wasn’t in
    relationships, interests, love, career or anything like this.

    It was in the Realisation that if I didn’t engage my dreadful anxiety that it would eventually soften, and when this happened my mind would see things completely differently, and I would intuitively KNOW what to do.

    If I hadnt accessed this Realization I would have ended up back in Psychiatry.

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      • I’m sorry that you even USED that term “demons”. Are they “demons from hell”, or some other kind of “demons”? Are these the same “demons” that the Bible and Koran speak of? Joanna, I’m seriously disappointed that you still use the term “demons”.
        *THINK* about what you’re SAYING!…..

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    • What made me decide to make a leap and quit my “meds” as they called them was an existential question troubling me.

      Do I need these pills to make moral decisions? If I’m dependent on pills to do right I am not a free moral agent; I don’t have a soul at all.

      Now I have concluded these drugs took the edge off my conscience and ability to understand others’ feelings. I wish I had quit them long ago.

      They made me sick and miserable, but I felt I owed it to those around me –not just to keep from annoying them, but I believed I might go on a random killing spree.

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      • You have it right. When is anyone going to figure out that drugs and stress was definitely ruled the cause of mental disorders in the 1940’s? Are we as a society so used to drugs were split between terrified of them and simultaneously tolerant?

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  7. Where to begin? Moncrieff presents us with yet another article that attempts to legitimize or to solidify the myth of mental illness. As if this myth weren’t already engrained too deeply in our cultural consciousness.

    What is a mental disorder? It is a fabrication. It is psychiatry’s attempt to justify its own existence. It is a figment of the psychiatric imagination that is used as a weapon to destroy the lives of innocent people, including children, the homeless, and the elderly. A mental disorder is, in other words, a lie of egregious proportions.

    Of course it is more difficult to set out a positive notion of what a mental disorder consists of, because it is the futile attempt to make concrete something that is absolutely ethereal. To succeed in such a project would be even more disastrous than it was to invent “mental illness” in the first place.

    Moncrieff is right, however, that both Szasz and Wittgenstein would suggest that looking for the essence of mental disorder is a mistaken pursuit. But that is beside the point. Why would one wish to pursue such a disastrous course in the first place?

    As for Szasz, I don’t know how many times I need to chime in on his behalf before people will actually start to read his books, and to understand them. It is a gross distortion of Szasz’ thinking to propose that he understood so-called “mental disorders” as merely “problems in living.” This ignores entire volumes of his work in which he outlines in no uncertain terms that so-called “mental illness” is a myth. Read, for example, Szasz’ book “Schizophrenia: The Sacred Symbol of Psychiatry.” The thrust of his argument in this and in many other books is that psychiatry is fake medicine that helps fake physicians (psychiatrists) to coerce and control fake patients (the “mentally ill”). So-called “Schizophrenia” is just one of the many fake diseases that psychiatrists use to justify their fake medical interventions.

    “The claim that some people have a disease called schizophrenia (and that some, presumably, do not),” Szasz explains, “was based not on any medical discovery but only on medical authority; that it was, in other words, the result not of empirical or scientific work, but of ethical and political decision making.” Thus the only definition of so-called “mental disorders” is the definition that psychiatrists impose upon it in order to justify their practice of fake medicine.

    How should we respond to problems that are labeled as mental disorders? Simple. Stop labeling people with fictitious diseases. But this is the wrong question to consider. The real question to ask is the following: “Since so-called ‘mental disorders’ are fictional diseases concocted by fake doctors in order to control fake patients, why are these fake doctors allowed to continue to label people with fake diseases?”

    Moncrieff’s confused jumble of Wittgenstein, Hegel, Heidegger, Szasz, Laing and others does nothing but obscure the problem that she seems eager to perpetuate or to exacerbate. This is unfortunate, especially considering her sound understanding of the dangers of psychotropic drugs. In any case, who sets up psychiatrists as authorities as to what constitutes healthy reasoning vs. what should be interpreted as “mental illness”? Who else, but psychiatrists themselves.

    What if psychiatrists were to subject their own reasoning to the same critical scrutiny? Is not the practice of psychiatry, the so-called “medical treatment of the soul,” the craziest thing that a person can imagine? Should it be categorized as a disease? Perhaps the propensity toward practicing psychiatry could be called OMD, “obsessive meddling disorder” or IQD “insufferable quackery disorder.”

    Who is more detached from the everyday understanding of ourselves and the world than the average psychiatrist? By comparison, the young man in Moncrieff’s example stands out as supremely sane and reasonable.

    Again, what is a mental disorder? It is part of the deeply engrained myth of mental illness that is used to justify a system of coercion and slavery that is disguised as a branch of medicine. It is a figment of the psychiatric imagination that psychiatrists employ in order to justify their brain damaging and destructive practices. If there really were such a thing as a mental disorder, psychiatry itself would be the clearest manifestation of it.

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    • The problem with saying “mental illness does not exist” is people outside our movement won’t know what you mean. Seriously.

      “My son John doesn’t leave our house. He sits around talking to the voices he hears and barely talks to my husband or me at all. Are you calling that normal?”

      “I feel rotten all the time. I lie in bed feeling so depressed I can’t get up for days at a time. How dare you say I’m faking it!”

      Be prepared to make lengthy and involved explanations when you run around saying, “Mental illness doesn’t exist.”

      Szazs said a lot more than that! He took pains to clarify that men might hear voices telling them to murder their wives or imagine they were poached eggs. He went on to say why and how this was so.

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      • I know all too well the cost of telling the truth about so-called “mental illness.” Even Szasz refrained from writing or speaking of this “taboo” subject for many years, until he had the necessary credentials to be heard. Even then, he was mostly rejected or ignored, just like Karl Kraus before him. Of course I can’t possibly share everything that Szasz has written or said in one comment. He also said that cases such as the one that you mentioned, hearing voices or imagining things, or even cases such as the one mentioned by Moncrieff, are RARE and the EXCEPTION when it comes to psychiatry. In other words, psychiatry uses such rare and exceptional cases to justify its broad enterprise of labeling, drugging, and involuntarily incarcerating average people. Furthermore (and this is something that Szasz failed to understand completely), psychotropic drugs CAUSE people to manifest the very symptoms that are then “diagnosed” by psychiatrists as mental illness. If you don’t hear voices or think that you’re a poached egg, just start a regimen of psychotropic drugs and before long hearing voices or thinking that you’re a poached egg will be the least of your worries.

