Why the ‘Psychological Injury Model’ Will Ultimately Triumph

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George Washington was killed by his own doctors. This actually was not the outcome they were hoping for. They meant well and wanted to save the life of the first President of the United States. They got to work eagerly to try to help.

But there was a deep problem. Their theory of what caused illness was wrong. They believed in the humoral theory, that sickness was due to an excess of humours, or fluids in the body (bile, phlegm, blood, etc). Therefore, they thought the solution to his throat infection was blood letting, to reduce the excess humours. They removed 40% of his blood in 12 hours, and thereby killed him. Which shows that good intentions and hard work, plus the wrong understanding of what causes illness, leads to disaster.

Deep Flaws in the ‘Chemical Imbalance’ Model

To avoid this type of needless harm and death, we need to be very sure that our theory of what causes illness is correct. In terms of mental illness, the dominant model is the ‘chemical imbalance’ theory, that depression and other disorders are due to low levels of serotonin, or abnormal levels of dopamine, or other imbalances of chemicals in the brain. Yet when we look closely, three problems emerge in this chemical imbalance model. The first flaw is that there simply is no way to measure the levels of neurochemicals in a living brain. Therefore, we cannot know what is a correct balance of neurochemicals or what is an incorrect balance. The assertion that there is an imbalance has no data to support it. The next flaw is that the theory never explains how the chemicals become imbalanced in the first place.1 It claims that depression is due to low levels of serotonin, or that schizophrenia is due to abnormal levels of dopamine. It never explains why the levels of serotonin supposedly dropped in the first place. Is it due to a random fluctuation? Too many X-rays? Not enough Vitamin D? This inability to explain the origin of the drop means that the theory is incomplete. If there is something upstream that causes the levels of serotonin to drop, then that would be the actual cause of depression.

The third flaw is the most serious. When researchers try to measure the levels of serotonin in the brain (blood plasma levels, autopsies, etc) they simply find no evidence of a chemical imbalance.2 None. They do not find that depressed people have lower levels of serotonin in the brain than non-depressed people.3 This conclusion can be hard to acknowledge, since the belief in a chemical imbalance is extremely widespread in our culture, and is repeated on major media nearly every week. Yet in the words of Lacasse and Leo, “there is not a single peer-reviewed article that can be accurately cited to directly support claims of serotonin deficiency in any mental disorder, while there are many articles that present counter-evidence.”4

This has colossal implications for the whole field of mental health. The dominant theory has no direct way of measuring the balance of chemicals in the living brain, it cannot explain how the chemicals apparently become imbalanced, and there is no scientific evidence of a chemical imbalance resulting in any mental disorder. In short, it has no more intellectual credibility than the humoral theory, which held that an excess of yellow bile caused sickness, or which said that bloodletting was the correct treatment for a throat infection.

Why Care About the Cause of Problems?

So how did a theory that has zero scientific support become the dominant model for why people become depressed, anxious, or have problems with their thoughts? The reason is simple. A person’s theory of causality is extremely powerful. Once you have defined what you think is the cause of a problem, then the solution follows right behind. In fact, you have to use the solution. And because doctors in 1799 believed that an excess of humours (certain fluids in the body) caused illness, George Washington was bled four times in the final hours of his life. Cause determines solution, even if the solution is occasionally lethal.

Which is why the drug companies spent billions of dollars promoting the “chemical imbalance” theory of depression, schizophrenia, and other conditions. As soon as someone accepts the concept that their emotional difficulties or experiences are due to a chemical imbalance, then they believe they have to take a pill to correct this imbalance. Nothing else will do. They will have no reason to believe that psychotherapy or other interventions will correct the imbalance, so they must start the pills. And once they do, they have to stay on them. If they stop, then the ‘chemical imbalance’ will reassert itself, causing misery all over again.

And as long as the cause is believed in, alternate approaches are excluded. Even if they are far more effective. For example, Ignaz Semmelweiss found that if physicians washed their hands before they delivered a baby, then the death rate for the mothers due to infection was less than 1%. However, if the physicians did not wash their hands, then the death rate was 10%. This was so well known that women begged to be admitted to the clinic where hands were washed. In fact, it was safer for a woman to give birth in the street than to give birth when a doctor assisted. The maternal death rate was 4% when she birthed her child in the gutter outside the clinic.

