“The Power Threat Meaning Framework”: A New Perspective on Mental Distress

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In January, 2018, the clinical psychology division of the British Psychology Society published a very important paper. The document is titled The Power Threat Meaning Framework and is subtitled:

“Towards the identification of patterns in emotional distress, unusual experiences and troubled or troubling behaviour, as an alternative to functional psychiatric diagnosis.”

The term functional psychiatric diagnosis does not imply that the “diagnoses” in question are useful or helpful, but is rather a reflection of the historical division of psychiatric “diagnoses” into those that are organic (i.e., stemming directly from brain damage or disease) and those that are functional (i.e. all the rest). This distinction was formally embedded in DSM-I (1952), but has been largely abandoned in psychiatry’s promotion of the hoax that all their “diagnoses” stem from brain malfunctions.

The authors of the report are:

Lead authors
Lucy Johnstone, Consultant Clinical Psychologist and Independent Trainer
Mary Boyle, Professor Emeritus of Clin Psychology, Univ of East London

Contributing authors/project group
John Cromby, Reader in Psychology, ULSB, University of Leicester
Jacqui Dillon, Survivor Activist and Chair, Hearing Voices Network, England
David Harper, Reader in Clinical Psychology, University of East London
Eleanor Longden, Postdoc Service User Research Mgr, Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust
Peter Kinderman, Professor of Clinical Psychology, Univ of Liverpool
David Pilgrim, Honorary Prof of Health and Social Policy, Univ of Liverpool
John Read, Professor of Clinical Psychology, University of East London

The Power Threat Meaning document consists of an introduction, eight chapters, an appendix, and 58 pages of references.

THE INTRODUCTION

It is clear from the Introduction that the document has been long in the making:

“In 2013, the British Psychological Society’s Division of Clinical Psychology (DCP) issued a position statement entitled Classification of behaviour and experience in relation to functional psychiatric diagnosis: Time for a paradigm shift. The summary is:

The DCP is of the view that it is timely and appropriate to affirm publicly that the current classification system as outlined in DSM and ICD, in respect of the functional psychiatric diagnoses, has significant conceptual and empirical limitations. Consequently, there is a need for a paradigm shift in relation to the experiences that these diagnoses refer to, towards a conceptual system not based on a ‘disease’ model (DCP, 2013, p.1).”

And, of course, individual members of the BPS have been drawing attention to this need for decades.

The Introduction of the PTM Framework enumerates some of the limitations and inconsistencies of psychiatry’s disease model, and then:

“The philosophical position outlined in this document suggests a more sophisticated view of human beings and human emotional distress, within which we are active agents in our lives at the same time as facing many very real limits and barriers to the changes we can bring about. Those limitations may be material (money, food, transport), biological (physical disability), psychological (fear, anxiety, self-doubt) and/or social (gender expectations, isolation, discrimination). More subtly but perhaps most damagingly, they may take the form of the meanings, beliefs, expectations, norms and values that we absorb, often unconsciously, from wider society.” (p 17)

CHAPTER 1: PROBLEMS OF PSYCHIATRIC DIAGNOSIS AND THE NEED FOR A DIFFERENT APPROACH

Many of us in the anti-psychiatry movement have drawn attention over the years to the problems and shortcomings of psychiatric “diagnoses.” One of the achievements of the Power Threat Meaning document is that the authors have not only drawn together the various threads in this debate, but have also managed to blend them into a coherent, cogent, and highly readable account.

“…the DSM presents itself as adopting a descriptive or atheoretical approach, as if its contents involved no underlying assumptions but were simply read off from nature. This is far from the case. We will be arguing in this document that what is needed is a completely different way of thinking about emotional distress and various forms of troubling and apparently unintelligible behaviour. Most of the document will be concerned with describing this way of thinking, the evidence which supports it and its implications for practice and service delivery.” (p 20)

“Most importantly, we have argued that it is the adoption of an inappropriate theoretical framework, designed for understanding bodies and not persons, which is largely responsible for the problems which have beset psychiatric diagnosis and the DSM since their beginnings, including a lack of fit between DSM categories and people’s actual problems and a failure to discover biological causes of ‘mental disorders’. Another effect of the DSM’s medicalised framework has been to marginalise the very large amount of research showing close links between social and personal adversity and mental distress. But above all, the DSM removes meaning and intelligibility from an increasingly wide range of human thoughts, feelings and actions, by treating them as ‘symptoms’ often fundamentally explicable in terms of genes and biology, using the theoretical frameworks of medicine. Yet as we have seen, there is no reliable evidence to justify this approach — as the DSM itself admits. Instead, there is abundant evidence — presented later in this document — that actions, thoughts and feelings said to be symptoms of ‘mental disorder’, including those said to be symptoms of ‘schizophrenia’ and other ‘psychoses’, are intelligible in terms of people’s contexts and life experiences. And, if we want to understand people’s problems and offer effective help then it is vital to take account of this relationship.” (p 32)

CHAPTER 2: PHILOSOPHICAL AND CONCEPTUAL PRINCIPLES OF ALTERNATIVES TO PSYCHIATRIC DIAGNOSIS

Having exposed the inappropriateness of psychiatric diagnoses as a framework for conceptualizing human distress, the authors turn their focus to the question of developing an alternative perspective.

“In developing alternatives to psychiatric diagnosis, in trying to understand and respond constructively to personal distress and troubling behaviour, we therefore need to move away from the assumptions underlying medicalised approaches and address four major questions:

  • What different assumptions should we make, what different theoretical frameworks can we draw on, in understanding the behaviour and experience of persons within their social and relational environments, rather than the (mal)functioning of bodies?
  • At the broadest level, what patterns have researchers described that might be helpful in understanding and alleviating emotional distress, unusual experiences and troubled or troubling behaviour from a non-diagnostic perspective?
  • How might these broad trends and relationships be used to delineate narrower, provisional, general patterns which can inform our understanding of the particular difficulties of an individual, family or other group?
  • What are the implications — therapeutic, social, ethical, legal — arising from adopting these non-diagnostic approaches and how might we address them?” (p 37)

The authors emphasize the fact that their approach is radically different from that taken by psychiatry.

“First, we question the idea of ‘mental disorders’ which have an independent and universal existence across time and culture. More specifically, we question that the experiences this term refers to are analogous to physical disease processes.

Second, we question the epistemological validity of defining these hypothesized ‘disorders’ by a process of revising and refining editions of diagnostic manuals such as the DSM and ICD, and of directing the majority of research endeavours towards biology.

Third, in relation to the ethics of diagnosis, we note the requirement for the procedures and information offered to patients to have a sound epistemological basis. This ethical scenario is the case in all forms of medical and psychiatric diagnosis, but psychiatry has an additional mandate to operate under conditions which are sometimes involuntary. Ethical considerations also apply to the potential harms caused by the imposition of psychiatric diagnoses (http://psychdiagnosis.weebly.com), and to the misuse or over-use of medical treatments and other interventions that a diagnosis may seem to justify (Whitaker, 2010) as well as its role in obscuring the importance of social factors as causes of distress.” (p 38-39)

The problems of applying a scientific methodology to human problems are discussed in detail, with particular regard to the routine marginalization of clients’ first-hand accounts as subjective, anecdotal, and untrustworthy.

“The implication of all of the above arguments is that human beings are active agents in their lives, both determined and determining beings, rather than objects acted upon by external forces. As human agents we both conform to the reality we encounter and seek to transform it. We do this through our capacity for meaning making, and for reflecting on and learning from our experiences. Social and cultural influences do not simply provide backgrounds and constraints; they are the conditions out of which meaning, agency, feeling and action arise (Cromby et al., 2013, Chapter 6). Alternative frameworks for distress must be built on these foundations.” (p 45)

The fact that psychiatric “diagnoses” are routinely used to obscure and divert attention from deep-rooted social and economic problems is addressed.

“…we have also suggested some principles and assumptions which should inform non-diagnostic approaches. We have shown that we need to go further than selecting a new model from existing alternatives. Instead, we need to re-visit a whole set of often unarticulated and unquestioned philosophical, theoretical, historical and cultural traditions and assumptions, supported by a range of personal, professional, economic, social and political interests. Moving away from what can be referred to in shorthand as the ‘DSM mindset’ is very difficult, since it is inextricably linked to deeply internalised aspects of the basic fabric of our thoughts, feelings, identities and worldviews. Such a move is also likely to reveal many social and ethical dilemmas which have been obscured by the current framework.” (p 74)

CHAPTER 3: MEANING AND NARRATIVE

It is a fairly obvious reality that we humans attach meaning to our experiences, and that these meanings can have a profound effect on how we respond to these experiences. Adversity, for instance, can be interpreted as: punishment for misdeeds; evidence that one is the victim of a conspiracy; evidence that life “sucks”; random events; etc.

It is also clear that the meaning that an individual attaches to his/her life events is an area that is largely neglected by psychiatry.

“Social standards and expectations are obviously not new but in contrast with older, more overt forms of power, modern, less visible forms of power achieve their effects partly by establishing new forms of knowledge — often claiming scientific status — which in turn create new norms. People then engage in self-surveillance across a wide range of behaviours, personal characteristics, desires and achievements, routinely comparing themselves to these implicit norms, and identifying themselves as inadequate, deficient or pathological if they deviate from them. Such self-surveillance has huge consequences for psychological distress (see Chapter 4).” (p 81)

CHAPTER 4: THE SOCIAL CONTEXT

This section addresses the question:

“At the broadest level, what patterns have researchers described that might be helpful in understanding and alleviating emotional distress, unusual experiences and troubled or troubling behaviour from a non-diagnostic perspective?” (p 92)

In its efforts to promote its self-serving and spurious disease model, psychiatry routinely downplays, and even ignores, the role that circumstances and social context play in the development of emotional distress. In contrast, the PTM paper addresses this issue head-on.

“There is a great deal of evidence, which we will discuss in detail in following sections, that the circumstances of people’s lives play a major role in the development and maintenance of psychological, emotional and behavioural problems (further evidence is presented in the Appendix). Among the most important factors are: social class and poverty; income inequalities, unemployment; childhood neglect and sexual, physical and emotional abuse; sexual and domestic violence; belonging to subordinate social groups; war and other life-threatening events; bullying, harassment and discrimination and significant losses such as loss of a parent in childhood.” (p 92)

“Some of the strongest associations between social context and mental distress and troubling behaviour are in relation to factors which loosely describe social inequalities.” (p 94)

“The visibility or invisibility of power is also important in relation to the different experiences of privileged and more marginalised groups.” (p 96)

“Being in an aversive situation from which there seems no escape or possibility of change is a major cause of emotional distress, especially feelings of anxiety, hopelessness and depression (Brown et al., 1995; Kendler et al., 2003).” (p 122)

The negative effects of racism and discrimination are addressed.

“Racism and discrimination take many forms, some more visible than others. They include subtle putdowns, insults and dismissals (‘micro-aggressions’) as well as more overt racist insults, hostility and violence. Discrimination may also be deeply embedded in the procedures, policies, laws and employment practices of organisations and services (institutional racism) in a way which renders it more or less invisible except to those discriminated against. All of this is supported by the ideological context described earlier and there is consistent evidence that these various forms of racism and discrimination can have very negative effects on mental and physical health.” (p 134)

“Research across many countries suggests that feelings of shame and humiliation are integral to living in absolute or relative poverty…” (p 142)

“Bringing together our discussion here of social context, in Chapter 2 of ‘crossing cultures’, and in Chapter 3 of narrative and meaning, we can argue that it is the fundamentally social nature of humans and of the contexts and predicaments which ‘produce’ distress, as well as the social nature of its modes of expression and of judgements and evaluations of them, which also construct similarities and differences in patterns of distress within and across social groups and cultures. There are no ‘mental disorders’ which can be separated from all of this and diagnosed.” (P 150-151)

CHAPTER 5: THE ROLE OF BIOLOGY

Those of us in the anti-psychiatry movement are often falsely accused of neglecting, and even ignoring, the biological underpinnings of human activity. It’s not true, of course, but it makes a nice sound-bite for psychiatry’s adherents. The PTM paper devotes an entire chapter to biological issues.

“We argue, however, that there is a meaningful and important difference between forms of distress and troubling behaviour that are enabled and influenced by our biology — as all human experience is — as opposed to those cases where there is evidence for a primary causal role for biological pathology or impairment in the major aspects of the difficulties. This would include diagnoses such as the dementias, Korsakoff’s syndrome, Huntington’s disease, syphilis, urinary tract infections in older adults, and so on. But, as we noted in Chapter 1, in relation to the great majority of psychiatric diagnoses including those experiences and behaviours labelled as schizophrenia, bipolar disorder, depression or depressive disorder, anxiety disorder, personality disorders and eating disorders, there are no consistent associations with any biological pathology or impairment, and no biomarkers have been identified.

There are nevertheless hundreds of studies claiming to have discovered relationships between these functional diagnoses and one or other aberrant biological feature. For example, and with respect to the diagnosis of ‘schizophrenia’ alone, in recent decades these claims have focused upon anatomical features such as enlarged ventricles, cerebral asymmetry, temporal lobe abnormalities, thickened corpus callosum, thinner corpus callosum, abnormalities of the basal ganglia and cerebellum, and reduced overall brain volume. At the same time, relationships have also been claimed between schizophrenia diagnoses and abnormalities of, or differential functioning within, neurotransmitter systems and pathways for dopamine, glutamate, serotonin, acetylcholine, gamma-butyric acid, prostaglandin and neuropeptides (Cromby et al., 2013). Nevertheless, in all of this research there is no pattern of well-designed studies with large samples and adequate controls, replicated successfully by other groups and not significantly contradicted by other findings, and which consistently demonstrates associations between any of these features and the diverse experiences associated with a ‘schizophrenia’ diagnosis. In any case, even if such a pattern were to emerge we would still need to remain wary of assuming that correlation means causation.” (p 153)

CHAPTER 6: DESCRIBING PATTERNS WITHIN A POWER THREAT MEANING FRAMEWORK

In this chapter, the authors describe how the general principles developed earlier in the paper can be used to help understand the particular difficulties of an individual, family, or other group.