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        • It’s a very good point you make about neurotoxins causing the very things they were presumably developed to manage. My experience was that they made me madder, or at least more confused, than when I was off them, and so it was relatively easy for me to quit. I wasn’t going to continue to take drugs that were so obviously harmful.

          There are people who claim that the drugs work for them in maintaining their stability, but there is a big question as to whether or not this feeling that the drugs work for them isn’t a entirely subjective view of matter, not supported by the evidence. Certainly, the system itself takes all sort of pains to convince people to adhere to a neurotoxin regimen regardless of what the science says.

          I see the system itself as trying to run something that resembles re-education camps for anybody who would be in-compliant and refuse treatment, in other words, the only real out, as I see it, is outside the system.

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          • Precisely. Many people who think that they are being helped by the neurotoxins are simply suffering from that which Peter Breggin has called “medication spellbinding.” The question of whether or not drugs “work” depends so much upon what we mean by the word “work.” Do drugs sedate or excite the brain in such a way as to produce unnatural outcomes? Of course. If this is what is meant by drugs “working,” then I suggest that we might want to rethink the value of what “works.”

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          • The question of whether or not drugs “work” depends so much upon what we mean by the word “work.”

            You’re treading dangerously close to a critique of class rule here, DS. However since I’m feeling mildly provocative I’ll suggest that what they mean by drugs “working” includes a) being content with one’s meager lot in life as determined by those who profit from the demoralization and labor of the masses; and b) working your ass off without complaint no matter how meaningless or even destructive that work may be, just grateful that you have a “job.”

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        • For my part I started out terribly unhappy and so nervous I was scared to leave my room. Being sexually harassed almost daily for two years was behind these problems.

          The SSRI kept me awake for 3 weeks straight. That made me psychotic.

          From what I hear, my experience is so typical it’s boring.

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        • I think it’s simple to explain. “Mental illnesses” as defined in the DSM are not scientifically true. What is called “mental illness” is very real. It’s the names they put on them, or the way psychiatrists group people together that have little to nothing in common that is the trouble.

          OK, it’s not simple to explain, but it isn’t that hard, and NOT explaining it means allowing the mythology of the DSM to continue unchallenged.

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          • It’s more complex than you think, and I don’t think you’ve explained anything, as you refer to “them,” which implies there is an “it”; however there is/are only infinite behaviors and states of mind which are problematic to someone somewhere, each of which represents a unique culmination of a lifetime’s experience for a particular person. The fact that the unique experiences of more than one person may evidence superficial similarities in their outward expressions does not mean that these people belong in a category. So to say “‘mental illness’ is ‘really’ X” is logically equivalent, as DS says, to saying “the Easter Bunny is ‘really’ X.”

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          • Yes. Exactly Oldhead. This point is crucial. The only sense in which “mental illness” is very real is that “mental illness” is a very real myth. It’s not just that the fictitious diseases in the DSM are not scientifically true. That’s the outgrowth of a larger problem. The fictitious diseases of the DSM-V, for example, would not be so widely accepted if the myth of mental illness itself were not so widely accepted. What is called “mental illness,” therefore, is no more real than the Easter bunny, but it is a lot more dangerous. Szasz liked to refer to mental illness as a myth and a metaphor because he made a distinction between actual brain diseases (i.e. cancer, tumors, etc.), and fictitious “illness” of the mind. “Mental illness” is a metaphor that people who occupy positions of power and authority apply to those whose behaviors they dislike or who simply don’t fit into their preconceived notions of “mental health.” It’s a very powerful and convenient weapon that has been used against political dissidents, and many others. Think of it for a moment. What do people mean when they say “mental illness”? There is no biological marker or blood test or any other proof for the existence of such a thing, and yet millions of people are “diagnosed” as “mentally ill” and subjected to psychiatric “treatments.” It’s a veritable witch hunt. In former times, false priests ostracized and condemned certain people through the use of abstruse Latinisms and labelling people as witches. Nowadays, the pseudo-medical, pseudo-religious priests of psychiatry ostracize and condemn certain people through the use of DSM labels. False priests drew their authority from false religious beliefs and practices, whereas psychiatrists draw their authority from the myth of mental illness. Once the myth of mental illness is exposed, the entire enterprise of psychiatry collapses. This is why it is crucial to expose the myth of mental illness for what it is.

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        • People are morons. And they enjoy being stupid and ignorant. That’s why they go around saying garbage like, “Zoloft is my salvation!”

          Tell them the drugs aren’t magical and the chemical imbalance is a myth and they throw temper tantrums accusing you of blackest villainy and trying to steal their “meds.”

          My response? Call yourself a sick, crazy bipolar/schizo and take your damn drugs! You’ll only have yourself to blame when you gain 100+ pounds, can’t think straight, lose your job, lose your family, and people treat you like a monster!

          Stupidity bites.

          My guess is there are kickbacks to embracing the role of nut-job.

          1. You can act like a jerk. As long as you’re “meds compliant” you can abdicate moral responsibility for all bad behaviors.
          2. You can loaf all day and never have to grow up or take on adult responsibilities.
          3. Maybe you like the way those uppers make you feel. Just like the meth or speed addict.

          Apparently people beg to enter the system. I read a blog by a psychiatrist (more honest than most) who swore that for every unhappy person who left or tried to leave the system there were dozens–maybe hundreds–begging him for drugs and MI diagnoses.

          Such willful ignorance! I’m becoming a misanthrope. 😛

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      • FeelinDiscouraged

        I support your comment.

        Thankfully the reality is that People can overcome dreadful situations and make Complete Recovery with suitable help.

        Dr Allen France’s (Link below) on Elanor Langdon

        https://m.huffpost.com/us/entry/3792524

        But if Elanor Langdon did not get the help she needed by way of Non Drug Human support, the outcome could have been absolutely dreadful.

        The first time I tried to stop taking my “medication” with permission, but without taper in 1983, I ended up in hospital.

        When I was in hospital I got talking to a Psychologist. In the course of the conversation I was amazed when the Psychologist reassured me with complete confidence, that every single “patient” in this hospital could make Full Recovery through non drug means.