But even though Semmelweis produced data (and thankful mothers) showing that washing hands saved many lives, he was ignored because he “could offer no acceptable scientific explanation for his findings.” He had no theory of causality. It was only after his death, when Louis Pasteur confirmed the theory that germs caused disease, that doctors began regular hand-washing. A new cause for illness had been discovered, which was germs. This displaced the old cause, the humoral theory. As a result, bloodletting stopped, hand-washing became widespread, and many lives were saved.

Several key lessons can be drawn so far. It is not enough to say that the current solution is ineffective. Bloodletting was harmful, and it still persisted for two millennia. It is not enough to say that the new treatment is far more effective. Semmelweis cut the death rate by 90% and was still ignored. If you want to change health care practice, you must propose an alternate cause. Only then can the useless or harmful solutions be stopped, and people receive real help.

That is why there is so little change in the landscape of mental health problems. “Chemical imbalances” are seen as the cause by the majority, and alternate solutions are side-lined. It is not enough to say that psychoactive pills are ineffective over the long term. Prescription rates are still climbing. It is not enough to say that psychotherapy has better long-term outcomes and no side effects. It still is side-lined, relative to using pills. It is not enough to say that there is no research that supports the idea that chemical imbalances cause depression or other problems. The pharmacological approach retains tremendous power, and the number of people taking pills rises each and every year, because the causal theory has not been replaced with a new one. There was no research that showed an imbalance of humours caused illness, but that theory lasted for millennia.

There is a New Model of Mental Illness

There is now an alternate model for what causes mental health problems. Unlike the chemical imbalance theory, it has the backing of thousands of research studies. It can also explain some of the vexing contradictions in psychiatric research. It proposes a brand new way of assessing people and their emotional health issues — one that fundamentally replaces the DSM and other symptom-cluster models. More importantly, it leads to safer and more effective interventions for people who are in serious emotional pain. It places their experiences and their choices about treatment front and center. Instead of pigeon-holing them with a diagnosis, and using power to impose an intervention on them that they often do not want or understand.

The new model is the psychological injury (PI) model. It states that the single largest cause of mental health problems is when a person experiences a psychological injury. These occur when the person is subject to marked neglect, abuse, disrespect, or chaos in their social environment. They can also occur when the person experiences a traumatic event. There are at least four groups of psychological injury, the first being trauma in childhood, the second being highly stressful life events, the third is working for an abusive boss, and the final is trauma in adulthood. The PI model acknowledges that mental health problems can occur from other reasons (i.e. hormonal fluctuations leading to postpartum depression) but maintains that the single largest cause is psychological injury. We will briefly look at each of these four types of psychological injury, before discussing assessment, treatment, and how the PI model resolves contradictions in psychiatric research.

Childhood Trauma as Psychological Injury

The groundbreaking research in the area of childhood trauma was carried out by Drs. Fellitti and Anda, of the Centers for Disease Control. They asked 17,000 residents of San Diego whether they had experienced different types of abuse and neglect, as well as five types of dysfunction in the parents. Initially, they did not expect much. Three-quarters of the sample had been to college, and they had good jobs, good healthcare, and lived in one of the most beautiful and affluent cities in the US. But the pain was right below the surface. Two-thirds of the sample had some form of abuse or parental dysfunction. Most had multiple traumas. Kids with alcoholic fathers also experienced emotional abuse, and saw Dad smack Mom around.

The effect of this childhood pain carried on for decades. If a woman was fortunate enough to grow up in an emotionally healthy home, she had an 18% chance of developing depression by middle age. But having just one adverse childhood experience (ACE) boosted her risk by 50%.5 Two ACEs boosted her risk by 84%. And the poor souls who had five or more ACEs had a 340% greater risk of developing depression than someone who grew up in an emotionally healthy environment.

Suicide attempts follow closely behind cases of severe depression. If someone had no childhood traumas, they had a 1% chance of attempting suicide.6 But their risk increased with each additional trauma, until the people who had seven or more traumas were 36 times more likely to attempt suicide than those who had none. Crunching the numbers showed that 2/3 of all suicide attempts were due to trauma in childhood.

