As a longtime participant in the conversations here on Mad in America, I’m very excited about taking over Emily’s role as moderator for the MIA discussion boards. MIA considers the community discussions to be integral to its mission to serve as a forum for “rethinking psychiatry,” and I am assuming this role at a time that the organization, in response to the reader survey we conducted, is striving to make the discussions more welcoming to all.
As a brief introduction, I’m a former “mental health professional” who never really believed in the DSM, the “medical model” or psychoactive drugs as a solution for mental/emotional distress. For reasons I won’t get into here, I had a rather sad and isolated childhood and experienced a lot of what might today get diagnosed as “Social Anxiety Disorder” and “Major Depressive Disorder.” School, in particular, was a very anxious place for me, and I did everything I could never to have to speak out loud in class. After making some improvements on my own, I was fortunate to engage with a very capable therapist in the late 1970s, before the DSM-III and the “label, drug and dismiss” model had become the cultural force it is today. As a result, I became very interested in the process of helping people deal with childhood adversity and difficult social situations, and ended up getting into the world of “emotionally disturbed” teen moms, despite my having an undergrad BA in Chemistry and a MS in Education.
When I started out in a “residential treatment” setting for teen moms in 1983, exactly ZERO of our clients were taking any kind of psychiatric drug, and there was never any discussion of “diagnosis.” We used a “positive peer culture” model that taught good communication skills and taught the residents to be more assertive and intentional in how they lived their lives. By the time I got to the point that I couldn’t take it anymore (about 12 years later) and went into advocacy, “residential treatment” residents were drugged at over a 50% rate. And in about 2005, when I was doing some research in the interests of protecting foster youth from random drugging, I discovered that 80% of kids in “residential treatment” were being given psychiatric drugs. Zero to 80% in just over 20 years. And the kids’ behavior seemed worse than ever!
Knowing from personal experience how a person (aka me!) could move from “disordered” to very high functioning over time by a combination of good therapy, sharing my story, reading lots and lots, developing new strategies for dealing with the crazy world we inhabit, surrounding myself with sane people, and challenging myself to do things I’d never thought I could do, and seeing how “treatment” had meanwhile deteriorated from listening and empowering to labeling and drugging, it became apparent how important it was to challenge the current paradigm at every turn in the road. So here I am.
So now to the topic at hand: comment moderation at MIA.
One of the reasons I’ve come to love posting here at MIA is because of the wide range of opinions and data brought in both by the articles and by posters in the comments sections following. I personally find the comments at times even more educational than the articles themselves.
That being said, feedback from readers and my own observations lead me to the conclusion that the comments section can be a rough place to hang out. Some of this is inevitable — we are talking about issues that are highly complex, highly emotional, and that challenge the accepted mythology of the mainstream culture. Anyone expecting to enter into such an arena and have things be neat and tidy is going to be disappointed. There is such a range of different objectives evident! Some people want to abolish psychiatry and any other professional psychological “treatment” altogether, some want to focus on eliminating forced “treatment,” some believe it’s possible to salvage what is workable from the wreckage. Some believe that reforming the system is possible and desirable. Some just want to tell their stories, some are focused on getting off the drugs and/or escaping “treatment,” and others are just trying to survive the system as it is. And some come in to defend the current system as it is, because they feel it is working for them. One of the great strengths of the MIA community is that a wide variety of voices can be heard here, and whether we agree or not with these diverse opinions, it provides a great opportunity in particular for the voices of those harmed by the system to be heard.
On the other hand (and this is true of any online community I’ve ever known), discussions can sometimes deteriorate into personalized name-calling, accusations of foolishness or stupidity, or gross generalizations about groups of people that are offensive or simply rude and thoughtless. Such comments tend to drive away people who might otherwise be valuable contributors to our discussions. That is why moderation is important.
It is true that the ideas expressed on this site may drive certain people to avoid us, and that is because these ideas, or presentations of fact, provide a critical view that they find difficult to reconcile with their own beliefs. In a big-picture way, MIA presents a “narrative” regarding psychiatry that is completely at odds with the conventional narrative, and clashing narratives always provoke heated emotions. And I have no intention of editing or censoring posts based on the possibility that the ideas expressed may make other people uncomfortable.
However, it is possible to engage in even the most difficult conversations in a way that respects and welcomes different opinions and viewpoints, and that is our goal here. Our mission is to promote a “rethinking” of the current model, and do so while welcoming every possible viewpoint. That includes welcoming the “abolitionist” viewpoint that the only solution is to eliminate the current system and/or start over.
So here’s the deal. I will NEVER edit or moderate ANY comment based on the ideas that are expressed, provided that they meet our requirements that comments be civil in tone. People can say they love the system and they’d die without their drugs. Other people can say that they see psychiatric drugs as an evil force, marketed by drug companies that only care about their profit margins. I will respect any and all ideas that are presented respectfully and honestly.