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    • Dear Slaying the Dragon,
      I agree with you that we should jettison the concepts of mental disorder and mental illness but I do not agree that that will make the problems we now refer to as mental disorder go away (or at least not the sort that I see, or most of them). I also think you are wrong to imply that Szasz felt there were no problems to deal with. He wrote many times about how the term mental illness/schizophrenia refers to behaviour that bothers or disturbs people (the sufferer or other people around them). The example I gave is not rare in my sort of practice, it is quite routine, and people with these and more severe problems have been documented throughout history. I don’t know what things are like in the States, but in the UK resources are far too thin to be locking up anyone who is not pretty badly disturbed.

      I am not trying to say that there is a thing called mental disorder that is a bit like disease. But I do think there are certain patterns of behaviour that can be problematic in various ways to other people or to the people themselves. Some of these are characterised by what I referred to as an impairment of reasoning, but I was not trying to argue that this should be judged by psychiatrists. I think how we judge it is complex, and there should be a democratic debate about how to do it. In the US this used to be done by a jury – I would be interested to know whether you think this would be better or worse than having psychiatrists doing it?

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      • How is it possible to agree that we ought to jettison the concepts of “mental disorders” and “mental illness” and almost in the same breath to call for ways to reinforce these very concepts? With all due respect, it doesn’t make sense. What exactly are the “problems that we now refer to as mental disorders”? Who is the “we” in this sentence? Do people have problems? Of course. Have people always had problems? Naturally. Are those problems a manifestation of a “mental disorder” or a “mental illness”? Not at all. Does psychiatry have the capacity to address or to resolve such problems? Not remotely. The opposite is true. Psychiatry causes or perpetuates what is sometimes interpreted as “problems in living.”

        I did not imply that Szasz did not recognize that people have “problems in living,” or that they do not exhibit behaviors that “bother or disturb people.” My point was that this was not the crux of his argument. Szasz was far more critical of the purveyors of the myth of mental illness than he was of those who struggle in any way. Even so, Szasz didn’t quite comprehend the power of psychiatry to create the very “problems in living” that are so often interpreted as “mental disorders.” Psychotropic drugs, just to name one example, are one of the major causes of the epidemic of that which is perceived to be “psychosis.” Other cases are exceptional, outliers, and even these people ought to be respected, as Szasz was fond of saying, as responsible and free beings.

        Could it be that the most disturbing behaviors are actually those manifested by psychiatrists who persistently seek to “diagnose” and drug people? If there is one person in a million who thinks that he or she can fly, why not leave that person alone and go after the hoards of psychiatrists, social workers, and so-called “mental health” experts who think that they have the power and the authority to “diagnose” fictitious diseases, and by so doing, drug people into a state in which they not only think that they can fly, but also carry out their plans (yes, drugs often CAUSE suicide). The truly disturbing behavior is not some random individual who thinks that the CIA is after them or that the TV is broadcasting his or her thoughts. These people are the epitome of sanity compared to those who apply DSM labels to innocent people, including little children, the homeless, and the elderly.

        The kinds of problems that are routine in your practice would be much less so if your practice did not exist. Psychiatry causes the vast majority of those problems, and for the rare exceptions, it has been proven over and over again that in societies that are not dominated by psychiatry, people with such “problems in living” find healing and hope in their families and communities, and are eventually reintegrated into society instead of become social pariahs and scapegoats.

        And what is this about locking up people? That’s what psychiatry does best. As Szasz frequently pointed out, psychiatry inculpates the innocent (by means of “mental illness” mongering), and it exculpates the guilty (by means of the insanity plea). Under psychiatry, the practice of involuntary incarceration in prisons is euphemistically referred to as “hospitalization.” Drugging is called “medication.” Ostracism is called “diagnosis.” Jailers and wardens are called “doctors.” And so forth. Psychiatry is, as Szasz rightly demonstrated, the “Science of Lies.”

        And what are these patterns of behavior of which you write? Of course there are patterns of behavior that can be problematic… psychiatry produces a wide variety of disturbing behaviors, the most disturbing of which are manifest by psychiatrists themselves. But psychiatrists’ behaviors are more than problematic… they are harmful and dangerous. Szasz was very clear that the concept that patients are a “danger to themselves or others” is one of the most deceptive lies of psychiatry, but he was also very clear that psychiatry causes the very harm that it purports to cure.

        The most impaired kind of reasoning is the reasoning that produced psychiatry in the first place. Perhaps there can be a democratic debate about how to abolish psychiatry. Perhaps psychiatrists should be subject to trial by jury and held accountable for their crimes. How do you think that the concepts of “mental illness” and “mental disorders” ought to be jettisoned? In what way should psychiatrists be held accountable for their crimes?

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        • “Psychotropic drugs, just to name one example, are one of the major causes of the epidemic of that which is perceived to be “psychosis.””

          Absolutely correct. Pharmacogenetics and all the common food stuffs, herbs and spices that inhibit the metabolizing enzymes will prove this. Psychiatry will not allow this to come to the forefront.

          ∴ psychiatry must be buried.

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      • In 1 Samuel, David is fleeing King Saul whose jealousy has driven him crazy so he wants to murder the folk hero.

        David seeks refuge in enemy territory with the Philistines. Fearful that their king will recognize him, David fakes insanity. He froths at the mouth, refuses to talk, and marks various doors. (With chalk or–maybe like a dog.)

        “Don’t I have enough loonies to worry about without bringing me another?” demands the Philistine king. They show David the door and he escapes.

        This was written thousands of years before psychiatry. Madness certainly existed.

        But it’s interesting. To be “mad” back then usually meant you were so out of it you couldn’t talk or at least talk coherently and ran around like a rabid animal. Much higher standards for insane behavior. 😀 Also.notice the king was annoyed rather than frightened. He didn’t lock David up; he just drove him away.

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    • The young man you describe as “reasonable” – well, if you asked him, i think he would say he was suffering. I don’t think he would be enjoying his “psychosis” whatever you like to call it. Maybe you could tell him, “There’s nothing wrong with you! In fact, you’re prime material to become a shaman!” But he doesn’t live in Africa. He lives in NYC and wants to be able to function.
      You are very eloquent in your arguments that “there’s no such thing as mental illness” etc. and somehow, i’m beginning to wonder if you have any first-hand experience with “madness.” Sorry, but it’s not something you can let go along its merry way. Things don’t usually end up so merry if you try that. Laing didn’t do that either. He recognized the need for a place to “chill.” Call it what you like, but there is a problem to be dealt with. The question of prosecuting psychiatrists for crimes against humanity is unrelated. Why do you have to conflate the 2 issues all the time?