“Humans are fundamentally social beings whose experiences of distress and troubled or troubling behaviour are inseparable from their material, social, environmental, socioeconomic, and cultural contexts. There is no separate ‘disorder’ to be explained, with context as an additional influence.” (p 182-183)

“The evidence cited in this document supports the contention that humans are social beings whose core needs include:

  • To experience a sense of justice and fairness within their wider community;
  • To have a sense of security and belonging in a family and social group;
  • To be safe, valued, accepted and loved in their earliest relationships with caregivers;
  • To meet basic physical and material needs for themselves and their dependants;
  • To form intimate relationships and partnerships;
  • To feel valued and effective within family and social roles;
  • To experience and manage a range of emotions;
  • To be able to contribute, achieve and meet goals;
  • To be able to exercise agency and control in their lives;
  • To have a sense of hope, belief, meaning and purpose in their lives

…all of which will provide the conditions for them to be able to offer their children…

  • Secure and loving early relationships as a basis for optimum physical, emotional and social development and the capacity to meet their own core needs.

Anything that prevents these core needs being met may be experienced as a threat to emotional, physical, relational and/or social safety and survival.” (p 189-190)

“The identity of ‘mentally ill’ has mixed consequences. It may represent relief from guilt and uncertainty, and hope for expert guidance and effective intervention. At the same time, the ‘sick role’ identity has been theorised as facilitating passivity and a reduced sense of responsibility for one’s recovery. Diagnosis has been shown, overall, to incline the person diagnosed to have less optimism about recovery, make less effort to recover, and be more likely to use alcohol to cope, as well as to have lower perceived control over their difficulties and undermining the effects of therapy. Conversely, rejecting one’s diagnosis has been linked to better outcomes. However, this may lead to conflict with professionals, and the need to access services and benefits rules out this option for most people.” (p 221)

CHAPTER 7: SERVICE USER CONSULTATION AND FEEDBACK

In developing the PTM paper, the authors consulted with a group of eight service-users/survivors and carers. Most of the consultants had been assigned more than one “diagnosis,” including:

“‘borderline personality disorder’, ‘PTSD’, ‘bipolar disorder’, ‘bipolar disorder-2’, drug induced psychosis, ‘depression’, ‘schizophrenia’, anxiety, and at risk mental state/sub-threshold ‘psychosis’.” (p 255)

The consultants were a heterogeneous group with “a range of perspectives.”  In general, their responses to the PTM framework were positive, and sometimes tinged with regret that such a perspective had not been available to them during their contacts with the mental health system.

Meaning to what was going on was given by medics to my detriment and [any resistance] resulted in being labelled as a troublemaker. As a direct consequence I started to not trust people…” (p 257)

“…absolutely everything I had to say, including that the drugs were making things worse, [staff] made me, and more specifically my brain, the problem, rather than my traumatic experiences…” (p 258)

“…another . . . spoke of the difference a PTM Framework like this could have made to the trajectory their life took, and another . . . of their sense of grief that had a PTM Framework like this been available at the time, they might not have lost so many years of their life to mental health problems.” (p 259)

CHAPTER 8: WAYS FORWARD

 The authors are fully aware of the difficulties that lie ahead.

“Such a major shift in policy, practice and thinking will take many years to develop and to embed fully, and we make no claim to be providing a complete answer.” (p 262)

 “Regrettably, economic inequality and associated levels of discrimination and disadvantage in the UK show no sign of reducing.” (p 266)

“Some public health reports have made explicit links between distress and inequality, austerity and social injustice, although this message has not always been taken on board in terms of national economic policy.” (p 268)

“Another common feature is the need for action and intervention at a whole community level in order to address these multiple causal factors.” (p 269)

 “…calls for better access to MH services fail to acknowledge the extent to which diagnostically-driven practice can reinforce and actively obscure the disconnect between social contexts and distress, downplay the need for care that acknowledges the impact of adversities, and may be disabling and re-traumatising in its own right. There is little detailed consideration of the ways in which inequalities of power and privilege arising from subordinate or devalued identities profoundly influence both the nature of adversities and people’s responses to them.” (p 270-271)

“In conclusion, there is general acceptance within current UK mental health policy that social adversities are both cause and consequence of mental distress, and that intervention needs to take place at a societal as well as individual level, even if the details are sketchy and fall short of challenging the governmental policies that underpin inequality and injustice. At the same time, these progressive ideas are, if these documents are taken as typical, undermined by unquestioned assumptions of medicalisation. Social factors are ‘related’ to mental health problems rather than being at their root. Emotional distress is conceived as ‘illness’ to be ‘treated’ rather than intelligible response to life circumstances. The prevention of adversities is less of a priority than the need to increase access to ‘treatment’. More mental health services are promised, but the appropriateness of the diagnostic model on which they are based is not open to question or dispute.” (p 272)

“However, the issues relating to the development and implementation of alternatives to diagnostic thinking and medicalisation will not be resolved without the driving force of those who have been ascribed a psychiatric diagnosis. This needs to be backed up by a sea-change in messages to the general public about alternatives to the narrative of medicalisation. We hope that our PTM Framework will be a contribution to these aims.” (p 317)

APPENDIX: EVIDENCE TO SUPPORT THE GENERAL PATTERNS

Evidence for the various positions and perspectives is provided in the general narrative, but is also summarized in this chapter for ease of reference and convenience.

SIGNIFICANCE OF THE PTM FRAMEWORK

The Power Threat Meaning Framework document constitutes a critically important contribution to the anti-psychiatry debate, and to the development of valid, person-centered and context-focused perspectives. In marked contrast to psychiatry’s simplistic and spurious “diagnostic” system, the PTM paper examines the various questions and issues in a manner commensurate with the inherent complexity of the subject matter. The paper runs to 411 pages, which includes 58 pages of references for readers who wish to examine the evidence or to pursue issues in greater detail.

In a post of this nature it is not possible for me to convey more than the barest flavor of the paper, and I strongly encourage readers to study the document for themselves.

There is a short version (139 pages) of the PTM Framework available, for readers who are pressed for time.

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140 COMMENTS

    • Sorry Pat. 🙁

      I don’t know why this feels like a kick in the face, but you have your reasons. Being left by everyone would be painful in itself.

      You’re not the only one offended by this article judging from the comments below.

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      • That we feel what we feel is our experience – which is our freedom and right to have. But why or what causes us to have the resulting feeling or experience is our interpretation. We all have different versions of ‘separation scripts’ and they also trigger or reinforce each other as a kind of entanglement in grievance.
        I support the true in everything I meet – insofar as I have the wits to notice it – and so I join with the true willingness in the Phillip Hickey’s desire to abandon and extricate his profession from the drugging approach to presumed or believed ‘biological’ causes as THE basis of ‘mental illness’. (Noting that it generally DOES cause biological imbalance to take such substances – that are then self-reinforcement to persist in the error – and THIS pattern is common to all defences that DO the very thing they purport to be defence AGAINST. IE: war on cancer, war on terror in larger terms – but no less to our own psychological defences.)

        While Szatz may be considered an ‘extremist’, he was very specific as to the prices use of words to mean consciously and clearly defined meanings. THAT makes him an ‘extremist’ in the ambivalence and compromise of a masking persona intent on survival and self-advancement within a mentally ill society.

        I tend to see spiritual cause as the basis of all ‘dis-ease’ even though the patterns of that may be ‘physicalized’ to our experience as fixed or set realities within which we have learned to address, mitigate or suppress and mask over. But then my first recourse is not my ‘thinking’ but awareness of existence – which I do not experience EXCEPTING as I give and accept definition of. To talk of this will seem philosophical – but you can only have an experience of ‘something’ through the giving of meaning to it – and while society or personal adaptation learns models and patterns of a world in which we interact and share meaning, nothing comes with built in meanings.

        This co-creative interaction is lost under the subjection to a separate physical ‘world’ assigned as ‘Causal’ – such as will posit your thought is only neurons firing, or chemicals bonding or signalling currents within an electrical complex that is devoid of an actual ‘self’. Thus the ‘pinnacle of human achievement’ (sic) is to assert we don’t exist, and replace our self with robot-management systems, pharma or technocracy of inhuman ‘control’ running rules of targets and checkboxes instead of a creative adventure (though of course it remains a created set of rulebound limitations reacted to as ‘real’). Invested identity is played for keeps – unless it opens to new perspective.

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  1. As a survivor of service using, I’m kind of partial to liberation from service use myself. If you’re saying why don’t all adult baby sitters take a vacation, and adult babies can take care of themselves. Sure. I can see that. I don’t think that’s what this is all about though.

    I have a great many qualms about this service industry that has grown up around the idea of servicing those who are deemed, by a leap of negative judgment and faith, plus corresponding judicial decisions, incapable of serving themselves, however you frame it. For career opportunities, there are more vital jobs to take on out there in the real world I would suspect.

    I applaud that they are working to counter the escalating medicalization of everyday life in their own fashion. (They are doing so, aren’t they?) I’m not too sure that the “pattern of distress model” is ever going to be the great advance over the “disease model” of mis”treatment” that people would hope and expect. I’m kind of partial to the “get off my back model” when it comes down to it.

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    • Frank – We hope the Framework will indeed support people to get services off their back by offering the alternative perspectives that are rarely available from professionals, along with resources for constructing non-medical narratives about their struggles or difficulties without the need for professional input. I would be interested to hear what you think of it.

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      • Frank,

        Like you, I am also wary of replacing the psychiatric system with another system. Given the fundamental dynamics of our present society, there is always the possibility that a replacement system can be co-opted by commercial forces. Indeed, I imagine that commercial interests have already set their sights on the PTM framework and the “opportunities” that might lie therein. I like the notion of a get-off-my-back non-system, and I think Lucy’s comment above is apt.

        I personally favor a mutually supportive non-system along the AA model, but without the dogmatism and religious overtones that put so many people off AA. But we also need a radical transformation of our societal values and institutions.

        In my view, the great value of the PTM framework is not that it provides an alternative system, but rather an alternative perspective. Depression is not an illness, but rather an entirely understandable response to truly dreadful circumstances and oppressive discriminative institutions.

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        • How about “depression is the end result of living in a world in which all human values have been reduced to monetary values and our souls are slaves to the pursuit of wealth by those who control our very existence”? This still doesn’t offer a solution, it only points out the problem. What “perspective” will help us defeat totalitarianism?

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          • I believe, the “AA” is ABLE for open and calm “sharing” on potentially the most extreme and “distressing” experiences in life – whereas most professional therapists might not be.

            I believe, the “AA” (also) expects people to make full recovery from their life experience no matter how tragic – where as most professional therapists might not be prepared to “acknowledge” full recovery from very tragic life experience.

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          • The recovery rates for fully intensive 12 step programs for substance misuse is very modest actually. Not much better than single figures which you’d probably expect anyway without all the proselytising.

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      • Responding to lcjohnstone:

        “Without the need for professional input”, sounds great, but still I’m wary having encountered a number of non-professional professionals in training of late. Also, I balk at the word “alternative” in “alternative perspectives”. You mean “alternative” to the professional perspective I imagine, but many of the “alternative” treatment programs that have developed over the last few years have become seriously compromised due to organizational considerations, namely funding issues, and a perceived need to work with groups that promote forced treatment. (Business survival matters one might say.)

        I wish you success, in so far as it goes, but I wonder about the details, and I’m very apprehensive. Abolish forced treatment, and you don’t need an alternative to forced treatment as forced treatment itself would be kaput.

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        • Brilliant, powerful stuff Lucy and Co. I wish you well with this project. More and more as the neo-liberal thought collective triumphs the malevolence of power gets written out of the narrative of social affairs. By ignoring the horrors of life institutional care comes to serve just those horrors!
          , good luck.

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      • LC, where do you get these “perspectives” and why do you think you have the “alternative” answers to “offer” people? Why do you assume your goals are the same as those to whom you offer “services”?

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  2. A paradigm shift is absolutely needed. And there are some elephants in the room that the “mental health professions” do not want to address, but need to address. Number one, the psychiatric drugs create the symptoms of the serious DSM disorders.

    Here is medical proof that your “schizophrenia treatments,” the antipsychotics (aka neuroleptics), can create both the negative and positive symptoms of “schizophrenia.” The negative symptoms can be created via neuroleptic induced deficit syndrome, and the positive symptoms (including psychosis) can be created via antidepressant and/or antipsychotic induced anticholinergic toxidrome.

    https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome
    https://en.wikipedia.org/wiki/Toxidrome

    And Whitaker pointed out in his 2010 book that the ADHD drugs and antidepressants can create the “bipolar” symptoms.

    https://www.alternet.org/story/146659/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america

    And your antidepressants result in worse long term outcomes for those you’ve stigmatized as “depressed.”

    https://www.madinamerica.com/2018/04/antidepressant-use-leads-worse-long-term-outcomes-study-finds/

    Your DSM disorders are NOT real “genetic” illnesses. They are theorized, but incorrect, iatrogenic illnesses that can be created with your psychiatric drugs. Number two, the “mental health professionals” have been misdiagnosing child abuse victims with the billable DSM disorders on a massive scale.

    Today, over 80% of those you’ve labeled as “depressed,” “anxious,” “bipolar,” or “schizophrenic” are child abuse victims who have been misdiagnosed with those “psychotic and affective disorders.” Over 90% of those you’ve mislabeled as “borderline” are child abuse victims.

    https://www.madinamerica.com/2016/04/heal-for-life/

    The psychological and psychiatric industries have been misdiagnosing child abuse victims with the “invalid” but billable DSM disorders on a massive scale for decades, because child abuse is classified in the DSM as a “V Code,” and the “V Codes” are NOT insurance billable DSM disorders.

    https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1

    Despite the reality that child abuse is a crime, not a brain disease. And distress caused by a crime is not cured with drugs. The primary function of the “mental health” industry today is profiteering off of coving up rape of children, which is illegal. As a matter of fact, covering up child abuse has always been the primary function of the “mental health professionals,” even when the psychologists were in charge.

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

    We need the “mental health” industry to get out of the business of profiteering off of silencing child abuse victims, by turning them into the seriously “mentally ill” with your psychiatric drugs, on a massive scale. That is pure evil. You are mandatory reporters of child abuse, and you are breaking the law in the US, “mental health professionals.”