And I’d like all of you to do the same. That’s what I’m asking of commenters — to respect any person having the courage to post their views, even if you totally disagree with their viewpoint and see their opinion as uninformed or even dangerous. You are welcome to present evidence and experiences and logical arguments to critique or counter any argument that is presented. But you’re not allowed to attack the person presenting their views.
Hence, the posting guidelines.
I’d like to highlight three key points that seemed to come up the most during my two-week trial run as moderator in early June.
First: personal attacks. Obviously, we can’t accept calling people names of any sort. But there are more subtle ways to attack someone. For instance, saying “that is the dumbest comment I’ve ever seen!” is pretty much the same as saying “the commenter is dumb.” Personal attack — not gonna fly. And it doesn’t matter if your insult is “true” or if “he insulted me first.” The only question to ask yourself is: “If someone said that to me, would I potentially find it personally insulting?” If so, rephrase. Or just don’t say it.
This is different from logically attacking the CONTENT of a comment. For instance, you might say: “Your comment doesn’t appear to be based on any kind of studies or data.” Or “That comment sounds very similar to the propaganda put out by the drug company.” But saying “You’re a drug company shill” will get your message removed with a friendly reminder from me about the guidelines.
The key point here is: critique the message or the concept with facts, experiences or logic, but don’t attack the person him/herself.
Second: insulting generalizations about groups of people. This one’s a lot more subtle. Sometimes.
Obviously, anything sounding like “Black people do X” or “White people are always Y” or “gay people suck” is going to get cut, every time, no questions asked. But what about generalizations about, say, “bipolar people can’t be trusted?” Or “psychiatrists are all evil?” (Really? EVERY psychiatrist? What about Peter Breggin? What about Joanna Moncrieff? What about the guys who run the Open Dialogue program in Finland? Or the other psychiatrists who write on MIA?) Some of these generalizations (especially about people with DSM labels!) are used very regularly in our culture and may not even be noticeable unless we’re looking. But again, stick to critiquing the IDEAS and the DATA and sharing your experiences, and don’t make generalized statements about groups of people, because all groups are composed of individuals, and one of the main thrusts of psychiatric critiques is that we need to treat people like individuals. We need to do that among ourselves.
In particular, I want to be very sensitive to anyone who has participated (voluntarily or by force) in the system. The use of psychiatric drugs by recipients is very, very complicated. Some have been coerced and are legally compelled to use these drugs. Some have been intentionally or unintentionally deceived by the mythology and pressure that pervades the system. It’s really not OK to attack those who are (wittingly or not) victimized by the psychiatric system, whether through propaganda, manipulation or coercion. Everyone has the right to his/her own story, and some stories are that a person finds the system helpful or finds it impossible or impractical to escape at this particular time. Listen compassionately, and don’t criticize the person for getting enmeshed in the complicated dynamics of the system. I’d strongly suggest that you direct your passionate resistance toward those who set up the system that created those dynamics in the first place.
And it is important to remember that some have engaged voluntarily in the system and found it helpful. This may be hard to accept if you feel you have been invalidated, attacked or severely harmed by the system, but some people don’t have that experience at all. Some (like me) have found psychotherapy very helpful in sorting out their lives. Some value CBT, DBT, nutritional approaches, meditation or religious practice and find it essential to their current well-being. And some have found and continue to find psychiatric drugs helpful, and either experience little in terms of adverse effects, or feel that the benefits are worth the cost. Whatever an individual’s story or experience with the system, positive, negative, or mixed, we need to respect that this has been their experience, even if ours has been very different. Again, this is not to say that such people can’t be challenged to understand the research, or understand that not every person has had a similar experience or that you believe that the evils of the system so far outweigh the benefits that abolition of psychiatry is the only viable solution. But everyone is entitled to tell their own story and have it respected as such.
Professional people (and I am one of these) have at times found the MIA commenting environment more than a bit rugged. And while I absolutely intend to apply the same rules and expectations that comments be respectful when they are in response to writings by professionals, I’d nevertheless recommend that anyone who has been a service provider be prepared to be challenged vigorously and with passion. Many MIA commenters have been hurt by the system, and some would say that their lives have been destroyed. As such, it is reasonable to expect intense emotions, including anger and rage, expressed toward the psychiatric system that has felt so destructive to many who comment here. We all meet here without the usual power dynamics that are present in most other settings, where professionals — and I am speaking as one here — are privileged with a level of power and protection that allows us to avoid dealing with the intensity of emotion that our interventions can sometimes create (often inadvertently) in those who receive them.
Thus, here is the dialogue that we are trying to create a place for: This is a web magazine devoted to “rethinking psychiatry,” and that means that we are going to provide a forum for those who may tell of how they have been harmed by psychiatry, and in a multitude of ways. Forced treatment, their lives on psychiatric drugs, the disrespect, traumatization and humiliation they may have experienced while in psychiatric care… there is a long list of grievances that may be aired. We would like to think that for professionals who post and comment here, this then presents an opportunity — an opportunity to listen and learn from those who experienced psychiatry in this way, and, at the same time, to engage in a dialogue that can help foster one’s thinking about what needs to be done to create a new “paradigm of care.”