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  8. I think the world has already determined the cause of mental illnesses.

    Like with schizophrenia there are many reasons it can onset.

    Biological root is one, trauma, issue during preganancy, an injury to spine or cranium. The lists even goes on.

    Try to note that Psychology is an ABSTRACT science and also a SOFT science. You know what I mean with that?

    It takes the skill and know how of a trained professional to determine the root.

    If you begin to know the root it’s not actually clear how to move forward with healing. In other words how to treat is not ABSOLUTE.

    Healing can take a variety of methods and of course medicine is one way to support recovery.

    To conclude in my opinion the world knows the cause of schizophrenia. I would not hold my breath that scientists will identify a specific gene or bio marker. That may even be a waste of time and research money. In the end it’s your own battle and you own it.

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  9. I have schizophrenia and to me its a real biological illness. (See comment above about other causes.)

    It’s more like heart trouble than something else because it is a significant organ like the heart. I don’t really prefer the diabetes comparison.

    It’s definitely an illness with me because of the privation of my brain functioning. I lack capacity to function and maybe even survive.

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    • A “myth” in this sense means a belief system that is not necessary ENTIRELY false, but is based on assumptions that are not factual and verifiable. It is a “story” told not for the truth of it, but for the symbolic content. In other words, for psychiatry, these “disorders” are “disorders” not because there is proof of it, but because believing that makes their job seem more meaningful or confers more power to them. A myth is a way of structuring the world through a system of beliefs which are not verifiable, but are held so strongly to be true that questioning them often feels like some sort of attack on reality.

      In my personal observation, it appears you have been both exposed to and indoctrinated into these myths to a heavy degree, as many people here have been initially. It appears you have become aware that the truth varies from what you have been told, but it seems like it’s hard for you to conceive that this mythology is both intentional and known to be less than truthful. It’s very hard to emerge from this mythology, because it means accepting you’ve been deceived and that the general field of psychiatry has not had your best interests at heart.

      Remember that something mythological doesn’t have to be entirely false. It can be true, for instance, that some people feel better when they take psychiatric drugs, or that biology plays a role in at least some people’s “mental illness” as identified by the DSM. The fact that there is some truth in the myth doesn’t make it any less of a myth, because the point of the myth is not truth or falsity, but control over the belief system of those who are exposed to it.

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        • The “Fraud of Mental Health Treatment”, it must be like planting an mirage, or “The Fiction of Mental Illness”. Mental illness isn’t a fraud, it’s a premise and a theory, a complaint, and/or the cardinal belief of a certain pernicious religion. The medical treatment of non-medical conditions is fraud. To say much fiction is derived from truth, sure, but fiction doesn’t make it real. Were we to separate the truth from the non-truth, well, doing so doesn’t pay now does it? Thomas Szasz does a lot of separating the fiction from the reality, but doing so doesn’t support the business end of selling diagnoses and drugs, the main factor involved here. The other side of this matter are all those economic dependents that this kind of system manufactures and manages. Now we’ve got this entire service industry that has grown up around the idea of managing the under employed, be they homeless or diagnosed. You’ve got service industry careerists who realize they can’t get these people “healthy” (i.e. employed) without jeopardizing their own careers, therefore, it is convenient to pin it down to “the human condition”, and claim that it would be impossible to do so.

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        • Good points, all. Szasz entitled one of his books “Psychiatry: the Science of Lies.” That is a great book, and a great title. Perhaps the term “myth” is too congenial, since there are many good myths. Psychiatry is a fraudulent pseudo-science, and the mental illness illusion or chimera forms the base of this pernicious practice. This is one of the reasons why I chose the name Slaying the Dragon of Psychiatry, because it will take a good myth, or true symbols, to conquer the bad myth and false symbols of psychiatry.

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          • Szasz did a lot of good work, wrote a lot of good books.
            Where did it get us?
            All of you people write lots of good stuff – to people who already believe that “there is no such thing as mental illness.”
            Great! Now that we all agree, can we also agree that there is no point in telling each other another million times the same thing?
            Can we agree that in order to achieve something we have to do something?

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          • Then go ahead and do something Julia26. The rest of us are actively involved in slaying the dragon of psychiatry, and not just on the Mad in America site. Furthermore, the people who read these articles and these comments need to be educated and taught the truth about psychiatry. There is no reason why we shouldn’t do that here, as well as in other forums.

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          • I think you’re deliberately missing the point.
            Here on MIA we have a concentration of well-informed people who are full of energy and enthusiasm – but it doesn’t seem to translate into anything other than telling each other the same thing over and over.
            I do what I can – which isn’t much, given that I don’t live in Europe or the U.S., have zero spare money, and am busy raising a household with 7 children under the age of 10. But even if I could do more, what is lacking is not individuals doing what they can, but organized, planned action.

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          • “Don’t waste any time in mourning. Organize.”
            ~Joe Hill to big Bill Haywood

            Let it be remembered that Thomas Szasz was certainly better than all talk and no action. Firmly committed to ending coercive psychiatry he was instrumental in organizing the American Association for the Abolition of Involuntary Mental Hospitalization hat existed during the 1970s. When that organization folded, he joined together with the Church of Scientology in co-founding the Citizens Commission on Human Rights which is still very much in existence today. Psychiatry, and the entire “mental health” movement, are very organized, and if we expect to get anywhere against them, we’re going to have to do some organizing of our own.

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  10. Myth comes from mythos, Greek for story. Should you start believing those stories, you’ve got a religion. Should you cease believing them, you’ve got a dead religion. Either way, you’ve got a lot of superstition. Stories may contain truths.

    Truth comes from the Germanic, it means ‘having good faith’. Deriving perhaps from ‘tree’.

    Skeptic, derives from the Greek word meaning ‘inquiring, reflective’, and related to a word meaning ‘to reflect, look, view’, and further ‘to observe’.

    Let see. What does myth relate to…Oh, yeah. Tall tale, and every tall tale is a whopper.

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  11. Combinations of childhood trauma,poverty,discrimination,loss,stress,drugs,
    and shock produce biochemical cascades leading to psychosis.

    The psychiatric myth is that the root cause of psychosis is a life-long
    incurable dopamine dysfunction which requires life-long drug treatment.