    By the way, my experience with pedophilia covering up “mental health professionals” was their goal was to prevent and attempt to destroy these core needs:

    “To experience a sense of justice and fairness within their wider community;
    “To have a sense of security and belonging in a family and social group;
    “To be safe, valued, accepted and loved in their earliest relationships with caregivers;
    “To meet basic physical and material needs for themselves and their dependents;
    “To form intimate relationships and partnerships;
    “To feel valued and effective within family and social roles;
    “To experience and manage a range of emotions;
    “To be able to contribute, achieve and meet goals;
    “To be able to exercise agency and control in their lives;
    “To have a sense of hope, belief, meaning and purpose in their lives
    …all of which will provide the conditions for them to be able to offer their children…

    “Secure and loving early relationships as a basis for optimum physical, emotional and social development and the capacity to meet their own core needs.”

    Thank you as always, Philip, for pointing out the fraud of today’s DSM deluded psychiatric and psychological industries.

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  3. Thank you for this clear and concise summary, Phil.
    This link gives access to both the online versions of project documents, plus slides from the launch, an accessible 2 page summary, and the Guided Discussion for starting to think about these ideas in relation to your own or someone else’s life.
    https://www.bps.org.uk/news-and-policy/introducing-power-threat-meaning-framework

    This is a link to interviews with the authors and attenders at the launch:
    https://vimeo.com/264387393

    This an interview I did on the project for MIA:
    https://www.madinamerica.com/2018/03/dr-lucy-johnstone-power-threat-meaning-framework/

    UK residents can order a hard copy of the shorter Overview document from the British Psychological Society – you do not have to be a BPS member. Email [email protected]

    The video of the main talks from the day will be out very shortly.

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    • Apart from ‘psychiatry’s promotion of the hoax that all their “diagnoses” stem from brain malfunctions’ (second paragraph), Philip Hickey provides a good summary of the PTMF, which itself (as far I have read) avoids the accusation of deliberate deception.

      Even if it was qualified by, for example, ‘establishment psychiatry’, such language is likely to alienate many moderate professionals and others. There is now good evidence that extremist statements such as ‘depression pills cannot cure anything’ ( http://www.madinamerica.com/2018/01/antidepressants-effect-depression/ ) cause unnecessary distress: https://drnmblog.wordpress.com/2018/04/18/pillshaming-is-real-heres-a-newish-way-to-reduce-it-and-to-reduce-antidepressant-use/ .

      And ‘antidepressant’ prescribing has doubled (in the UK) in the decade since Joanna Moncrieff’s ‘The Myth of the Chemical Cure’ (2007): attention has been sought and attained, but has that message worked? Or been counterproductive?

      I plan a further Blog piece on ‘pillshaming’ in 7-10 days, and another on the PTMF in 1-2 months.

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      • Have you considered the notion that the hatred of prescription drugs comes, not from simply the unintended negative effects of the drugs themselves, but rather from having individuals who play the role of medical mental health professionals, existing as arbitrators between what is ideally a relationship between the individual and the drug store?

        People in distress may want to try out drugs. When they want to, they might want to consult someone knowledgeable about what the drugs do, and also talk to people who have used them. When they want to taper off, they might want to do that with someone’s help as well. Of course, the best help, if possible, is self help. But the consulting is ideally between a few knowledgeable humans who are looking to help one another. Not between a professional backed by the state and a person in the patient role.

        However, the law mandates that the only way a person can get prescription-only drugs, is by just that. The prescription of a mental health professional. A person who will label, do record-keeping, can infantilise and coerce individuals, force drugs onto them, and with the best of intentions turn them into a revolving door patient etc. Your very institutions and playing the patient role in those places is nauseating.

        Granted that most of you are not evil individuals who are picking random people off the streets and looking to torture them with drugs. I am not trying to push the “mental health professionals are the children of satan” viewpoint. But that does not remove the associated dangers of interacting with people such as yourself.

        Get out of the way and stay out is what I’m trying to say. But that is not possible. People are forced to rely on your unwanted, and frankly intrusive, mercy and charity.

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        • Read my Blog pieces and you won’t find claims to ‘mercy, charity’ etc.

          Pharma regulation must include professional prescribers. Its extreme laxity has led in the US to an epidemic (literally) of synthetic opioid dependence and deaths. Any patient with depression, say, is free to read up on information and any reasonable psychiatrist or family doctor will respect choice, within limits. My view is that at least 9/10 people on ‘antidepressants’ shouldn’t be and the same is probably true for bipolar 2.

          I appreciate the ‘freedom’ culture is different in the US, but if I had a recurring tendency to psychosis and limited funds I would rather have been born in the UK. See Allan Frances’ tweet today: ‘Providing easy access to care & decent housing for people with severe #mentalillness is simple humanity.
          And it’s also smart government policy-reducing cost of other services- eg emergency rooms/cops/jails. UK giving high priority to reform. US is shamefully behind.’

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          • Dr. Neil,

            I’m sure you’re not a bad person who wants people to be on his mercy and charity. But the fact is, you are the gatekeeper to the drug-store. You are also the enforcer of paternalisation, however subtle or well intended.

            You are a labelling, record-keeping, behavioural observation noting, file transferring creator of revolving door “patients”.

            And people like you, irrespective of their good intentions, are still a massive roadblock to the well-being of individuals.

            It isn’t merely the drugs which make people resist your profession. Drugs don’t take themselves. It’s the fact that you exist with all the other facets of your profession.

            You write: “Any patient with depression, say, is free to read up on information and any reasonable psychiatrist or family doctor will respect choice, within limits”.

            Your “limits” and your code of conduct and “professional practices” are dangerous to me.

            “Pharma regulation must include professional prescribers”

            No. That depends on who is making the rules and for whom. If you ask me, the professional role must become more lax. If you want to act as consultants between voluntary individuals, like a business contract, then fine.

            You cite people who are dead due to drugs. On the other hand, there are people who are alive but whose existence is just that; merely existing (or even utter misery), thanks to the mental health profession in between.

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          • I am totally with registeredforthissite (also because of that unparalleled nickname) and one of the things my father tought me that helped me a lot was “if somebody tells you, he wants to die, give him a rope”. Highly politically incorrect but he challenged me with such seemingly rude and harsh statements all the time. How can any professional build up himself as the one who decides for an adult being what is best in their interest? I know, suicide is a very difficult topic on many levels, and I do not say that I have already reached a certain viewpoint on it, but I will treasure my father’s statement because by giving me a hard wall to crash against with my teenager mind he enabled my critical thinking because I had to find ways to counter his sometimes quite …. simple and harsh statements… and in retrospect I now even have to understand that he deliberately made me angry and questioned my well-meaning liberal attitudes…

            And this comment targets the ‘but if we don’t help people with depression they might kill themselves’.

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          • I agree with Registeredforthissite. My existence is far from idyllic but my “cocktail” and the babysitting/put downs I endured at the hands of the community “mental wellness” center were a torment and made me long to die. Left the system/drugs/label. No more suicidal thoughts. Wow!

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          • Neil, you mention that most people on antidepressants shouldn’t be on them, and then you bring up the term “bipolar 2”. Keeping aside the disgust of labelling, you guys regularly label people as “bipolar” due to the iatrogenic effects of the very drugs you prescribe.

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          • Quit inflicting mental illness on us and we can find our own darn housing!

            The only employment I have ever found was in spite of my “mental wellness” team. My moods have stabilized and I’m starting a freelance career…despite psychiatry’s best efforts to keep me helpless and dependent.

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      • Neil,

        For decades, psychiatrists (including psychiatric leaders) have avidly promoted the falsehood that depression which crosses arbitrary and vaguely defined thresholds of severity, duration, and frequency is caused by brain pathology; specifically neurotransmitter imbalance. This is a monstrous deception, but is compounded by the even more appalling suggestion that this supposed pathology is corrected by psychiatric drugs (especially SSRIs). This is a hoax: something intended to deceive or defraud. Similar comments can be made concerning other psychiatric “diagnoses”.

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      • I think you might have a point Neil but the massive marketing budgets of big pharmaceutical might have something to do with it! They now have an easy message to sell as do many self help gurus indeed a message often to good to refuse. And why is it that you think many mental health professionals seem so resistant to evidence that their treatments don’t work if not make things worse for people?

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          • Lol my we are the cynic – where did you find out about the gold wired fruit baskets I thought they where a secret? They probably construct them in OT but couldn’t trust us with the wire sure where I am we hardly see fruit for godsakes☹️

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  4. “Diagnosis has been shown, overall, to incline the person diagnosed to have less optimism about recovery, make less effort to recover, and be more likely to use alcohol to cope, as well as to have lower perceived control over their difficulties and undermining the effects of therapy.”

    I like that, “undermining the effects of therapy” given that no therapy has ever been substantively shown to be better than any other, and even then the outcomes of being on a waiting list for 6 months has been shown to be as effective as 6 months of therapy.

    What are the assumed effects of therapy? Given that most therapists are, according to the 15 or so people I’ve talked to (that’s nearly twice the number consulted by the PTM team, and is thus, doubly robust) affirm that the therapist themselves were utterly dire. In other words, the therapists were half-arsed and not making enough effort to be a good therapist.

    And then this bit: “Diagnosis has been shown… [to make people] make less effort to recover.”

    Recover? Beg pardon?

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    • Just one last comment or two.

      Therapy is as much (if not more) dependent on the placebo effect as drugs are. And therapy can be at least as toxic as the drugs. The more narcissistic the client, the greater the chance the relationship will be considered a success (at least to begin with…)

      Also, this insistence on “distress”. For almost 20 years I’ve been trying to help people understand that mania, for instance (and psychosis) isn’t always a distressing event. In fact, it can be one of the most pleasurable experiences in life. Messy, unpindownable, and with little patience for swell-heads that claim to understand… and like, you know, really feel you… etc and so on… but just about the most tremendous and awe-inspiring event your noggin has the fortune to go through.

      What follows mania is often a depression, a soul-saving flight from the unbearable lightness, the unbearable beauty. I understand that is the reverse of what therapists often claim. But what do they know? Hold on a moment… this is not what their carefully selected (from a infinitely informative cache of 3 or 4) ex-/service user colleagues are saying, so dismiss it outright. It doesn’t fit the model.

      But we need a model. We must have a model.

      And so it goes that the model becomes more real than life itself…

      Again.

      Time to quote Judi Chamberlin’s On Our Own again.

      “Many alternatives are “alternative” in name only, repeating us-them dynamics and reinforcing the notion of professionalism and expertise in contrast to incompetenece and inability.

      In her own words:

      “Becoming a client of any mental health service may result in being subtly degraded. Whether the service is a “traditional” mental hospital or an “alternative”, such as a halfway house, it is likely to view its clients as incompetent people who constantly need looking after. These attitudes prevent professionals from helping their patients to move toward independence and self-sufficiency, even when that is precisely what they claim to be doing.

      Alternative services must be designed so that this psychiatric elitism is eliminated. People who are having difficulties in living and who seek help with their problems are not served by a system that maximises their inadequacies and ignores their strengths, nor by one that implies that only incompetent people have problems. Professionalism demands that mental health practitioners project a neutral, impersonal manner. Sometimes this may be concealed by a bland friendliness, such as an insistence on first names, but it is, more likely than not, only a pretence of friendliness.”

      Puzzles me why she isn’t quoted more often…

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      • Your mention of “mania” is pertinent in demonstrating that “emotional distress” is sometimes more distressful to others than to the person supposedly “suffering” from “mental illness.” So even the term “mental distress” does not work as a synonym for such.

        The term “alternative services” is also problematic, as it implies that psychiatry is the standard and everything else is “alternative.”

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        • Thank you for reminding me that I exist.

          Bu to paraphrase your closing gambit:

          Psychiatry is the standard and everything else is “alternative.” Well, yes psychiatry *is* the standard and everything else *is* the alternative.

          I still haven’t read the book and am therefore in default cynical mode. So far so good for people who identify their problems as stemming almost wholly from some form of abuse. It’s long overdue that services readjusted to their experiences and needs. And psychologists are probably best placed to help them. Even if psychologists tend to also shoo away the most challenging of these people. In the UK, the new culture in helping survivors of abuse and neglect is to call in the police and send them off to Accident and Emergency Units. So yes, a well-equipped crisis service, even better, a well-equipped pre-crisis service, would be helpful to them. If that is what people want. And, there is plenty of evidence to suggest, that that is what people want if only it was provided to them.

          And, to be honest, for someone like myself, to be given time to spend with a rookie psychologist (someone who was nearly or about to complete their higher studies) would potentially be very helpful to have around during darker times. For instance, they might accompany me to Rome or New Zealnd on a fact-finding mission. Or they might find a way for me to crack jokes and offend people for a living. The sky’s the limit.

          Until I absorb the book — that is going to take months, I imagine — then I’ll keep my gob shut. Other than to say, on reflection, that I would have gladly been kidnapped as a child by social services — on the advice of a child psychologist — and taken away from my family and plonked into a more stable middle class home. I understand that this is going on rather more than it should, though.

          Due to overzealousness, a weakness which psychology doesn’t often talk about.

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          • My position on “alternatives” is that, as psychiatry is by definition of tool of repression, we do not need “alternative” forms of repression any more than African people need alternative forms of slavery.

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          • Like yourselves I was on occasion in the throws of a happy hypomania – the shrinks soon put a stop to that having declared I was chemically imbalanced – how regrettably that was. If they’d asked wharhappened to me which I was trying to tell them rather than deciding erroneously what was wrong with me which I also tried to tell them the power dynamics affecting me might have revealed themselves as more tractable than they became! But I suppose you’d be hard pressed expecting such a conservative enterprise to fight the power, better to recruit ‘customers’ for big pharma for life.

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          • to oldhead: What is seen as repression by one side is a power of control to the other side. Likewise the cost of ‘health services’ is a revenue stream or profit to those who are paid or make charge.

            Psychiatry seems to operate a form of ‘mind’ or ‘reality’ control that embodies the power of the state under the aegis of the power to determine what is deemed ‘sick’ or unacceptable and the power to enforce the suppression of ‘sickness’ for a conformity of behaviours.

            Mind-control is the prevalent or pervasive consensual ‘reality’ under a pervasive and largely invisible “power-threat meaning.