So, here’s my message to professionals: You will, of course, be protected from personalized attacks, just like anyone else. We need and welcome your thoughts. At the same time, a bit of a thick skin and a sense of humility will help you gain the trust and respect of those members of our community who feel both betrayed and deeply hurt by psychiatry.
And that brings us to the third point. If someone DOES appear to insult you or a group you are a part of, DON’T INSULT THEM BACK! There are a range of options if you’re feeling insulted:
- Ignore the comment. Ever hear the statement, “Don’t feed the trolls?” There is no reason you HAVE to respond to anything. Sometimes the best response is no response at all.
- Return to analyzing the substance of the comment. Maintain control of the conversation and don’t be distracted by these attempts to make it about you. One of the oldest rhetorical tricks in the book, documented as far back as ancient Greece, is the “ad hominem attack” (attacking the person rather than the arguments they made). It usually means the person doesn’t have a real answer to your arguments and wants to draw you into a personalized exchange of insults so they don’t have to deal with the weakness of their position. So keep to the facts and don’t let them get away with deflecting the conversation to a bout of character assassination.
- Let the person know how you’re feeling. It’s always safe to use an “I” statement: “I find your last statement insulting. It looks like you’re making negative generalizations about women.” This makes it clear that you object to the presentation without escalating it by attacking the original poster, and allows you to maintain the moral high ground.
- Make a “process observation” that points out what is happening without attacking the person involved: “It sounds like you just made a gross generalization about people who are taking psychiatric drugs. Do you really believe that everyone who does so is stupid or deluded? Do you think people may have a range of reasons for their choice?”
- REPORT THE COMMENT! Seriously, that’s why I’m here, to sort out this kind of situation and to remove or address comments that are insulting or otherwise violate our posting guidelines. Don’t consider reporting to be “ratting out” someone. It is part of making sure that our community is welcoming and safe for anyone to post their views.
Select any one of the above 5 options and you won’t have to worry about being “moderated.”
So what happens to a comment that gets moderated? First off, I’ll remove it from the queue — essentially, I “unapprove” the comment and it becomes “invisible” to readers but it remains unchanged. Second, I’ll read the comment over carefully and see if it is a total loss or if there is some legitimate stuff in there beyond the problematic comments. If it is a no-go, I’ll write the author a note letting him/her know that it’s been removed and why. If it’s unclear what the writer’s intent was, I’ll e-mail him/her and ask for clarification. And if there is part of the post that was appropriate and contributes to the discussion, I may give the author the opportunity to edit the post so that it meets the guidelines and can be re-posted.
If anyone thinks this is a clear-cut, black-and-white issue, think again. A lot of judgment and communication may go into deciding to remove or edit a post, and some will be tough calls. My goal will always be to fairly apply the posting guidelines to everyone without bias or preference, but I’m sure I’ll make my share of mistakes or miscues. If anyone feels I’m not doing what I should in a particular case, I’m always open to respectful communication of your concerns. Feel free to contact me at my MIA e-mail: [email protected].
I’d also ask that we all keep in mind that our comments are often construed by those reading the site as reflective of the organization’s opinions or beliefs, despite any provisos to the contrary from the editors. That’s no reason for us to back off from legitimate rational critiques of the system, even if these might chase off some potential interest in the site. But we don’t want to drive off people because they think we’re mean-spirited, rigid or closed-minded. There may be the odd person here or there that isn’t willing to play by those rules themselves, but I and the rest of the staff can easily block any such rare examples from further participation. So let’s welcome anyone who wants to listen and participate, and let the rest of us do our jobs if someone needs to be kept in line.
Finally, I want to thank Emily, James, Emmeline, Justin, Louisa, Kermit, the rest of the staff, and especially Bob Whitaker for setting up and supporting this unique space and showing me such a warm welcome!
I’d like us extend that same kind of welcome to ALL of our readers, even if they are in a different place than we as individuals might like them to be. After all, we should remember that all of us went through a process to gain the understanding any one of us has arrived at today. Who knows, the article or comment a person reads that really bothers them and that they feel the need to argue and complain about may be the first step in their process of enlightenment. Instead of making them feel bad, let’s gently and respectfully invite them to explore the many other perspectives they will encounter in this wonderful community!
Steve McCrea, MIA Comments Moderator
P.S. I will continue to post comments as myself, despite my new role. Please don’t take anything I say as representing MIA or my role as moderator unless I let you know I’m wearing that hat at that time. I’ll make sure to be very clear when I’m stepping in as moderator, but most of my comments will continue to represent only my own views.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.