    The truth is that people can and do recover from psychosis without drugs.

    The lived experience of psychosis suggests that for a time some brain functions are inhibited while others are activated, leading to delusions,
    hyperactivity and loss of judgement. It seems possible that this is an
    evolutionary adaptive reaction to enable change within destructive
    environments by searching for alternative solutions.

    Our brains are wired to test hypotheses against reality, to try out
    various “delusions” and discard them in favour of reality.
    The psychiatric paradigm is broken. The disease model has crumbled.

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  12. Joanna Moncrieff says: “I don’t know what things are like in the States, but in the UK resources are far too thin to be locking up anyone who is not pretty badly disturbed.”

    Oh dear, if only that were true. Where do I start? How about with the profit motive…

    “Private providers of NHS mental health care lock patients in more often than NHS trusts… That may fuel suspicions among NHS mental health staff that private operators hold on to some patients longer than necessary in order to maximise profits.”

    https://www.theguardian.com/society/2017/jul/20/thousands-of-mental-health-patients-spend-years-on-secure-wards-nhs

    Then there’s straightforward, shameless abuse of power…

    https://www.youtube.com/watch?v=TaExut-MeAk

    And, most heart-breaking of all, a callous, inhuman inability to empathise, compromise or heed pleas for mercy…

    https://www.youtube.com/watch?v=BBJBMXw7-fw

    Any more for anymore?

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  13. Do not really understand why Joanna doesn’t do something else. Why would you, on the one hand put forward on your website many of the horrendous reasons not to use these drugs – and thank you very much for that, it was very very much appreciated – and still work at the very same thing…. giving SSRI’s and the rest, which is the NHS standard NICE procedure, and which you have stated you would ‘never under and circumstance take’. You know that the patient is unwittingly playing Russian roulette with SSRI- and almost all the other drugs- drug induced akathisia. Why would you do that and not do something else? Forgive me if wrong, but I’m informed you section people as well. Again, why would you want to do that, would you do it if you were paid minimum wage or if it were possible as a voluntary job? I do not mean to ‘attack’, it’s just fascinating to me, how this can be and how it came to be allowed to be. I mean would an NHS heart surgeon be allowed to totally trash his/her own profession on their website and then practice the very same thing?

    Have to be fair and balance this. The RADAR program is excellent work and very well done to you on that.

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    • Thanks for this. I understand why you are asking. What I am trying to say in these blogs is that although the behaviour we call ‘mental disorder’ is not a disease, some of it does nevertheless present a problem that society needs to address, and indeed always has addressed in one way or another, long before psychiatrists appeared. I am trying to work out a fairer and more transparent way of doing this that does not involve labelling people as ‘diseased’ and thereby invalidating them. In my ‘day job’ I try to help people to find alternatives to drugs for managing their distress, and when nothing else works to use drugs as safely as possible to help suppress distressing or debilitating (usually psychotic) symptoms. Sometimes I am involved in use of the Mental Health Act (sectioning people) when someone’s behaviour is out of control and posing a danger to themselves or others. This is, I acknowledge, a form of social control, but I think it is sometimes necessary. What I am uncomfortable about is that the process is presented and understood as if it were a medical procedure which it is not, and which prevents it from becoming more transparent and accountable.

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  14. It appears to me that a great many people who have commented haven’t understood the article or are just giving their usual response we read frequently on MiA- its a justifiable argument to present the Szasz anti-psychiatry argument – and I can understand how many of you are angry at what psychiatry has done – but it seems that it is arguments like Joanna is writing that is going to dismantle psychiatry – not just your expressions of anger. I would like to hear from some more philosophers, especially those with a Wittgenstein bent. I think he holds a key because unlike Descartes he starts out from a position of social unity, whereas Descartes starts with individualism.

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  15. This is a really important debate, even though when I saw it was under the mantle of philosophy I was apprehensive. The labelling of people with a biological illness or disease is dis-empowering and demeaning in my view, it seems to be designed to dent your hopes and make you compliant. I tend to think of it as a deep psychological injury, but sometimes you see exactly what Joanna points to: a reasoning approach which seems OK to a point but with a gaping flaw. But then again a large number of psychiatric doctors seem to suffer from some kind of erroneous group think, so maybe we shouldn’t be so judgemental. I think its phenomenal that she has the courage to stand up for what I think is common sense, and I’m looking forward to the results of RADAR.

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  16. I would like to thank Joanna for offering a thoughtful article about how we might best think about the problems that get called “mental disorders.”

    I know a lot of the focus of MIA, and especially of many of the commenters on MIA, is problems caused by those who try to “treat” “mental disorders” – and those problems are so great that it isn’t surprising some propose we would be better off if we just didn’t recognize anything like a “mental disorder” by whatever name – then there would be no efforts to “treat” anything, and no treatment induced damage!

    This approach unfortunately doesn’t work for the more severe forms of the problems that get called mental disorders – those problems can easily by themselves lead to severe life disruption and often death if not addressed in an adequate way. So playing “let’s pretend that the only kind of problem in the “mental health” field is the treatment itself” doesn’t play out well in the real world.

    We do need to continue to critique approaches that do more harm than good, but in a way that is balanced with an awareness that people do often require some kind of actual assistance with problems they have.

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    • The approach doesn’t work, because psychiatry continues to justify its atrocities in the name of “caring” for this mysterious and illusive group of people who are referred to as the “mentally ill.” In the real world, thousands upon thousands of innocent people, including children, the homeless, and the elderly, are being labeled with fictitious diseases and subjected to cruel punishments such as involuntary incarceration and psychotropic drugging, all because psychiatry insists upon maintaining the appearance of a legitimate medical practice while it is nothing more than a pseudo-science. These so-called “severe forms of the problems that get called mental disorder” are the exception, and not the rule, and the problems would not be half as severe if they didn’t get labeled as “mental disorder.” In any case, this is psychiatry’s alibi. It is psychiatry that plays “let’s pretend that only psychiatry has the solution to the world’s problems because psychiatrists are the experts.” Perhaps that is how the real world currently works, but that is only because the myth of mental illness has permeated almost every corner of society to the detriment of many, including the most vulnerable.