            In order to not ‘need’ or invoke repressive or suppressive reactions from others in positions of power, we need to integrate at a deeper level than an identity in reaction – that others feel threatened by.
            The primary field for healing or wholing (reintegration) is the awakening of compassion. Emotional sympathies can play into ‘self-righteous’ power trips – because they are not rooted in an integrity of being, but are themselves the expression of a repressive and controlling exclusion.

            There is need for suppressing behaviours that are harmful to self and other, so as to heal the underlying pattern of thought, feeling and perception-reaction.

            The sickness of ‘mind-control’ is of a mind-framing in expression or suppression of natural impulses filtered through unnatural thinking.
            You have every right to the power of your being – but not at expense of others.

            The Fall – is a symbol for the taking of power in self-image at expense of wholeness and of the recognition of wholeness in others and all. It is told as an actual accomplishment, resulting in guilt and punishment, struggle, war, sickness and death… and yet all arising from a deceit! A deceit wished for and given power, meaning and identity TO – by reacting to its experience as personal attack – and generating a personal ‘identity’ by attack.

            The wish to enslave life is the mind of fantasy given power. If you KNOW your wishes are idle fancies, you can play in them and engage in ‘as if’ as a private experience. Two or more may play under rules that are shared or generated by the sharing of the role play. The rules of such a joining in private agenda, rule out wholeness of being – in order to ‘survive’ the game and the identity of the players.

            When the engagement in the private personal sense is as if locked into the mask, the sense of separateness is reinforced by all attempts to restore love, power, peace or joy – for they all build from the belief in self lack (of love, power, peace or joy). The capacity to live from a different foundation than self lack is the gift of a shift of perspective.

            The gift is never withheld – excepting by our attempts to ‘get for ourself’ or manage all by ourself. Relationship is key – but as a contextual honesty and acceptance of being – not when used to get from. However, the latter is the result of our societal conditioning in large respect – and of the training for any therapy that seeks to change others rather than facilitate a willingness for change as a result of honesty of being and communication.

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        • “Mania” is simply a pseudo-pathological term for partying too hard. Patty Duke and Carry Fisher didn’t need shocks/drugs/labels. Just not getting sloshed multiple times a week and bedding strangers.

          Unless you’re referring to a high induced by a Serotonin Reuptake Inhibitor. That’s iatrogenic.

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          • I agree on a certain level. The only “manias” I had in the past were drug (SSRI) induced. And it was nothing more or less than a drug high. It’s literally like taking a very strong stimulant. I suppose it’s similar to what snorting coke would be like (which I’ve never done, BTW).

            I suppose a large number of manic episodes that people experience in our day and age are drug induced. Either due to legal, illegal, or legal-by-prescription drugs. While I know that “spontaneous” i.e. non-drug caused mania exists, I have never yet personally met someone who experiences it.

            I met a man once who would have “spontaneous” manic episodes every now and then, but that’s because he says he had a brain injury when he was a kid. I have no idea about the legitimacy of his words regarding the matter though.

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    • The placebo effect is a positive expectation.
      The nocebo effect is more of a voodoo curse.
      Diagnosis operates belief induction on the unwary.
      However my sense of sanity is of being conscious of the thoughts I accept true – such that – for example a cancer diagnosis would not automatically mean a death threat.
      Once shocked into reaction, the mind is in a sense captured to seek in the terms or framework of threat to power or indeed a threat by power.
      Because of this simple fact, all attempts to mitigate the power threat STILL operate the equation of power with threat; attack; defence; protection.
      It isn’t only psychiatry that assigns false causes by which to generate self-righteous crusades ‘against evils’ that operate a negative economy that feeds upon sickness, and so pharms sickness or indeed war and division.
      The mind that ‘gets’ a sense of security, power or protection from fear, war, sickness, operates self-interest.
      But the ‘self’ of such interest is defined negatively in terms of escaping, masking or mitigating power-threat or outcomes we fear and don’t want- instead of aligning in purpose of what we DO want.
      Under the power-threat meaning, what you do want is denied, blocked or made ‘impossible’ and so a layer of substitution operates as the temporary escape of pain of lack of life as flow and connection. This is the mind adapting to insane premises that reflect an insane world as its only way to survive.

      Relationship is not fixed, but where another’s mind is negatively fixated you cannot change it by force – but you can extend the conditions in which whatever willingness there is for relationship and communication to naturally arise – for the blocking of our channel of communication is an unnatural condition – regardless how many align in protecting and reinforcing the block as if separation is salvation.

      An extension of positive regard, acknowledgement for being and sense of worth – is the natural disposition of health. We see ourself in others whether we know this or not. Denied fears project as if to disown and get rid of. But that is how to keep them while believing they are ‘outside us’. It would seem MORE fearful to own them because they are negatively charged and seem to be attacking or denying us. But that is the nature of the trick of judging the negative through the filter of its own framing.

      The purpose we are embodying (in any moment) is the determiner of our experience.
      Power-threat frameworks of ‘meaning’ generate purpose of self-survival at cost of sacrifice to such ‘meanings’. Questioning the reality of such ‘meanings’ rather than reacting in equal and opposite reinforcement of the very thing one is set against.

      The mind is like a trickster while it serves the purpose you gave it to keep hidden by always looking away.
      The internal bully is the self negating voice believed and reinforced as ‘right and true’ within any outer experience of being bullied. Putting the problem OUT THERE is not facing what lies beneath – and that is a choice that can be revised or changed in willingness and curiosity for both truth and healing – for of course they are the same at heart – but not to the power-threat meanings of the split mind.

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  5. No! No. No. No. No. This is very disappointing. Phil is one of the best writers for MIA, but this is just wrong. I’m very disappointed. Psychiatry must be ABOLISHED, along with all of the pseudo-scientific subsidiaries. Anti-psychiatry has nothing to do with finding replacements or criticizing psychiatry or the so-called medical model. Anti-psychiatry means ABOLISHING psychiatry and everything that reeks of psychiatry. Usually Phil is spot on with his articles, but I’m very concerned about this trend toward critical psychiatry that attempts to usurp the name of anti-psychiatry.

    Frank is absolutely right. “Mental distress” will become yet another psychiatric euphemism. For HEAVEN’S SAKE people! Just mind your own business. If you think someone else has “mental distress,” then go look in the mirror and consider the ways in which you might be causing it. Good grief. I’m so sick of psychiatry. Come hell or high water, I will find a way to slay the dragon of psychiatry.

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    • So what do you suggest for people that are so distressed they seek help? I agree that it is important that “mental distress” doesn’t become an psychiatric euphemism but the fact is there are people who need professional help to deal with the trauma they have been through or the irrational thoughts they have when they led to not being able to function.

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      • People seeking help should not be lied to, plain and simple.

        The system lies to people. I work in a state “hospital” where people are treated for “chemical imbalances” with the toxic drugs. When I voiced the fact that there aren’t any such chemical imbalances (in a small meeting of administrators) one of the administrators told me that he didn’t think that any of the psychiatrists at the “hospital” believed in “chemical imbalances” anymore. I then asked that, if this was true why was the only treatment for people on the units the psychiatric drugs that are given for supposed “chemical imbalances”? I received no verbal reply but a lot of blank stares. Then the meeting continued as if I’d asked nothing at all.

        People seeking help should not be controlled by the system that they seek help from. Even people who sign themselves into the “hospital” voluntarily end up not being able to leave when they become disillusioned with the so-called “help” that they receive. They supposedly had insight when they signed themselves in voluntarily but all of a sudden, when they don’t agree with what is done to them they no longer have any such insight and become a “danger to themselves and others”. At that point they are not going anywhere. And they will be drugged against their will, all for their own good of course!

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    • Offering some sort of support like a consultant does is very different from a sort of ‘educational’ approach of supervising or even the need to ‘control’ things and forcing a singular solution strategy on somebody. When being in your subjective distressed and confused state nobody should ever force something on you but merely offer several strategies that have been evaluated by professionals according their successfullness. But every technical approach is constantly upgraded and even changed as new insights are reached and further knowledge and experimental data has been gathered. This approach explained so well and in much detail by Phil who does a fantastic job indeed is of high value, but it still doesn’t address the distorted roots of psychiatry and psychology where it is believed that they have to ‘correct’ a certain behavior or thinking. It’s simply none of their business. When I as a IT technician get a job to fix something for a company, they tell me what they want to acchieve and I tell the of the state of the art and all necessary facts but they decide what they ultimately want and it’s my job to implement their needs and tell them if first I can do that and second decide if I want that to do for or with them.

      If they decide to use some strategy that I am not fond of I simply tell them, no, I am not the right consultant for you, I’m sorry. But psychiatry takes away your rights and psychology does the same but in a more subtle and seemingly ‘kind’ way to then force a solution on you. That’s wrong and it stems from psychiatry and psychology never having addressed and processed its very dubious history.

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      • Phoenix,

        Thanks for this interesting perspective.

        Paradoxically, although I’m very clear about aims, methods, perspectives, and philosophy of the psychiatric profession, I cannot say the same about the profession of psychology. This is because, almost from its beginning, psychology glommed onto psychiatry as a ready-made portal to the “mental health’ business. And in many (perhaps most) cases, psychologists adopted psychiatry’s spurious philosophy whole-heartedly. At present, psychologists in America are lobbying hard at state level for prescribing “privileges”, and in some states have already achieved this. Psychology was co-opted by psychiatry decades ago.

        During my own career (I’m long retired), I always opened my discussions with people who came to me for help with a simple question: “How can I help you?” I then shut up and listened.

        And here’s the great heresy: most of what I did that was helpful wasn’t so much a product of specialized training in psychology, as a willingness to listen, an ability to empathize, and some personal experience of life’s vicissitudes and challenges.-

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        • Thank you Mr. Hickey,

          the precribing privileges are a problem indeed, one of my therapists also talked about wanting to get the right to prescribe and you know, she merely had that psychotherapy education and no academia background. In my opinion you need to have a profound education in medicine (how the human body works) to dare to do that. Although I also somehow get the idea of registeredforthissite above who wants to have pharmacists handle the thing completely on their own. I think that is fine for a certain kind of people but not everybody is able to handle so much independence and freedom (as to get the right medical and pharmaceutical consultants and come to their own conclusions and so on). Maybe thats where Mr. MacFarlane’s social control comes in… What do you do as a society with people who have a so-called ‘self-destructive’ behaviour (which is of course subject to a certain viewpoint because ‘self-destructive’ is already a judgement) and seemingly have troubles to deal with so much freedom?

          Psychology to me is a science, different to medicine (aka psychiatry). Medicine is a more technical thing, they work with and on the body. Therefore, they should stay where they are needed, to understand consciousness and awareness. And finally dare to learn some scientific methods, refrain from isolating themselves by merely philosophizing about things but educate themselves in maths and statistics and physics and biology and IT (artificial intelligence) to get a working model of what consciousness (and subsequently behaviour and so on) is. I really liked Freud’s thinking, allthough he got many things messed up also because of society’s beliefs at that time and limited scientific knowledge, but he had a very natural science and technical viewpoint and I think that is desperately needed in the field of psychology. But psychology in my opinion needs to establish their own reputation as scientists and keep off the territory of medicine and also off social worker. Those social scientists (and yes, I reckon social studies to be a field of their own) need to find ways to deal with society’s issues in cooperation with the law to find solutions and acceptable means for the social control thing…

          I so much know without even telling me that you were the kind of psychologist that would listen. Its in the vibe you are giving in everything you do. Its so thoughtful, you know and so gentle.

          Best wishes to you!

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          • I got it wrong, psychiatrists are not needed to “understand” consciousness and awareness, that would be the psychologist’s task, well, interestingly, as I just think about it… these professions got the roles confused somehow … the scientist should be the ‘chief’ because he comes up with knowledge, therefore, its very wrong for the psychologist to be sort of an advisor to psychiatrists it feels to me … psychiatrists are medical technicians, who should be very well paid as technicians always are because they do a very complicated job, but hold little power because they are merely technicians, meaning they offer solutions for the body to get back into its respective balancy… so in fact, Mr. Hickey and Mr. MacFarlane, don’t you agree that it is quite funny that its the psychologist who carry the blame, because they are really lousy scientists in modern times having too little hard scientific education (maths, chemistry, physics) and therefore we are still stuck with the old philosophical based concepts of behaviour and therefore psychiatrists get it wrong and society as a whole…

            Or am I following the wrong train of thought here?

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        • Another thought on that concept of seperating the fields, you know, that is the very sound approach of democracy, seperation of powers, and it is a very intelligent concept that is used in nature and the body very well. You have highly specialized departments but you also need a communication system and so on.

          I think the problem psychiatrits face is a kind of being overworked. A technicion should never be allowed to have too much power because technicions forget everything when they are testing out some funcionality. I know it from myself, I get lost in programming because I want to find a working solution. Well, I work with machines, thus I have less troubles causing them pain (as long as they do not reach some sort of consciousness, anybody out there watching the series Westworld?). But psychiatrists work with people and in their technical way of thinking they also are doing, are sort of forced to, do experiments and there it goes wrong so often.

          They are in need of a working theoretical concept, which should be brought along by a science. Scientists again needs restrictions which should ideally come by laws, as we have experienced with history e. g. the atomic bomb. Because again scientists are prone to loose reality when they are figuring out something new and forget about consequences for society. Can anybody follow what I am sort of on to?

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    • And a word to family members supporting a loved one in distress. Like with medical decisions e. g. regarding life support for somebody unconscious, you of course are in the ufortunate position to make decisions like hospitalizing your loved ones. But when the loved one comes out of his or her distressing state and is angry because of what treatment they received you have to step into your responsability and explain yourself without refraining from this by hiding behind ‘there has been no other means,we had no chance’. The latter mentality, when nobody ever stands by his or her deeds, the blame just moves along from person to person and destroys everything. Explain your reasons, try to understand the one accusing you as having been wrong, defend your action if you feel the need to do so, but never give away your autonomy by claiming it on ‘circumstances’. For someone labeled incapable of making decisions for himself but simultaneously being blamed for his behaviour its just unbearable that he is shut up of assessing what happened and that everybody just says, ‘there has been no other option’. Haven’t we learned from WWII that by refusing to take responsability for our individual actions and blaming it on a certain authority leads to unspeakable horrible things happening? If nobody feels to be holding responsability nothing can be changed. Why are we again getting so afraid in the last years to stand by the erroneous decisions we sometimes inevitably make? Who prompted us to forget that being human does not translate to being perfect but to be of failure from that we can learn and grow?