These results have been replicated over and over. Canadian researchers accessed an even larger sample, where every person in the country had an equal chance of being studied. They asked 24,300 people about three childhood traumas (physical and sexual abuse, domestic violence).7 If people grew up with all three of these traumas, they were 26 times more likely to attempt suicide as those who suffered none. That is almost a photocopy of the results from Drs. Felitti and Anda. The Canadian study went beyond replicating the results from San Diego. It assessed nearly all major mental disorders, both through self-report and structured interview. Summing across mental disorders, the risk was 2.5 times greater if the person had one trauma, 4 times greater if they had two, and 8 times greater if they had all three traumas.

This is the pattern for bipolar disorder. People were 8 times more likely to develop bipolar disorder if they had all three traumas. Although it is widely conceived of as a chemical imbalance, the research paints a completely different picture of the primary cause. It is significant emotional dysregulation as a result of childhood trauma. Same thing with schizophrenia. A summary of the research found that people with childhood trauma were 3 times more likely to develop schizophrenia than those who had none.8 Major studies in the US and Britain found that having five traumas increased the risk of having symptoms of schizophrenia between 53 and 160 times.9

These numbers are so staggering that it is worth stepping back to recognize what they mean. They show that schizophrenia is not fundamentally a brain disease. Nor is it a chemical imbalance, either. No. What we call schizophrenia in most cases is actually people with trauma who have significant difficulty with regulating emotion, organizing their thoughts, and connecting with reality.

At this point, some will vigorously protest. They will point out that people who report hearing voices or have odd experiences have problems in brain structure and functioning. They will mention the damage to the hippocampus in the brain, cerebral atrophy, and other structural problems. They will say that the HPA axis (hippocampal-pituitary-adrenal) is overactive in the brain, and that there are abnormalities in certain systems of neurotransmitters. That is true. However, as Dr. John Read has pointed out, those are exactly the same changes as occur in the brains of children who have been traumatized.10 11 When a 7-year-old boy is terrified and ashamed as his mother slaps his face and screams at him that he is as much of a failure as his father is, his brain is flooded. The amygdala is sparking off with the fight-flight-freeze response. Fear is making adrenaline and cortisol gush into his bloodstream. If this happens day after day, month after month, then his brain will surely change. And if the child has five or more different traumas, then the child’s risk of having difficulty regulating their emotions, organizing their thoughts, and connecting to reality goes up anywhere from 53 to 160 fold in adulthood. It is the variety and frequency of traumas that alters the brain, and enormously increases the risk of problems later in life.

Stressful Life Events as Psychological Injury

These highly stressful events can occur in adulthood as well. One study followed 2000 twins for over a year.12 This enabled the researchers to separate genetic factors from environmental ones. When life was calm, those people at highest genetic risk were twice as likely to develop depression as the lowest risk group. But when life became highly stressful, such as being abruptly fired, or a teenage son starting to use drugs heavily, then they were 14 times more likely to develop depression. Although genetics may have played a role in the onset of depression, psychological injuries were a far more powerful factor in pushing someone into depression. This sparked a flurry of research. The summary of all these papers was that the serotonin transporter gene had no influence on whether someone became depressed or not.13 14 It was stressful life events such as finding that your spouse cheated on you, or a major conflict with your mother, that predicted depression. Even when people were followed for up to 12 years, 88% of episodes of depression were triggered by stressful life events.15 This finding contradicts the chemical imbalance theory, which would assume that depression occurs on a random basis, unrelated to events in a person’s life. But when 88% of depressions can be traced to a stressful life event, then the psychological injury model has robust support.

Toxic Boss as Psychological Injury

The third group of psychological injuries (after childhood traumas and highly stressful life events in adulthood) is not in our personal life, but our work life. Every single week in my private practice as a psychologist, a brand new client comes in. They say they are so depressed that they want to die, or that they wake at three in the morning quivering with fear. And when I ask why they are in so much pain, they say, “I think it is my boss.” They describe managers who tell them that their work is a 2 out of 10, but give no feedback on how to improve it. They talk about bosses who claim that their co-worker Kelly dislikes them, but when the person checks in with Kelly, he honestly says that everything is fine. As they tell me these stories of abuse and manipulation, they start sobbing in my office. One person, who had been selected employee of the year for a multi-billion dollar company, came back from vacation and was assigned to a bully of boss. Within weeks of reporting to the toxic manager, he told me he was going into the woods with a weapon and not coming out.