      The notion that there are approaches that “do more harm than good” is one of the great psychiatric myths that keeps the whole psychiatric enterprise cycling through endless loops of “reform” and “rethinking.” Thus psychiatry has reformed and rethought itself from whirling chairs and chains to lobotomies to insulin shock, electroshock, psychotropic drugging, and even brain implants. All this so-called reform in the name of “treating” a mysterious group of people falsely labeled as “schizophrenic” or otherwise is precisely why psychiatry has evolved into the beast that it is today. The iatrogenic harm caused by psychiatry is exponentially higher than any supposed harm that is caused by problems that others, particularly psychiatrists, label as “mental illness.” In fact, it is proven that in countries where psychiatry does not dominate, the rare individuals who might be subjected to psychiatric “care” actually recover and heal in a relatively short amount of time. In the United States, however, once anyone gets dragged into the dark web of psychiatry, it is next to impossible to extricate oneself. Psychiatry has nothing to do with assisting people with problems, and everything to do with exacerbating problems or creating new ones in order to keep the enterprise running and the dollars flowing. The horrendous thing is that psychiatrists and mental health workers continue to do this damage with the approval of their own conscience:

      “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.” – C.S. Lewis

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    • I disagree, Ron. The reason there are approaches that do more harm than good in the first place is because such “care” began as incarceration. The problem with our “care” today is that it feeds the “mental illness” industry. In other words, “mental health” treatment is always a euphemism for “mental illness” treatment. “Mental health” doesn’t require any “care”. Accept people as they are, and you get rid of all that.

      Nursery school for repeat adult child nursery school flunkies? I don’t know, Ron. I’d think there should come a point when people can leave that kind of thing behind them.

      My big beef right now is how all this talk about getting more government funding for alternatives expands the “mental illness” system, and works against, abolishing force and protecting human rights. You’ve got “peer” agency bureaucrats who are as cynical as any psychiatrist. Along those lines, I’ve got to look a little aslant at you sometimes.

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    • Hi Ron, thank you for making this point. I understand people’s anger about the often nasty treatments that psychiatry inflicts on people, thats why I have spent much of my life desconstructing the evidence for drug treatments. But there are real problems out there that are not just created by psychiatrists, psychiatric drugs, or the mental health system. I want to think about how we, as a society, might approach these problems without medicalising them.

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        • Intense fear of being around people making a college freshman stay in their room all the time. Being unable to eat normally. Flashbacks to rape that won’t go away. Being so unhappy you want to kill yourself or feel you can’t leave your bed. That kind of stuff.
          Are you saying those problems aren’t real–regardless of the cause?

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          • Zoe_Awakes,

            those are real and perplexing symptoms of real problems, but just like any real and perplexing symptoms of real problems, they have nothing to do with fictitious “mental illness.” Furthermore, the symptoms that you describe are very often, though not always, brought about iatrogenically by psychiatry itself. The question is not whether or not there are real problems in the world. There are real problems in the world. But psychiatry is responsible for many of these problems and in no way remedies any of them. In fact, a person with the problems that you described will find his or her problems compounded 100 fold by psychiatric “treatment.”

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          • SDP, I certainly can’t disagree with you. I belonged to a support group for people who have been abused by fellow members in the church. The well-meaning (but clueless) ladies running the forum were arguing how wonderful psychiatry was and how abuse victims should not be afraid to get “help they needed.”

            Nothing drugs and stigma can’t fix, right? Abusive spouses and parents will love the handle a “crazy” label will give them over the person they want to control.

            Everyone imagines it’s scientifically indisputable that brain diseases cause odd behaviors called mental illness. Have to hear this crap everywhere! I posted a couple links that showed articles saying otherwise–one by Dr. Pies himself. Then I told them to be careful since he uses big words and his article is harder to understand than a drug commercial. 😛

            No longer following that blog. Disgusted by such willful stupidity! Apparently they don’t really care about abuse victims at all or they would take time to do their homework. Damned IDIOTS!

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  17. Dear Slaying_the_Dragon_of_Psychiatry ,

    You said in a previous post:

    ” I did not imply that Szasz did not recognize
    that people have “problems in living,” or that
    they do not exhibit behaviors that “bother or
    disturb people.” ”

    Joanna has said:

    ” I want to think about how we, as a society,
    might approach these problems without
    medicalising them.”

    Seems reasonable to me.

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    • Reasonably vague, yes. The argument thus far seems to be that…

      A. people have problems
      B. psychiatrists solve problems
      C. therefore more psychiatry

      It sounds reasonable, doesn’t it? What it fails to explain is what these “problems” are, what psychiatry is, and how it solves these problems. It is, on all counts, a weak argument and just as vague as psychiatry likes things to be.

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      • That seems to be a description of the attitude of the American Psychiatric Association.

        But it bears no resemblance whatsoever to the analysis advanced by Joanna Moncrieff, who has done as much as anybody to show that the drugs are not cures and the side-effects are terrible.

        The problems of experiencing “madness” have been described at great length on this website over several years. Are you denying that these problems exist? And since they do exist, and since it is evident that the disease model of “mental illness” has been broken, and that institutional psychiatry causes massive harm and suffering, wouldn’t you want to support the idea that we, as a society, should look for ways to heal these problems without medicalising them?

        Isn’t that the core of what this website is about?

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        • Stick around waydownunder, and you may discover the truth about psychiatry. Even the notion that neurotoxic drugs produce “side-effects” is false. As yet, no one seems willing to answer my questions about just what constitutes “madness” or “these problems.” That is most likely because people don’t have a real answer. In any case, such speculation does real harm and serves as a major alibi for psychiatrists and other omnipotent moral busybodies. (see the C.S. Lewis quote above). I’ve read Joanna’s great work on psychotropic drugs, and her contribution in that regard is valuable. It’s just unfortunate that she still supports psychiatry and the use of such barbaric “treatments” for the so-called severely “mentally ill.” It will be interesting to see how she tries to work through these contradictions.

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          • Does Joanna support locking people up, drugging, shocking and defaming them?

            Emotional pain, bad habits, and using an overactive imagination for coping…these can all be real problems.

            Mind problems or soul problems. Not brain problems. There’s a difference.