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    • “So what do you suggest for people that are so distressed they seek help?”

      I suggest that psychiatry be abolished so that it stops causing people so much distress. For the rest, I suggest that people seek help from God, family, friends, and others who won’t extort you, rob you, drug you, and possibly kill you.

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    • Slaying the Dragon,

      Thanks for this. Please see my response to Frank Blankenship above.

      You are, in my view, correct in pointing out that psychiatry will try to co-opt the PTM perspective. Watch for statements like: careful and experienced psychiatrists have always been cognizant of these matters, etc.

      My own position has always been that psychiatry’s systematic medicalization of all human problems is a destructive, disempowering hoax which has done and continues to do untold damage to people world-wide.

      It is also my position that psychiatry is irremediable, for the simple reason that they cannot let go of their spurious illnesses and their destructive “treatments”. Psychiatry must go, and it is to this end that I direct all my writing.

      In my view, the PTM document sets out clearly and in great detail the shortcomings of the psychiatric model, particularly the fact that psychiatric “diagnoses” are routinely used to conceal many of the great flaws and injustices in our society.

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      • Well you have made things pretty clear Phil: no concessions to ‘moderation’. Like all such extreme Utopian positions it’s quite comfortable, as there’s little danger of it being tested against reality.

        Seems you have little sympathy for those many people who, as I believe, are overmedicated, especially in the US. I guess from your lofty position you think they deserve their fate as they are too stupid, unlike you, to see through the obvious ‘hoax’.

        It’s pretty clear that your position is much more prevalent in the US than in the UK, and I think you are probably wrong in predicting the PTMF will change that. I suspect that more moderate views here will continue to be associated with less overmedication. As for ‘great flaws and injustices in society’, yes, ordinary psychiatrists over here are ‘cognizant’ of social factors, but even Joanna Moncrieff recognises that psychiatry should have a medicalised ‘social control role’ on the way to her particular version of post-Capitalism.

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        • Neil,

          The essence of my response to you (above) was that psychiatry has been actively promoting two enormous deceptions for decades. If you are disputing this, then please send me references to support the illness assertions or the curative assertions concerning the drugs. I would be happy to take a look, and, as I’ve said many times in my posts, if the evidence disproves my position, I will promptly apologize for my errors. In the absence of such proof, or even a convincing argument, however, what kind of “moderation” are you expecting? A destructive, disempowering hoax is a destructive, disempowering hoax.

          To the best of my knowledge, there is nothing in my writings that could even remotely be described as Utopian. If you have seen something of that sort, I would be grateful if you could draw it to my attention.

          With regards to the assertions that I do, in fact, make, they are eminently testable against reality. For instance, if it were demonstrated that all the individuals whom psychiatry identifies as “having major depression” were found to have a particular neurological pathology in a part of the brain associated with emotions, then my assertion fails, or at the very least is in serious trouble. To date, despite decades of lavishly-funded and highly motivated research, no such findings are to hand.

          You assert that I seem to lack sympathy for people who have been damaged by psychiatry. How you can interpret any of my writings in that light is beyond my comprehension. I have enormous sympathy toward the people who have been damaged (some, very severely) by psychiatry. Indeed, my primary motivation in writing these posts, which I’ve been doing for the past nine years, stems precisely from sentiments of that sort.

          I assume that your reference to my “lofty” position is sarcasm.

          Your leap from my response to the assertion that I believe psychiatrists’ clients deserve their fate because they are too stupid to see through the hoax is groundless. I have never said, or even implied, anything of the sort, and it is difficult to avoid the perception that you are resorting to ad hominem attacks rather than substantive debate.

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          • Dear Phil

            Yes, a bit sarcastic, but proportionate I believe, to your ad hominem statement that all psychiatrists deliberately deceive: that’s what ‘hoax’ means in both the UK and the US (I’m pretty sure). I could equally well ask what your evidence is for escalating Szasz’s more ambiguous ‘myth’ to that level.

            You foreground drugs, but many psychiatric/developmental diagnoses have little or nothing to do with Pharma: autistic spectrum disorders, addictions (originally, anyway) and ‘personality disorder’, for example. In fact, Szasz’s original concerns were about psychiatry colluding with psychoanalysis, with the aim of social control.

            I wish I had time for a longer answer, especially as your entertaining piece on http://behaviorismandmentalhealth.com/2017/11/28/rebranding-psychiatry/ has led me to reading that BJPsych article for the first time.

            I you read my recent Blog pieces then you will see that I have been far harder on Pharma (Nemeroff, for example) than the PTMF Psychologists that you praise. They appear to have come to a very British ‘gentleman’s agreement’ (a gender-free equivalent doesn’t come to mind) with their psychiatric opposites to avoid such difficult issues: will be Blogging on that in due course.

            Best wishes

            Neil

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          • Mr MacFarlane, I would like to grasp the point you’d like to make and I think I get the sometimes sarcastic tone of your writing, because I reckon that’s just a British way to communicate. British humour is just such a dark but great ‘in a nutshell’ thing.

            The problem I have is that your very eloquent and elaborate use of English language and scientific/philosophic/political concepts makes it quite difficult for me to follow. Could you possibly lower your high standards of communication a little bit for me and specify what you mean with “a medicalised ‘social control role’”?

            And wouldn’t you think that there are quite some dangers involved when people mess around with things (i.e. consciousness, awareness, mood) that are not very well understood yet? Especially in a biologic way? Medication does have its merits but as the so very educated thinker you are you can surly grasp the point psychiatric survivors make about forced treatment and coercion. Thus how would you deal with the serious power imbalance issues when some people get the authority to enforce social control?

            And which blog do you mean, where can I find that?

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          • Mr. MacFarlane, my dearest Thanks for your correction, I do now understand it slightly better. I understand that the UK has very high standards on many matters. May I ask if you have an opinion on the concept which was introduced by registeredforthissite? Because the generation Y would very much like to contribute to further development in society with sharing economy principles that we proudly invented based on the availability of new technology, but that seem to come amiss with well established taxing laws and so on? It could very well clarify some further difficulties that I have regarding your slightly conservative approach, doesn’t it?

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          • Before the Civil War many slave owners accused abolitionists of not understanding or loving the folks who “needed” to be enslaved. MacFarlane’s accusation of you sounds similarly ridiculous, Phil.

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          • Sorry if unclear. I try to avoid jargon etc, but inevitably get drawn into it when responding to a professional (albeit retired) such as Phil Hickey. My Blog is at http://www.DrNMblog.wordpress.com .

            Of course there are serious ‘power imbalance’ issues when psychiatry is used as ‘Social Control’, but there are for other law enforcement agencies as well, in any society with inequalities. And there are many problems with both voluntary and forced ‘drugging’, especially the influence of Pharma.

            It seems a bit unreal to be even discussing with someone stuck in the ‘abolish psychiatry’ mindset that the UK left behind in the 1980s.

            I stand by all my points above, and I question whether Phil Hickey really wants a ‘substantive debate’ or just wants to vent a longstanding grudge. He seems to imply that his own ‘ad hominem’ attacks upon all psychiatrists are fine because they are aimed at a group, not an individual.

            None of the PTMF psychologists that I have engaged with over here have supported his ‘hoax’ smear (a regular feature, I now see, in his Blog pieces), and I will be surprised if any do in future.

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    • Anti-psychiatry has nothing to do with finding replacements

      Absolutely correct! Did slavery abolitionists ever demand an “alternative” to slavery?

      The problem again is with people seeing psychiatry as a branch of medicine rather than of the prison system.

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      • Neil,

        I don’t think any reasonable person would interpret my contention that psychiatry is a hoax as implying that every single psychiatrist is complicit in that hoax.

        This string began when you questioned/challenged my characterization of psychiatry as a hoax. I responded to this by pointing out the twin deceptions that the vast majority of psychiatrists promote: that depression, and a wide array of other human problems, are caused by neuropathology; and that psychiatric drugs remedy this pathology. The onus, I suggest, was on you at that point to come back with some facts, references, or evidence to the contrary, or at least, a cogent argument.

        But in your response, you completely ignored the deception/hoax issue, and instead launched several groundless ad hominem attacks at me.

        I responded to each of these attacks, and pointed out that you seemed more interested in scoring points than in substantive debate.

        Now you’re back asking me what evidence I have for my accusations of deception. But you’re missing the point. The statements concerned are false. So when psychiatrists promote these statements, they either don’t realize that they’re false (in which case, they’re not too bright), or they are being deceptive. As I don’t consider psychiatrists as a group to be particularly obtuse, the deception conclusion is inevitable. If you wish to read more on my position on this matter, please see my post Psychiatry DID Promote the Chemical Imbalance Theory http://behaviorismandmentalhealth.com/2014/06/06/psychiatry-did-promote-the-chemical-imbalance-theory/

        You say that I “foreground drugs”, which I assume means emphasize. This is untrue. I respect the rights of each individual to ingest whatever he or she chooses. What I challenge, and emphatically condemn, is the fact that psychiatry uses blatant deception to induce people to take these drugs. They tell people, who present no indications or evidence of neurological illness, that they have such an illness, and that the drugs are necessary to remedy this disorder.

        You have throughout this string failed to address the matter of the twin deceptions, and have consistently avoided substantive debate. But in your response to Phoenix, you “question” whether I really want to have a substantive debate or merely want to “vent a longstanding grudge”. The implication being that my critiques of psychiatry stem, not from any objective assessment of its activities or perspectives, but rather from some personal vituperation of my own. Is it possible that you imagine that this kind of petty retorting constitutes substantive debate? Is it possible that you consider these gratuitous, deprecative attacks as having some value?

        If you wish to discuss/debate the hoax issue, or indeed any issue on which I have written, then by all means come back. If your comments are pertinent and objective, I will respond. But if you persist in these vacuous and groundless attacks, I will not respond.

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        • I have to agree with Phil, here. The evidence is in that psychiatric diagnoses are almost totally subjective, that the “chemical imbalance” theory was disproven (at least for serotonin and dopamine) back in the 1980s, that psychiatric drugs are not specific to any problem with the brain, but are general agents that impact the brain and body in a wide range of ways, sometimes very unpredictably. There is evidence that psychiatric diagnoses and the chemical imbalance theory cause discrimination against those so diagnosed, there is evidence that long-term “treatment” with these drugs does NOT create better outcomes, and increasing evidence that it actually may WORSEN outcomes overall. There is a ton of evidence that the main thing those who are diagnosed as “mentally ill” have in common is a history of trauma, and that the psychiatric system ignores or minimizes traumatic experiences in favor of biological explanations. There is evidence that being a minority, being an immigrant, or living in an urban environment contribute significantly to the development of “schizophrenia.”

          In the face of all of this evidence, what evidence do YOU have that Phil’s line of reasoning is wrong or is biased?

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        • Dear Phil

          Sorry, but it is you who have failed to substantiate your ad hominem attack on the overwhelming majority of psychiatrists as complicit in the ‘hoax’. That, I believe, is what a reasonable person would understand from your repeated use of the term on your Blog.

          You now state ‘…when psychiatrists promote these statements, they either don’t realize that they’re false (in which case, they’re not too bright), or they are being deceptive. As I don’t consider psychiatrists as a group to be particularly obtuse, the deception conclusion is inevitable.’ To me, that is poor psychology: intelligent people selectively attend all the time.

          Some intelligent professional psychologists seem prone to selective versions of history in which mental health and neurodevelopmental diagnoses were solely invented by medical doctors. The version which follows Foucault (as in the PTMF) is useful to distract from other histories which include non-medical psychologists. Stephen J Gould’s ‘Mismeasure of Man’ is one example of the latter.

          Another is Szasz’s ‘Myth of Mental Ilness’, which I have already referred to as showing that psychiatry in the early 1960s was not allied to the pharmaceutical industry, but to psychotherapy. Even in the second edition of 1974 I can find only one reference to drugs.

          Since the 1980s an alliance between establishment psychiatry and Pharma has led to massive overprescription of medication, especially in the United States. Although, for me, your writings usefully add to the deconstruction of that overprescription and its recent causes, your black-and-white insistence on the ‘hoax’ and your call to abandon all mental health diagnosis undermine those who seek reform now, rather than waiting for Utopia.

          Best wishes

          Neil

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          • Hi, Niel,

            So I am a little confused by your comments. You refer to Szaz, who very clearly and articulately took the position that “mental illnesses” are social constructs, not disease states. Yet you use the term “overprescription,” as if there were a “right” level of prescription that has been exceeded. How can there be a “right” level of prescription for a social construct? Unless we had a real diagnostic system that allowed people with actual, physiological problems be sorted from those whose metaphorical “diseases” are a consequence of social and interpersonal stress, or “problems of living,” as I believe Szaz called them, how on earth could we ever arrive at an “appropriate” level of “medicating?”

            Or perhaps you are in the Moncriefian camp, and view drugs as simply having effects that we find desirable/undesirable? If so, how does the profession distinguish between effects found desirable by the individual him/herself and effects found desirable by the society around him/her?

            To me, this issue of “diagnosis” is central to the whole problem of “overmedication,” as drugs are being used to “medicate” people who are not objectively ill in the physiological sense.

            The fact that folks other than Big Pharma-influenced psychiatrists came up with some of the diagnostic categories is neither here nor there – the categories lump together people who have little to nothing in common and presume that they ALL have the same problem and need the same solution. This is not science, it is fiction, and to the extent that it is known to be fiction, can only be regarded as a hoax, as Phil outlines.

            Prominent psychiatrists have admitted out loud that the chemical imbalance concept has been known to be false for decades, and research backs them up on this. Yet they have publicly justified telling patients this is true in order to make them feel more comfortable with taking their prescribed drugs. Doesn’t that sound pretty “hoaxy” to you?

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      • Curious as to what MacFarlane and others mean when it comes to “moderate.” Sounds suspiciously like a code for business as usual.