If toxic managers can shift people from employee of the year to being suicidal in just three months, it shows how deep the psychological injury cuts. We spend the majority of our waking hours at work, reporting to a manager who has the power to promote or fire us. People are also quite psychologically invested in their work, as we evaluate status in our society by the prestige of our occupation. At social gatherings, people will announce that they are “just a housewife,” indicating they are near the bottom of the ladder of status. If someone else says they are a neurosurgeon, they automatically receive high status. And not only do our managers influence our status, but getting fired by them can financially ruin people. It also sends a message that the person is a bad employee, and should be avoided by future employers.

This is not just clinical observation. A study of 4234 employees in Denmark asked them how much they trusted their manager, and how fair the policies were in their workplace.16 They also assessed the employees on 13 other variables, ranging from personality variables to smoking history and more. The researchers followed the people for two years. Even after controlling for the 13 other variables, they found that people who had low levels of trust in their boss, or felt the workplace policies were quite unfair, had three times the risk of developing depression compared to people with good managers and fair employers. This shows that toxic bosses cause depression, in the same way that smoking causes lung cancer.

Trauma in Adulthood as Psychological Injury

The final group of psychological injuries in adulthood is traumatic events. Being involved in a car crash, a natural disaster, or combat can result in post-traumatic stress disorder and/or depression. The cumulative stress can be unbearable for many people. In fact, the psychological injuries are more dangerous than criminals or terrorists. Although it is the job of police to grab criminals (many who are high on drugs and/or armed) and shove them in the back of police cars to take them to jail, that is the safest part of their work. The most dangerous part is when they go home, and have to deal with the pain and PTSD of what they see each shift. Three times as many police officers committed suicide in 2017 as were shot in the line of duty. Exactly the same results were found in military veterans, with three times as many Canadian soldiers dying of suicide as died in service in Afghanistan. When it is safer to have the Taliban throw grenades at you than to deal with the flashbacks of combat, the gravity of psychological injuries is clear.

These four groups of psychological injuries show up in my office every day. People with trauma in childhood, highly stressful life events, toxic managers, or trauma in adulthood sit on my couch. I have done 24,000 hours of therapy in my private practice, and there is only a tiny percentage of people who do not have one of these psychological injuries causing their negative mood. They exist, but multiple lines of research, and tens of thousands of hours of clinical experience affirm that the single largest cause of emotional health problems are from psychological injuries.

A New Model Needs a New Measure

Now that we see the role of psychological injuries, the next step is assessment, in order to understand the scope of mental health issues. Unfortunately, the most widely used approach to assessment misses the point. The Diagnostic and Statistical Manual does not ask about psychological injuries in a systematic fashion. The DSM fusses about which symptom fits into which cluster. It does not start by asking, “What is your life story? What are the psychological injuries from the past that result in such pain and confusion for you today?” Instead, it is set up to say, “You have had this cluster of symptoms for the last month. Therefore you have this diagnosis.” It then is easy to say “therefore take this pill to numb those symptoms.”

The Psychological Injury Index takes the opposite approach. It asks about the varieties of psychological injuries that the person has lived through. When those are mapped out, then others can start a dialogue with the person about how they coped with those injuries. They can discuss how the injuries relate to the emotional distress and odd thoughts that they have now. The trajectory of the person’s life is now front and center. The focus is not on which cluster of symptoms they have had for the last 30 days. It is about the path of their life. And when people can talk about what caused them pain, how they coped with it, how those methods are working (or not), and what they want to change in their life to achieve greater wellness, then they are far more likely to grow.

If You Want Therapy, Why do you get Pills?

Then they can choose what their healing looks like. And overwhelmingly, they want to talk to someone. Three times as many people want therapy as pills, across different countries, age groups, and types of problem.17 Even when psychiatrists are asked to treat themselves, three times as many would chose therapy for themselves as would recommend it for their patients.18 It does not matter who you are, you want to talk to someone about your life and your hurt.