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          • Read her book The Bitterest Pills. It’s a great book that unfolds a mostly accurate history of psychotropic drugs. But sadly, she fails to account for some of the most horrendous practices in psychiatry. This is outside the scope of her book, so she claims, but her position is as follows: “antipsychotic drugs can be regarded as implements of social control, but that they can also help individuals gain relief from intense and intrusive psychotic experiences or destructive emotional states.” (p. 18) That’s a very disturbing assessment from one who has studied psychotropic drugs so thoroughly. https://www.amazon.com/Bitterest-Pills-Troubling-Story-Antipsychotic/dp/1137277432

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  18. I’d like to comment on the two competing theories mentioned about the nature of the impairment of reasoning associated with “madness,” one involving the loss of reasoning, the other involving hyper-rationality detached from “the everyday world.” I would like to point out some ways these may be more complementary theories rather than competing ones, in the sense that the one leads to the other, like yin and yang.

    It might be more accurate to say that “sanity” is based not on reason, but on a balance or friendly relationship between reason and unreason, or as Marsha Linehan would put it, between “thinking mind” and “emotional mind.”

    In that case “insanity” is anything where this balance is missing. And often when there is imbalance, there is a going from one extreme to the other – so there might be hyper rationality detached from feeling; and then problems with that leading to feelings and emotions taking over, detached from rationality; and then problems from that leading to even more efforts to make “rational” distance from feelings and emotions that seem even more too dangerous to engage with.

    In my own experiences that were on the “psychotic” spectrum, it was these kinds of issues I was dealing with. I was very good at logic, but I also became aware of the emptiness of logic, and I would often quote Wittgenstein on that: “In fact all the propositions of logic say the same thing, to wit nothing.” To me that meant that everything was absurd or arbitrary, and rationality itself was an illusion. (Enter here a lot of disorganized or weirdly organized speech and behavior!)

    What brought me back to some approximation of “sanity” was something more emotional, an interest in human connection. I was particularly interested in connecting with others who could see the absurdities I saw: and once I found people like that, my interest in making the connections work made me focus more on that balance between reason and unreason that allowed me to connect with everyday life.

    It’s kind of humbling to many to recognize that our “sanity” is not based squarely on rationality, but on a mix of rationality with more arbitrary factors, something perhaps even more like spiritual revelation. But more awareness of this aspect of things would I think help us better understand some of the paradoxes around madness and some of the routes back to human connection.

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    • I have a little problem with the whole schema here, Ron. The first approach is the traditional approach, the enlightenment meets madness, and finds it convenient to segregate and exclude. In the second instance, Freud has stepped into the picture, the unconscious is mentioned, and a little more method is “found” to this madness, but the prejudicial enlightenment is still lurking in the background. We have to do something to help these nut-cases see the light of reason, if only in the social sense.

      I had my own “episode/s” on the “psychotic spectrum” as you put it, and I was engaged in my own quasi-philosophical quasi-religious struggle and dialectical inquiry, that is to say, I was pretty delusional. Hegel, in fact, figured pretty prominently in some of my delusions. Ultimately, with a lot of help from the “mental health” system, philosophy won the day. I don’t mean by “help” that the “mental health” system was particularly helpful. I do mean by “help” that I realized that the role of “mental patient” didn’t serve me very well, and I didn’t want to make a career out of it. Let’s just say that the penal role of psychiatry convinced me that it wasn’t a direction that I wanted to pursue.

      Of course, there’s a lot of folly in the world, and some of it has to do with the blind side of reason, it’s answer to folly, but either way, were I a more religious man, I’d be seeing endless folly. Why? Wisdom isn’t innate, wisdom is acquired. I wouldn’t make too much of the blind side of reason, any more than I would make much of the blind side of folly, be it this hyper(un)consciousness of unreason, or something else.

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    • Ron

      You said: “It’s kind of humbling to many to recognize that our “sanity” is not based squarely on rationality, but on a mix of rationality with more arbitrary factors, something perhaps even more like spiritual revelation.”

      Your reference to “spiritual revelation” needs to be clarified. I do not view this “spiritual” necessity in a religious sense, but in the sense of the need for “human connectivity.”

      In order for us to truly believe that our “rationality” about the world makes complete sense, is to have VALIDATION from other human beings in our social group.

      It is very difficult to sustain oneself as a “voice in the wilderness” for an extended period of time. Loss of sanity usually comes when someone is engaged in a perpetual dialogue within themselves with no “validation” from other people around them.

      Richard

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      • Hi Richard, what I was trying to say is that we need to accept something that doesn’t have its source in rationality, and this process may seem to be spiritual – about faith, not rationally sourced – though others might describe the same process in non-spiritual terms.

        The “validation by others” thing I agree is important, but it’s tricky. I developed my rational side in the first place in a large part so I could protect myself from the destructive side of the views of others. I was getting defined in a negative way by others, so learning to reject how they thought, to see the holes in their views, was important (just as it is important for those negatively defined by psychiatry to see the holes in the reasoning of psychiatry.) But then, if I wasn’t going to accept what others validated, what was I going to use as the basis of my understanding of world and self? It was like I had blown up the world and now had no where to stand on.

        What helped me was connecting with people who were at a similar point in their journey, and sort of making up our arbitrary starting point together. It was kind of like asserting “everything is true, we can start anywhere and make sense.” This did feel pretty spiritual to me – like rediscovering how the universe was created, out of nothing, out of the void – but someone else might have seen it in very different terms.

        I wrote more about some of these dynamics in this post https://www.madinamerica.com/2013/06/madness-and-play-exploring-the-boundary/

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        • Ron, Frank and Richard,
          thanks for this dicussion. It is really interesting to hear how you and others have experienced ‘psychosis’ and how it might relate to academic theories. Just some arbitrary thoughts:
          I think rationality is necessary to connect with other people and the world, but not sufficient – there needs to be some emotional connection too. I agree that ‘wisdom’ must be aquired, even cultivated, but I also think (although I will have to give this some more thought) that ‘reason’ is a potential of human beings that that will be manifested in most conditions to some degree (think of the complex and logical thought processes required to hunt sucessfully, for example).
          I also think the issue of validation by others is complex. I agree that madness can be seen as the result of a ‘perpetual dialogue’ with oneself and that connection with other people is essential to living a functional life. On the other hand, as Ron highlights, other people can be a source of misery and also pressure to conform to immoral and sometimes irrational beliefs and actions. Sometimes it is necessary to detach oneself from the crowd, which can be dangerous and lonely.
          I think if you take a Wittgenstinian (or Hegelian) point of view on this, we get the understanding and concepts we use to think for ourselves from our shared social world and language. It is from being a social animal that we have the ability to be individuals.