        “Stay with us, be good–not uppity–and we promise not to hit you too hard most of the time. Unless you provoke us.”

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        • How does a ‘moderate’ aim of reducing antidepressants and bipolar prescribing by 90% sound? Maybe within five years. I don’t know enough about other drugs in the US to suggest goals right now.

          I will be blogging about what I regard as Dr Moncrieff’s false suggestion that reducing diagnosis will reduce prescribing. I used to work with the learning disabled (mentally retarded in US) and they are overmedicated on a ‘drugs-based model’, mostly to calm behaviour, without diagnoses.

          Szasz was an extremist, like Phil Hickey. As I have stated, his ‘just a construct’ view came in before Pharma. When Pharma became dominant he had to patch up his extreme libertarian views by saying the ‘Pharmacracy’ was an exception that had to be regulated.

          Have to leave this now…will be blogging on the various aspects…you can subscribe to my posts which won’t average more than one a week. drnmblog.wordpress.com/2018/04/30/the-inflamed-mind-by-ed-bullmore-book-review/

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          • Just when he posts something concise enough to respond to he leaves. Oh well. Anyway,

            How does a ‘moderate’ aim of reducing antidepressants and bipolar prescribing by 90% sound?

            Positive in the sense that reducing the incidence of murder-for-hire would be an improvement, but it wouldn’t solve the problem. But if that’s your goal go for it, we won’t try to stop you.

            Szasz was an extremist, like Phil Hickey.

            I’m sure neither would be offended, though some eye-rolling might be in order. In fact both were/are attempting to restore some balance in the face of psychiatry’s attempts to redefine the meaning of language (and “medicine”). If claiming that a metaphor can have physical properties isn’t extreme I don’t know what is.

            I will be blogging about what I regard as Dr Moncrieff’s false suggestion that reducing diagnosis will reduce prescribing.

            You mean that people will demand consciousness-depressing drugs whether there is a medical pretext or not? This is likely true, largely due to the atmosphere created by Psychopharm. If all drugs were legal I guess people would learn to pick and choose which ones are deadly and which are useful.

            Timothy Leary once postulated two additional Commandments: a) “Thou shalt not alter the consciousness of one’s fellow man [sic] without consent”; and b) “Thou shalt not prevent one’s fellow man from altering his consciousness.” (Or something like that.)

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          • So again you use the term “overmedicating.” How can you “overmedicate” when there is no objective means to determine what “appropriate” medicating is? Isn’t giving “medication” for a non-medical condition called “malpractice” rather than “overmedicating?” What is the standard?

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          • Since you’re the doctor, you can reduce your own prescriptions of mind altering drugs by 100% any time you choose and tell patients the TRUTH that there is no known organic cause for insanity. As far as Great Britain as a whole, you’ll need approval from Sir Simon first for your 90% reduction plan. Unduly optimistic…even Utopian….

            Btw, Steve, MacFarlane never did answer your question as to whether he tells patients they have “brain chemistry imbalances” when he prescribes them drugs. Most MI professionals are very vocal about this spreading this myth. No prominent psychiatrists (aside from a few mavericks) care to correct this view.

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  6. Personally I like the link that has been made between needs and more specifically threats to those needs and how people react, adapt and attempt to change their circumstances as an explanation for their “symptoms”.

    This framework is long overdue and well done to the BPS for showing initiative in this regard. The American Psychological Association and the Australian Psychological Society should be ashamed of how they have continued to live in the shadow of big brother psychiatry and how they have endorsed the lies and misinformation from this pseudoscience.

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  7. Thanks Philip, it’s nice to see some more excellent analysis, on Mad In America.

    SCHIZOPHRENIA
    (In my opinion ) the majority of “Schizophrenics” are misdiagnosed; they are tied into longterm “Illness” by Withdrawal Syndrome. Its the Psychiatric drugs that disable not any underlying “illness”.

    (I can substantiate what I’ve said above, from my own “medical history”).

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  8. Power, Threat, Meaning:

    To be, or not to be: that is the question:
    Whether ‘tis nobler in the mind to suffer
    The slings and arrows of outrageous fortune,
    Or to take arms against a sea of troubles,
    And by opposing end them? To die: to sleep;
    No more; and by a sleep to say we end
    The heart-ache and the thousand natural shocks
    That flesh is heir to, ‘tis a consummation
    Devoutly to be wish’d. To die, to sleep;
    To sleep: perchance to dream: ay, there’s the rub;
    For in that sleep of death what dreams may come
    When we have shuffled off this mortal coil,
    Must give us pause: there’s the respect
    That makes calamity of so long life;
    For who would bear the whips and scorns of time,
    The oppressor’s wrong, the proud man’s contumely,
    The pangs of despised love, the law’s delay,
    The insolence of office and the spurns
    That patient merit of the unworthy takes,
    When he himself might his quietus make
    With a bare bodkin? who would fardels bear,
    To grunt and sweat under a weary life,
    But that the dread of something after death,
    The undiscover’d country from whose bourn
    No traveller returns, puzzles the will
    And makes us rather bear those ills we have
    Than fly to others that we know not of?
    Thus conscience does make cowards of us all;
    And thus the native hue of resolution
    Is sicklied o’er with the pale cast of thought,
    And enterprises of great pith and moment
    With this regard their currents turn awry,
    And lose the name of action.—Soft you now!
    The fair Ophelia! Nymph, in thy orisons
    Be all my sins remember’d.

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  9. Can’t get behind this at all, sorry Phil. I saw this mentioned before on MIA.

    The “alternative” to psychiatric diagnosis is NO psychiatric diagnosis. Etc. And I see no critique of capitalism.

    However, as Phil Hickey is the only anti-psychiatry professional or ex-professional who seems to totally respect anti-psychiatry survivors I will read & comment more intelligently when I’m far less tired.

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      • And so do I, Phil Hickey…not only psychiatric diagnosis but the whole conceptual edifice on which it is built has to go. That is what the Framework argues. It also makes clear links between distress and social injustice in the form of capitalism, neo-liberalism and all the ideological messages that accompany and support them. How successfully it does this is up to others to judge. However, we are encouraged by reports not just from professionals but from service users, peer support groups and so on that people are finding it a helpful way of getting beyond diagnostic assumptions.

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    • I don’t see “diagnosing” “mental disorders” as all that different from “identifying patterns of emotional distress”. One difference is that the “mental disorder” label serves an insurance company purpose, “mental health” (“emotional distress”) treatment being very expensive. Getting insurance companies to pay for lessening “patterns of emotional distress”? If only the insurance companies wanted to save money that much.

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      • The difference is whether sovereign will is respected.
        A technocratic system of control does not allow for will excepting as quantifiable delusions of conditioned response. It is the insanity when we sacrifice life and lives to it instead of using it (system) only in service to life recognised and professed or witnessed.

        The very attempt to ‘officially’ define a fresh perspective can indeed work against healing while seeming to be a new crusade on its behalf.

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      • I do see them as different. Psych labels are external and fixed. “Patterns of distress” are more of a philosophical categorization and are both flexible and applicable by either “clinicians” or the people experiencing the distress. Plus, you can’t arrest someone for a “pattern of distress.”

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        • Distress may result from unwitting beliefs about self and world that guarantee frustration, failure or futility – but I don’t like the use of ‘philosophical’ as a term for what are inducted and acquired unconscious beliefs from preverbal levels of development.

          Very few engage philosophical reflection on the beliefs they are aware of holding – and not at all upon those they react from as if true without awareness that the reactions embody beliefs or self-definitions that are neither fixed or true. But for whatever personal reasons they served some purpose or payoff that still runs until recognized and released – even at cost of great distress.

          Insofar as philosophy is love of truth, it brings awareness the uncovering of our current beliefs and accepted currencies of belief. This can illuminate poor or insane choices to open new perspectives from no longer choosing them. ‘Medicalising’ human beings in order to disempower and ‘capture’ them is an insane choice with insane consequence.

          My feeling about ‘patterns of distress’ is to seek their commonality (within our own heart) whilst recognizing their unique personal expression. I never could feel another’s pain and no one can share mine – but resonance of compassion joins in love’s honesty, where separating while sympathising seems to join while labelling to patronise or take a superior position in ‘forms of caring’.

          Separation trauma is a commonality though it can take all kinds of forms according to the personal situation within the family constellation and social context.

          Focusing on forms to the exclusion of underlying psychic emotional conflicts is a psychological defence against feeling the conflict. Society can and does assign ‘form-meanings’ of invalidity and exclusion to collectively feared psychic emotional experience. That is how the ‘mind’ operates an exclusive or segregative identity. It is the underlying sickness of thinking from which a world where everything is backwards is given power over true cause and purpose.

          The shift to an inclusive reintegrative identity is the recognition of self in another and of other in our self. Everyone you meet offers you a part of your self. Abiding with, rather than recoiling from, is part of the process of welcoming presence instead of identifying in ‘conditional demands’.
          Any ‘system’ or tool is serving only the purpose it is actually being used for. A system of control is necessarily manipulation via incentives and penalties.

          The paradigm of ‘control of chaos’ calls forth the law of Man – in terms of holding order within what cannot be faced or recognized and reintegrated. As I see it ‘Jesus’ represents the law of love – not wishful masking in niceness – but a true recognition of presence and discernment of will to wholeness. Fear of love (healing) is the association of love with loss of control, sacrifice and loss of self. But this is fear’s assertion and not love’s freedom. Challenging fear formed beliefs is merely opening them to awareness. This is not a mentally framed action, but a willingness to see what is here, or a willingness to be seen and known so as to regain connection, integrate and move through rather than be fixed in.

          I am not a recovery from psychic abuse so much as one who chose NOT to engage with ‘helpers’ who – as I intuited – could only help me get back into a fake life, when whatever had opened me – held the quality and presence of being – albeit terrifying, overwhelming and beyond ‘control’. Over time I came to learned that fear was my (thought and intention) responsibility and that presence is a gift that is not my ‘doing’ nor under my ‘control’ – but holds within itself, all that it needs by being itself. So it is that when therapist and patient open awareness in shared purpose, the situation itself will guide them to a helpful step from a willingness rather than under coercion.

          Coercive mental frameworks can operate extremely subtly in terms of seeming to be kind. But true kindness is OF a kind, in that at some level we recognize we are of the same life – and that what we give is to ourself.
          The practice of giving as we would in truth receive depends upon self-honesty and worthiness of being. Without these foundations, nothing can grow or develop as consciousness of integrated and unified purpose.

          Distress is not something to deny, gloss over, protect from – excepting temporarily so as to regroup with a more practical approach. Distress is where the underlying honesty of true need breaks through the emotionally manipulative demand. This rising of perspective is of a different order than problem solving within problem framing.

          There is nothing wrong with your being, but your belief that there is can operate the experience of dissonance and discord within self and with other selves and world. One cannot pretend an active belief is powerless just because it operates subconsciously. But that still does not make you ‘wrong’ so much as choosing against your own good under mistaken belief it protects or serves who you think you are. The key is then to identify the habit-reaction so as to bring it to conscious choice, and then support a better choice. Because you’re worth it! Why? Because if you don’t start with where you are you will never uncover and share in the worthy. This is always a current choice – never a rehearsal. A life in rehearsal ‘seems’ safe while making Life seem dangerous!

          Relationship is challenging, and ‘chaotic’ when we lose the movement of our own being to fears made real.

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          • The conditions that trigger patterns of distress may change, but the pattern remains triggerable until it is brought into the responsibility of choice. The attempt to control ‘conditions’ (which includes the intent and attempt to control others), is a refusal or unconscious evasion to face one’s ‘issue’ – kept unconscious by seeking to change symptoms.

            Worshipping the false god of pharma is a variation upon the belief that self must be escaped, purged or denied. This ‘pattern’ of fear and guilt can take many forms. The fearful and the hated can be placed outside, the guilt packaged in complex derivatives – but the result is misery that pays the cost to keep a little back for oneself in which to protect the mind of judgement by which some sense of power is maintained over or against a mad world – a power that yet turns against its maker to condemn them.

            Patience (note the shift of meaning) for life could invite a curiosity of re-evaluating what matters and why, and then being consistent in noticing and choosing to value life, rather than be victim to the ‘patterns’ that trick us into valuing ‘escape’ from misidentifications.

            Negatively defined self is directed by what one does NOT want – and though this can seem positive – ie protective to our feelings and emotional beliefs – it always works the fear-fulfilling prophecy of persisting in the focus of what we do NOT want – even if as an attempt to avoid or escape it.

            Identifying and focussing in what we truly want – can be extremely simple and apparently inconsequential relative to the ‘Big Drama’ – but it is powerful and true. Consider how many moments for happiness you refuse – perhaps because your focus in the ‘drama’ disallows or discards them. Your own part in your imprisonment is hidden by the rules and conditions that filter the meanings you accept as real for you. Curiosity for what is real comes from relaxing and releasing fearful ‘rules’ in true moments of willingness, felt and acted upon. A sick mind is a fixation in worthlessness – regardless if that sense is packaged in compensatory self-inflations. The wonderful event of noticing a sick mind is that your health has stirred you to notice rather than merely persist in it. No blame. let insanity simply point to a meaninglessness that requires no further investment, so as to live your willingness and let yourself into health and wholeness.
            Of course old habits persist – but the mistake is in believing in regression and loss and investing in the belief. Noticing the pattern is awakening the choice – the freedom of the choice that is not fear-framed. Living without the fear-framed illusion of protection is very different. It may also feel insulting to our presumed abilities and powers to organise and manage our world – whether we be in the role of therapist or client. The urge to ‘do it all by ourself’ is an easy pattern to notice and a source of self-pride and failure in pain of loss or inadequacy. The ‘all by myself’ is a miser-y. The miser withholds their presence as if to keep it – and but a trickle induces a sense of poverty. When we alight in a joy – we are not merely ‘getting’ from – but giving or extending (the meaning of our presence) to. It is this that we forget in a weird world of strange and shifting ‘meanings’.
            A world that seems to define us – without recognizing we ‘made’ these meanings by fears, doubts and pains of conflict – from a time of terror that is passed and yet seems to repeat or re-enact through the generations.

            Humpty Dumpty sat on a wall,
            Humpty Dumpty had a great fall.
            All the king’s horses and all the king’s men
            Couldn’t put Humpty together again.

            What if Humpty’s Fall was a false flag?

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        • Steve, surveys show that viewing “mental illness” as caused by emotional distress lessens bigotry while the alleged biological explanation increases it.

          NAMI published an article a few years ago acknowledging that educating people about the “chemical imbalance” does not decrease “stigma.” Many of the bigwigs–such as Pete Earley–know it’s a myth, but continue to use it. Without Big Pharma’s support NAMI really would be a nonprofit. 😛

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        • Indeed Steve diagnostic labels are seen as intrinsic to the individual leaving us dependent on expert cure or management, their biological nature fundamentally disempowering and stigmatising. Whereas the idea of patterns of distress rooted in a response to circumstance leaves us free to explore the means of addressing those circumstances and whatever it is in those circumstances or our responses that trap us here.

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          • Rachel is quite right there. And empathic relationships with ourselves or others are key to responding to distress. Postulating biological causes renders the need for empathy, a difficult process at the best of times, pointless which serving the interests of power is probably just the point of such reasoning. ‘your loved one is ill, there’s nothing you can do, we’ ll take care of the problem’. Although for people diagnosed they often have few if any potentially empathic relationships in their lives and I suppose that is often why we can overvalue the role of professional help.

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  10. Split meanings operate power struggle in which victim/follower and victimiser/leader play out shifting roles.

    Meaning – with a capital M – is pre-split or indeed wholeness of being. The ‘broke and fixit’ or ‘Humpty and all the king’s men’ model engages attention under the ‘divide and rule out’ device. Otherwise the pain of the split mind constitutes a breaking of the rules, and is assigned to be ‘fixed’ or walled out (denied voice).

    The meaning of a power as threat is generally the trigger to fight or flight, and even at biology level this ‘sympathetic’ nervous response is known to suppress all else to focus in heightened perceptions of associated (past) dangers, involving extreme suppression (hiding or playing dead) and extreme release (fight or flight).

    But the subjection of the mind under a power that it is unconscious or unaware of is the nature of the human conditioning or human condition of masked self under split thinking. The persona or ‘masking self’ is necessary to a human experience – but the patterns of defences and strategies that are developed varies greatly – and yet operate a collective entanglement of invested meanings given identity.

    Our true responsibility for the accepting and sharing of meaning, is personal cultural significance as coherency of being. But a fear-protective denial of responsibility operates masking in forms of a hidden or private agenda. This split thinking is amplified in Orwell’s doublespeak – but is pervasive to ‘accepted reality under narrative control’ – where people are fear-trained to conform and comply without conscious awareness that what they take to be their freedom is slavery and so freedom is rejected and recoiled from as if it is slavery.

    While these reflections on ‘power threat meaning’ may seem off topic, I hold that the true meaning of power is corrupted – and I live towards correcting it. Power does not corrupt and limitless power is incorruptible – but in my usage here is power perfectly shared – and not split into victim and victimiser.

    This is a shift in perspective and not a strugge within or under fear.

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  11. OK this is the 3rd time I’m typing this out after “glitches” wiped out my comment twice.

    Anyway, I did read the piece, and still basically share Frank’s lack of enthusiasm.

    The value of this document to anti-psychiatry is questionable, but I suppose it depends on one’s perspective, and on whether one is a survivor, a “professional” or another. In that the “professionals” and academics to which this is primarily addressed are unlikely to ever confront systemic oppression effectively enough to risk jeopardizing their lives or careers, its relevance to the real world is suspect to say the least. It strikes me as more of a philosophical statement than anything; but even then many of the “insights” are platitudes and half-steps to anyone who has a true, developed anti-psychiatry analysis, which is what is necessary to defeat psychiatry.

    Psychiatry is a branch of the prison/”justice” system, not of medicine. This is not a “provocative” statement intended for effect; it is a simple fact. As such, any “anti-psychiatry” movement must disabuse itself of the notion that (bless our hearts) we are looking for better or more intelligent ways to “help people.” Maybe some of us are doing that too. But psychiatry is not there to “help” us, but to keep our behavior in check. This is what we must remember when developing strategies to defeat it.

    As for “science” — science went out the door when a critical mass of ignorance accepted the premise that metaphors can be the same as concrete reality, and allowed the logically and linguistically absurd concoction of “mental illness” to enjoy public acceptance. ANY “study” of “mental illness” or “mental disorder” is thoroughly UNscientific from its inception, no matter what the conclusion, as it accepts a logical absurdity as one of its premises.

    I’m guessing this post is only the beginning, and there’s more I could say. I respect that Phil believes this to be an important contribution to the anti-psych struggle, so I guess we’ll have to see. But don’t put down your banners and spray paint just yet.

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    • Unresolved and denied psychic emotional conflicts are the insanity of humanity – period.
      The article above illuminates some of the psychic emotional conflicts of ‘psychiatry’.
      “Psychiatry in search of an identity”.
      Psychiatry never was science. But nor is much else that might be science allowed to operate AS science under corporate technocracy – in any field. I include pharmaceutical ‘medicine’.

      But insofar as science seeks to manipulate or control outcomes rather than uncover them, it operates the subordination of the means to achieve its goal, in reversal of the laws of cause and effect – as a result of seeking identity in effects instead of being naturally identified in shared worth.

      Power as threat operates to prevent true shared meaning.
      This sense of blocked, denied, deprived or conflicted power in powerlessness operates intra-personally and inter-personally. A coercive social order tends to operate upon naming and blaming as the basis for shaming. This is no less so under ‘scientific jargon’ of a personal ‘diagnosis’, treatment plan, and assigned status of invalidity-dependency – all ‘normalised’ to mask the agenda behind presentations of presumed knowledge of the world, life, its purpose and meaning.
      Unhealed healers cannot BUT seek to use others to ‘resolve’ or play out their own psychic emotional conflicts – and the the group-think of self-interest operates a collective reinforcement against the exposure of needs – seen as weakness.

      Experiential education is needed to move us (including ‘therapists) out of mental schemes and systems of judgement, to exploration of our own lives – in the uncovering and working through of our own blind spots, fears and false self presumptions – so as to grow in compassionate presence in ourselves and thus with others. The Corporately captured State will not allow such freedom to be developed and grown. The Economy will pull out support from it, and the Law will be interpreted or changed to make it criminal to operate outside ‘standard practice’ as set by power, threat and imposed meaning. However, this is just such a situation in which to expose our ‘power issues’ of fear defined belief and reaction. The threat-meaning framework of society is the carrot and stick of ‘acceptance or rejection’; worth or invalidity, power or powerlessness – as externally defined and assigned – and self-subjected.

      A truly compassionate presence is discerning of the felt truth in the qualities and nature of any situation or communication, and remains vigilant against false sympathies that operate destructively in teaching weakness and dependency under the seeming ‘help and protection’ of expertise that may in effect be a blind template of technical specifications.

      The honouring of the will of the other or ‘patient’ is not the protection of their ‘feelings’ but of their capacity to make choices and learn, grow and recognize and align in more truly aligned choices for who they are the exploration and uncovering of. Serving the true needs of another is the only way to find our own are met.

      The head of thinking is never going to define and control life – nor direct the resolving of life conflicts. But insofar as we try to do this, we consign true causes to the dark by invoking magical appeals to their ‘diagnosis and ‘treatment’. Magical because the problems are not addressed at Cause – but as the manipulation and redistribution of effects.

      There are already many facets of wisdom approach to serving the need for healing in those who are no longer able to mask, manage or normalise their suffering and so it becomes more obviously a call for help.

      The ability to attend and abide with the apparently chaotic is the non reactivity of preset (subjective) judgements. The attempt to subordinate or indeed sacrifice a relational intimacy of ‘listening’ and response to proscribed technical procedures, is fear-driven control. But of course the tendency to ‘play god’ over others is where such fears originate. But that which is masked over or suppressed is no less active in its underlying distortion of communication – as embodying a framework of power-threat defence-meanings instead of truly meaningful relationship and communication.

      Every instance of relationship is a unique event. Running on templates of the past as in ‘auto-pilot’ is holding the quality of being to the past and inducing conflict within presence. Yet it is recognising this that enables its release – in therapist and patient alike. Naming to blame, as an act of power over – is making Presence powerless in our lives. And so our development of power masks a blind powerlessness under guilt-driven threat – BELIEVED and lived as if true.

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        • No – I generally sketch out meanings that are universally applicable. But they are consciously felt and shared without strings attached. Agreement may constitute a sense of self-reinforcement , or it may be a recognition of resonance at a deeper level of awareness than ‘thinking’. The latter opens new perspective on ‘old thinking’.

          Thinking is the means by which we maintain our personal sense of control, yet it is also the means by which we lose connection or genuine relationship and communication to a dissociated self-sense.
          This could be a therapist succumbing to the temptation to ‘play god’ over their patients. This could be the patient seeking magical answers by which to evade self-responsibility.

          Power-threat meanings are the pervasive nature of the world we experience and react to as if true – not just in the domain of psychiatry. They can operate in forms of ‘kindness, help and protection, as they can in seeking sympathy or rescue. This is to say that what is presented is not what is actually communicating. Listening to another is also listening within – because if we are not listening within, we are blind to our own reactive judgements as OUR reflective feedback to our OWN issues.
          Whether serving the call to help another or of aligning in our true desire, much of our part is to “get out of the way’. While remaining actively present with and within the situation.
          Much of my own ‘self-learned’ equilibrium and capacity for intimacy of being has been the noticing of what I am already doing that gets in the way. On one level this is like a tension that – once noticed – can be relaxed and released.
          Un noticed – it can seem that the world is sharp, hostile, treacherous, unworthy over the underlying fear that I am in some way inadequate or unable to abide it (and so dissociate).
          I could fill pages with examples – but we are all already living them out and a simple self honesty recognizes that ‘getting in our own way’ in our own particular patterns of learned, conditioned or acquired thought and behaviour.

          I speak for the ability to notice our active presumptions, beliefs and self-definitions, as the freedom to change them. Our experience of ourself, others and world can only change with a change at such fundamental level.
          Nothing is what it seems – in terms of having fixed built in meaning. Power threat can split the mind to conform to meanings associated with evading deeply feared conflicts or patterns of traumatic association. Thus an insane humanity can and does ‘lock itself’ into insane or split ‘meanings’.
          All of us are both therapist and patient – in the sense of being helper and helped in the course of our day, and our lives. But in the true of help is no separation – but rather a recognition of self in the other. This is not a thinking thing. Thinking is generally the self-differentiation and justification for withholding of presence – as a masking dissociation of ‘narrative identity’.
          I see power-threat meanings as getting in the way of a true appreciation and gratitude for power of truth. This is because the a-tempt to personal power will inherently conflict with the movement of being, and at odds with our being, is dissonant to our self-image – which is then defended against the true relational field of communication, so as to operate a reversal in consciousness in which fear overrides or overlays the mind of split meanings at cost or awareness of the truly sane or meaningful. Once fear is accepted as the power to protect, the fear is protected at expense of the truth. This ‘abstract’ sketch has very wide applicability.
          Uncovering the nature of fear necessarily a relational willingness. Fear cannot be forced out of our mind – when it is the result of split thinking of the mind.
          The wish to do so invites the denial of our own freedom. However, It remains fact that we do not create ourselves even if we use our creative capacity to generate self-imaged concept of self. life and world. Freedom is our Inherency of being – thus to stop thinking and get out of the way, is to be the receptive to the gifts of being, that are part of the very moment we are the being of – but filtered out by what thinking dictates or keeps hidden.

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    • Oldhead,

      I agree entirely that we should maintain an actively adversarial stance to psychiatry. Psychiatry is not going to “see the light” and abandon their destructive, disempowering, and stigmatizing activities. Nor will they abandon their spurious concepts, because their very existence as “medical practitioners” depends on these concepts.

      We need to maintain and support the critiquing of psychiatry as vigorously, and on as many fronts, as possible.

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    • “Mental illness” actually is a contradiction in terms unless you mean it as a metaphor–an imaginary illness that exists only in the mind as opposed to the body. People use the term to mean brain disease or physical illness.

      Some truly stupid articles have been written. “What Would Happen if We Treated Physical Illnesses Like Mental Illnesses?’

      What indeed? Would we have renowned cardiologists warning the public of how heart attack victims were a menace to society on 48 Hours? Would cancer specialists force people to undergo endless rounds of chemo with no proof they had leukemia? Would ear, nose, and throat specialists amputate people’s noses and ears just because they looked “abnormal”? Would endocrinologists sell cocaine to diabetics claiming it was insulin?

      But I digress. By the very wording of these articles the writers unwittingly acknowledge that there IS a difference between physical and mental illnesses. This would undermine their point if the American public weren’t so darn gullible!

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      • Ill is a term for evil – which can mean adverse or unwanted outcomes.
        Dis-ease is a conflicted dissonance or unrest that persists as if under its own power. As if a think in itself.
        The idea that I (or we) is a ‘thing-in-itself’ IS the root of the disease state.
        The psychic-emotional distortions of supporting such a narrative identity result in every manner of evil outcome – because the ‘thing-in-itself’ identifies against its relational context while seeking to gain power for itself at expense of others.

        The corruption of cardio vascular medical approaches is identical in its profile to the psycho-pharma distortion. The cholesterol fallacy works a destructive lie. Stents have no influence on recurrence of cvd ‘attack’ events or all cause life expectancy – but a huge influence of doctor salaries and hospital profits.

        The nocebo of life-denying ‘diagnosis’ works in many fields as a blitzkrieg of terror through which the ‘medical intervention overrides and then frames all else. The psychic-emotional context is THE core health issue – including paramedic assistance – where pause and focus are known to be essential to enable true help where it is truly needed.

        The cancer racket is like any ‘War on in that it protects and persists its employ, budget and the power of its ability to generate and protect its revenue stream – and suppresss, shut down or crush any rival to the ‘officially protected chemo-radiation ‘treatments’ – which are treatments that kill.

        Physicalised symptoms of psychic emotional conflicts are also ways to seek to hide or escape, mask or protect. Terror induces the employ of anything to avoid, escape, hide, or dump onto others (or even our body) so as to compartmentalise or split off into some degree of mental capacity/managed reality.