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          • Joanna

            You raise some good points.

            I believe this is where the term “consensus reality” has some serious limitations and problems in meaning.

            If the “consensus” is based on an inaccurate interpretation of the real world (the material world independent of our own individual thoughts reflecting that world), and/or the “consensus” is based on the social groupings of humans promoting and allowing any forms of exploitative and/or potentially traumatic type experiences to exist among them, then all forms of human “validation” will now be corrupted and ultimately lead to more extreme forms of psychological distress.

            Richard

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          • Disconsensus certainly has it’s place. I don’t think an accurate “interpretation of the real world” is ever attained through consensus.

            With regard to, “social groupings of humans promoting and allowing any forms of exploitative and/or potentially traumatic experiences to exist”. “Property is theft.” Pierre-Joseph Proudhon said that. Overlords, kings, presidents, corporate chiefs, etc., all got there through violence in one form or another. Reversing this situation, as ever, remains a tall order.

            As “invalidation” has always been a corollary to “validation”, I find “validation” often a matter of corruption, relatively speaking, to begin with.

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  19. “In the animal kingdom, the rule is, eat or be eaten; in the human kingdom, define or be defined.” – Thomas Szasz

    I hereby declare that everyone who disagrees with me or whose behavior I find objectionable is unequivocally and categorically insane and must be treated with the harshest psychiatric interventions possible, including involuntary incarceration and drugging.

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  20. A good first step to eliminate people’s suspicions would be for a substantial group of esteemed “psychiatric” professionals such as Drs. Moncrieff and other anti-“medical model” psychiatrists to publicly denounce the false concept of “mental illness,” condemn the mislabeling of neurotoxins as “medicine,” and, since there is no “mental disease,” turn in their “psychiatrist” badges to demonstrate they see no need for physicians to treat fake diseases. Then they could proceed with whatever they believe is most needed to genuinely help people with whatever their problems may be, call it something else, and it would be easier to trust and support them.

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      • The attack on what Peter Gotsche has
        described as Deadly Psychiatry and
        Organized Crime is multi-faceted.

        The arguments of activist survivors
        have been greatly assisted by those
        critical psychiatrists and
        psychologists who have publicly
        stated what is wrong with the
        disease model and current practice,
        backed up by rigorous science.
        They are valuable educators.

        The quasi-religious dogmas of
        “mainstream” psychiatry are being
        steadily eroded and cannot stand
        the light of scrutiny. Reform of
        attitudes toward ‘diagnoses’ and
        drug ‘treatment’ can open the door
        to further advances toward
        abolishing the horrors of forced
        incarceration and forced drugging.

        This is a reason why survivors
        should encourage criticism from
        within psychiatry rather than
        advocating withdrawal of these
        honest men and women from their
        sadly-corrupted profession.

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        • Nothing they can’t do or say with psychiatric credentials that they can’t do without them. It would be a gesture akin to Vietnam vets throwing their medals back at the Pentagon.

          Would you wait for change to be advocated by “good cops” within the police force rather than march against police brutality?

          Psychiatry is not corrupted; it is doing what it is meant to do. For something to be corrupted it must first have pure motives.

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        • Oldhead
          I agree that it was a great turning point
          for the peace movement when the Vietnam
          veterans came out against the war.

          I’ve heard that was when the tide of
          American public opinion finally
          decided that the war should stop.

          * * * * * * * * * * * * * * * * * *

          And they threw their purple hearts
          back against the face of military
          authority, in a blaze of publicity,
          on the crest of a great mass movement
          of protest of global dimensions.

          And Jimmy Hendrix nailed it when
          he played The Star Spangled Banner.

          And a young girl placed a flower
          in the rifle of a soldier guarding
          the Pentagon.

          And a child ran down the road,
          naked, burning from napalm.

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          • I think the problem of the forcible incarceration of lunatics arose before the medical specialty assigned to “treat” and “cure” them. I don’t think you end such force by ending that medical specialty because I don’t think the medical specialty is the source of the problem, not when the problem is forcible incarceration.

            Replace civil commitment to an asylum/hospital with something resembling house arrest, and you might begin to see the problem. That’s where things are going and it’s a very scary 1984ish type of direction.

            On the one side you’ve got this call for alternatives sabotaging the demand to end forced treatment, and on the other side you’ve got this throwing all the blame on psychiatry doing the same thing. Before getting around to ending the profession of psychiatry, if indeed that is our aim, we are going to have to confront the issue of power and force. Psychiatry is harmful, surely, but, and this is the issue, there is a difference between a person who consents to receive harmful treatment because that person has been duped, and a person who is harmed against that person’s will and wishes. Eliminate force, and you free the second category of humanity; eliminate psychiatry, and I can’t really say whether or not, at this point, you’ve freed either.

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  21. IF those who define “mental illness” were showing signs of something close to -what even the “mentally ill” can conceive as “normal”, we could put more faith in the ability of parts of our society to handle it’s ills.
    So far, the defining of MI has resulted, and stems from and continues to do so, in lies, corruption, abuses of power, an idealism and great harms that actually continue to create “MI”.

    We have not changed, and the very same processes of understanding, defining, treating “MI”, are in no way better than ever.

    So then, we are at a point we must ask. What kinds of MI exist? And is the system that defines MI, not just simply another MI, but one who is not affected by insecurities, anxiety, but in the absence of being bothered has developed an inability to understand or be emphatic, has in the absence of certain qualities, developed an idealism?
    And within that idealism, talks about those who fall outside of the imagined norm, as ill?
    What normal system when a client comes to it in distress thinks that telling the client that they are screwed, is somehow helpful for the client to think better of himself?
    After all, if a client sees an ‘expert’, for help, the client has insight into stuff happening, the client is not sure of themselves or else would never see need for help.
    How is it helpful to further say to the client “you are neurotic”…the client went for ‘help’ for his headache, not to be told he has a headache or is his headache.

    Psychiatry should stop talking about, addressing it, defining IT. They are the least equipped to do so, and I fear it stems from their own very ingrained lack of insight.

    It is far from uncommon of mankind to see another as acting or being strange.

    I do not deny that we have crap that makes life real tough and processing that causes one’s disfunctions.
    We have enough evidence that the absence of that crap in others, does not make those others capable of help.
    True help looks nothing like imbalance of power, labels and incarcerations or drug damage. That is another whole MI all to itself.

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