        The gullibility for false causes is the intensity of the psychic-emotional charge (wishing given power), that is seeking resolution in terms of escape. Hence the willingness of so many to presume that ‘drugs’ have ability to resolve or answer psychic-emotional (which is relational) conflict – in terms of shutting it off, shutting down the mind or shutting out or getting rid of the ‘symptoms”. They CAN serve such a purpose and any suppression of conflict CAN be used to regroup in alignment with a more conscious focus of what truly helps where it is truly needed – and can be accepted.
        The other side of this coin is that psychiatry is generally the same disease it seeks to treat in ‘others’ – in terms of evaded and escaped self-conflicts that are ‘medicated’ by roles of power, prestige and privilege that is knitted in with the pharma paradigm that intervenes and overrides and negates or undermines (sickens) to cure – while reserving the term ‘cure’ only for marketing press releases (PR) for pipeline ‘discoveries’. For the management of sickness is founded on worship of sickness, evil and death as the power by which to get energy for ‘thing-in-itself’ from the living in trade for sickness (toxic debt) packaged in falsely contrived instruments under belief they hold promise of protection against future loss.

        The worship of evil always frames everything in terms of division, sides and conflict in which someone pays or loses. For all its failings, the framework of this page’s main article holds willingness to open PERSPECTIVE, as a quality of being and relating within being, that opens to embrace and integrate, rather than defines to rule out and reject. The latter is the ‘old mind’ of a segregative movement by power over perceived and believed chaos – deemed ‘other’ – and subjugated as the (false) idea of power or necessity.
        The pattern of insanity that characterises human personality construct is insane by virtue of an arrested development. That is to say of becoming ‘stuck’ in a self-reinforcing conditioning loop – instead of unfolding our natural Inherence.
        It is easy to philosophise or criticise from the armchair of non-involment, but terror operates the mind of ‘thing-in-itself’ because the inherent meaning of ‘thing-in-itself’ is terror-inducing. Truly seeing this is a meaning-LESS identifiction, releases attempt to ‘survive’ and allows the relational embrace of a ‘field knowing’. Not a control-manipulating. It is an Inherence of being that aligns us as magnetic desire. IE: not as the need or result of ‘self’ efforting. But resisting the ‘tempt’ of the fear-minded thinking, will call for total commitment – because love cannot force itself into an unwillingness to receive. Loving to hate, seems like safety to a split off mind – as does hating to love. The simple truth and safety is in accepting that ‘of our self’ we do not know – and so we listen or feel for the ‘connecting movement’ of a knowing that is NOT wish-manufacture. This is a matter of honest desire and not clever thinking. Releasing the false ‘power’ opens to recognition of true. Hence the ‘arrested development’ within the identity of the fear of loss – and the Call to attend for what is true, beneath the corrupted currencies of appearances (thinking and perception).

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  12. No one has to read the Power Threat Meaning Framework or to agree with it if they do. It is certainly not perfect and we welcome feedback. However, several of the comments have fundamentally misunderstood its content and purposes. I will briefly correct some of these assumptions.
    1. The Framework is not an ‘alternative’ in the sense of a new or replacement version of diagnostic categories. Its starting point is that we need to completely abandon diagnosis and the whole biomedical model it supports, along with all the subsequent consequences and assumptions, and to develop a new perspective by unpicking the philosophical roots of the current system. These are deeply embedded in rationalism, positivism, and Western worldviews encompassing, but not limited to, the separation of mind from body, individual from social group, and humans from the natural world.
    2. The Framework was co-produced with the survivors in the core project team from the very start. In addition we benefited from input from a service user/carer consultancy group. It draws extensively on survivor literature and experience, and values these forms of evidence just as highly as the more traditional kinds.
    3. The Framework thoroughly supports oldhead’s suggestion that ‘depression’ (although it avoids this kind of diagnostic language) or any other form of emotional suffering, is one of the end results of damaging socioeconomic systems and social values. One of its main stated purposes is to restore the link between personal distress and social injustice. The Framework attempts to do this by placing a very strong emphasis on the aspects of power usually absent from analyses of distress – particularly ideological power, or power over language and meanings. It thus places its strongest emphasis on the need for social action.
    4. The Framework is not fundamentally about psychologists, or any other professional group, coming up with a new system for those said to need their services, for the simple reason that it does not recognise a distinction between ‘mad’ and ‘sane’, ‘normal’ and ‘abnormal’, those who are in need of intervention and those who are not. Emotional suffering is universal, and we are all subject to the impact of Similarly it places a very strong emphasis on people’s ability to create their own narratives and sources of healing outside services, once freed from the dominant medical assumptions that are imposed on them. For these reasons, we intend the Framework to be a publicly available knowledge resource, and have thus chosen to make it free online, rather than in book or paywalled journal article form. It is a fairly dense read, but accessible versions are available on the website (eg a 2 page summary and a ‘Guided Discussion’) and more are due to be developed.
    5. The Framework is a set of ideas, not a policy document or a plan for services. It is an entirely optional perspective. However, we hope that others may be interested in taking on its ideas and developing it in their own ways, whether in services, peer groups, training, or for personal use. So far the response has been very encouraging.
    As I say, we welcome feedback…ideally based on first finding out what we have actually said!

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    • I’m not opposed to the “framework” so much as befuddled about what purpose it is meant to serve. As I said, it reads so abstractly that I tend to back off from taking it too seriously, as we don’t have a lot of time for abstract philosophizing. In addition, it reeks of the language of the mh bureaucracy with references to “service users,” etc. And it lacks the passion of a resistance movement. For example:

      One of its main stated purposes is to restore the link between personal distress and social injustice.

      This is what I mean by abstract. Detached would be another word. It’s hard to argue with eliminating “social injustice.” But there are many people already taking up this goal who have conflicting theories and analyses regarding how to do it. The devil is in the details, which seem to be ignored almost entirely, as is a delineation of whether this is ultimately a political or philosophical question being pursued, and to what end.

      It would be a positive development if the masses could learn to internalize the connection between alienation, economic/class oppression and the general malaise which affects us all in varying ways. But one really has to read through the lines and do some speculative projection to glean such an interpretation from what is presented.

      Nonetheless, if this is what the mh professional bureaucracy is arguing about, at least it keeps them preoccupied and out of trouble. Just want to point out that this is not an anti-psychiatry document per se — though it does qualify as anti-“medical model.”

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    • Does the Power Threat Meaning Framework bear any semblance to William Glasser’s Reality Therapy/Choice Theory? I found his books much more readable. If you want this movement to catch on making the language more accessible is a must.

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      • No so called choice theory is a scam although for some a quite attractive one. I did a course in it and found out it was essentially another brand to manipulate and control including tomanipulate folks into ‘accepting’ they are ill and need tablets to deal with workplace stress or even go on disability rather than using the union to challenge the causes of such stress.

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        • Glasser was against drugs or labeling. He encouraged leaving abusive situations and was not against unions. Maybe you have confused him with someone else.

          Before I read Bob Whitaker, Glasser’s book Warning: Psychiatry Can Be Hazardous to Your Mental Health helped me realize that the “life saving medications” I had been conned into taking were the same stuff a street dealer sells. I was angry but empowered. Not hopelessly insane after all.

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          • Well good on you so. I’m not familiar with that book, psychiatry certainly can be hazardous to your health! Toxic psychiatry was one of the scariest reads avaikable!
            But I did a course in choice theory psychology, read a book of the same name and he struck me as a right creep, maybe it’s a different fella?
            And the nun teaching us showed some training video about how this fellas work was used to help beak the air traffic controllers Union under Reagans watch. In it the shrinks where describing stress due to excess workload as a mental illness and encouraged to abandon solidarity with their colleagues accept disability and take the tablets. He was a psychiatrist after all!

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          • Glasser was both a visionary and a very practical problem-solver. “Reality therapy” is about as fully empowering a concept as I have ever read about or seen applied. He does a fantastic job of separating responsibility for external circumstances (which we don’t control) and responsibility for attitude and decisions (which we DO control). He focuses on the intentions of the person asking for help, rather than having some “plan” for the other person that is outside of their control. His goal is higher self-determination for the client, not “compliance” with “treatment.” He is most definitely worth the read.

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  13. Quote// “Its starting point is that we need to completely abandon diagnosis and the whole biomedical model it supports, along with all the subsequent consequences and assumptions, and to develop a new perspective by unpicking the philosophical roots of the current system. These are deeply embedded in rationalism, positivism, and Western worldviews encompassing, but not limited to, the separation of mind from body, individual from social group, and humans from the natural world.”//

    I have written to this in significant measure. But not in terms that readily translate to the philosophical roots of the current biomedical system of assumptions, separations, and rational justifications.

    The point is that an identity imaged and maintained by ‘thinking’ is not going to let go of the judging/diagnosing and projection-displacement by which it presumes to be in charge of or in power over relational dissonance within others who seek help – or in social situations that induce or oblige another to accept or submit to help.

    What I can see in the quoted statement – beneath the presentation is more like this.

    “The presumptions upon which psychiatry is practiced are found to be untrue, unhelpful and to do harm or hinder rather than help”, but the willingness to be truly helpful remains, and seeks renewal by the facing or owning of the habits and choices that constitute the old model as the basis for replacement by a better (more sanely aligned) choices arising from opening and holding value for a truly relational field of being – in which Meaning reveals itself AS new perspective accepted instead of subjugating to or exacting sacrifice of, the meaningful to models or targets of coercive expectation or demand.

    The undoing of fears in therapist and patient alike, is a matter of the readiness and willingness to face or own them within a relational support for embracing them – and the power of the mind that made them.
    Fear divides to ‘rule out’.
    But to the fearfully fragmented or split thinking, fear seems to be the basis of power to defend against, shut down, cover over or evade. The split thinking serves to protect the fear from healing or reintegrating under the guise of displacement in which power is enacted in fantasy of external resolutions as self-inflation, or lost to the limitation in pain loss and failure of such wishing.

    The true willing is only restored to the mind of the release of the false. This may come in a moment of recognition from the ‘patient’ or from the ‘therapist’. In either event, both are helped.

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  14. oldhead May 9, 2018 at 1:04 am
    My position on “alternatives” is that, as psychiatry is by definition of tool of repression, we do not need “alternative” forms of repression any more than African people need alternative forms of slavery.

    ———

    Way too pedantically black and white.

    Apartheid in South Africa was an alternative to equality in a free democracy. When apartheid was being fought, the alternative proposed was equality in a free democracy. Some rightwingers proposed other alternatives, none of which offered equality, and all of which were finally rejected.

    Society by and large has embraced psychiatry. The majority of people enjoy their pills, enjoy their status as having a treatable mental illness. I used to think of these people as nincompoops. Many of them *are* bone fide nincompoops… but all of them? It simply isn’t the reality of the world. Take any cross-section of society and, all in all, many will be nincompoops. But rarely all, and not often most. So nincompoopness simply doesn’t stand up as a valid explanation for psychiatry’s chemical successes.

    What is the alternative to a psychiatry that is monomanic about the DSM and chemical imbalances and drug treatments? Can we live in a society in which social control of madness is abandoned completely?

    Every proposal to the myriad of questions, all those infinite-seeming what-ifs, are proposals for alternatives.

    I agree it is possible to reductively define psychiatry as repressive. Depends very much on the context. Unfortunately for these kind of extremist views they are dismissive of any narrative that betrays the hard line. Doubly unfortunate is the fact that the majority of people not only would not recognise their psychiatric encounters as repressive, it would be quite a feat of histrionics to convince someone that any repression had occurred whatsoever.

    Forced psychiatry is repressive. Most customers of psychiatry never get so much as a glimpse of that dark underbelly. Don’t have the slightest inkling about what goes on.

    Psychiatry, for most people, is an agreeable encounter, most of the time. Most people don’t lose their human rights, their dignity, their sense of self, and so on, due to trusting psychiatry. If they did, we’d be in a civil war and there would be public lynch-mobs.

    We need an alternative, and we need to have conversations about alternatives.

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  15. Just to add, the alternative to forced psychiatry is…?

    Well, as yet, no-one knows. I think I have this right that you and Frank and Slayer would have the alternative as doing nothing.

    The alternative to psychiatry is nothing. To actually have no alternative. Except, say, a society in which people hug each other more often, and maybe send one another positive affirmations in graphic form via social media? But would that really work for people?

    The alternative to forced psychiatry is do nothing. Just step in when the smoke begins to clear. O dear, what a sorry mess, we’ll be thinking — but it’s better to do nothing really well than to do something really badly.

    The alternative to the DSM is… let’s reconnect with our essential being, wherein the only labels we must endure are those attached to us at birth by well-meaning and not so well-meaning parents and wotnot. There will be no mental patient status. People will tell their stories about what happened to them, and so will have no need for mania, psychosis, or depression or anxiety.

    Some of that doesn’t sound too bad. I have to remind myself occasionally, as it happened so long ago, just how devastating it was to be diagnosed with schizophrenia. That now I had a spoiled identity that others were able to exploit. And exploit it they did. Though pretty much all of that happened outside of the mental health system.

    I only really have one desire for an alternative, and that is the alternative to forced psychiatric treatment.

    It wasn’t so long ago that most town and village places of worship had an anchorite or anchoress locked up in servitude to the Lord, with only little spy holes allowed for the curious to sneak a peek. That was one of the past’s many alternative approaches to extreme states and, arguably, self-harm (or the normalisation of it).

    There remains some relics of that culture of ascetism, in that, the self-destructive lifestyle of the average schizophrenic or manic or whatever follows a kind of path of almost evangelical nihlism. I’ve seen so many people destroy themselves, with state assistance. As people watched on, with interest, pity, or more usually, utter repulsion and contempt. And taboos exist to prevent the discourse, to tell of how damaging the drugs are, how social support and the resources to make meaning, are all powerful alternatives to the ascetic sacrifice we put so many of our mad people though, to the very end.

    Just like religious revelries, madness must be contained and colonised, and the mad person martyred.

    I’d rather have suicide lines that talked shit about chemical imbalances and going to see the doctor and so on than what would seem to be a preferred and respected alternative which is you’d ring in and someone would answer the phone and you’d be hearing, “I absolutely respect your right to die and your right to choose when to die. Good luck and good bye!”

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