But what people want is not what they get. They want therapy, but they get pills. Psychiatrists would send only 1% of their patients to therapy first. They would start the other 99% on pills, and refer 1/3 of those to therapy in combo with pills. The reflex to give people pills is so strong that in Canada, a country of 35 million people, there were 50 million prescriptions for antidepressants filled in 2015. That is enough for every man, woman, and child in the country. And enough left over for every dog, cat, and horse.

And these pills are not particularly safe. If people do take them for a while, they have high relapse rates back into depression.19 Antidepressants, and especially antipsychotics, can cause major weight gain. This increases the risk of diabetes from 30% to 258%, respectively.20 21 The pills can trigger suicidal thinking in young people. Antidepressants increase the risk of sudden cardiac death by 33%, while antipsychotics send it up by 226%.22 23 No wonder people are reluctant to take these pills.

This tendency to give people interventions they do not want has huge implications. When people are referred to a treatment they do not want, a significant number do not even show up for the first session, whereas everyone shows up for the treatment they want.24 Once they start, people who get a treatment they do not want are up to 7 times more likely to drop out early.25 If they do complete treatment, they are less likely to improve if they do not receive the treatment they want. One study found that only 8% of the people who preferred therapy but got pills improved. 50% of the people who preferred therapy and got therapy improved.26

Stepping back a moment, we can see why giving people pills, when they really want therapy, leads to high drop-out and poor outcomes. Because imposing something that is unwanted often echoes the psychological injury that caused the depression in the first place. The perverted swimming coach, the bullying boss, they imposed their will on the person in the past. The client did not want what they did, but was powerless to resist. And when a similar dynamic happens in the present (take this pill first even though you want therapy), then the client either never shows up for treatment, or drops out early, or makes less progress. But if you ask people what treatment they want, that is a cooperative approach. They have a say. They are not pushed into something, they are choosing. And three times as often, they want therapy.

What Heals Psychological Injuries?

This strong preference for therapy is because at a deep level, we know the most powerful method of healing psychological injuries. It is this. People heal people. This resonates right at our core. People heal people. The statement hums and sings with truth. We think of the times when another person’s caring words soothed our pain, and we want that when pain comes again. True, some people hurt people, and this is the cause of most psychological injuries, but the real change and healing comes when someone listens deeply and respectfully. The best way to heal a psychological injury is with psychotherapy.

And when the therapist walks with them, using an approach that makes sense for them, the trust builds again. When the client sees that the therapist is focused on helping them achieve their goals, and not manipulating them for their own ends, then healing continues. Most psychological injuries are inflicted by a perpetrator who did not care about the victim’s feelings, who cared only for their own agenda, regardless of what the victim thought or wanted. But when the therapist does the opposite, listening respectfully, helping the client with their goals, working with the client, then one person heals another.

And the healing genuinely lasts. Multiple studies have looked at people who take pills or therapy for depression and then stop all treatment. After a year or two of follow-up, people who received therapy are 260% more likely to be well, compared to those who took pills.27 People heal people indeed. Swallowing the pills may numb the pain for a while. But when the person stops the pills, it will likely return full force. Only therapy can heal the psychological injury. That is why it is 260% more effective over the long haul.

The importance of the human connection explains one of the great conundrums of psychiatry. A fact that is quite uncomfortable for biological psychiatrists to admit or discuss. For the reality is that who prescribes the pill is more important than what they prescribe. In a very sophisticated study on depression by NIMH, they asked patients how they felt about their psychiatrist.28 If patients thought the psychiatrist was cold or arrogant, their improvement was small when they got an active pill from him. But if the patient perceived their psychiatrist as caring and helpful, they had more recovery. Even if they got a placebo from her! This shows again that people heal people. An empathic psychiatrist who gives a useless placebo to their patients gets better results than a cold one who hands out active pills. It is the caring that heals, not the chemicals. This core truth, that people heal people, cracks the intellectual foundation of psychopharmacology. Psychopharmacology tries to find the right chemical to treat specific emotional problems. But it is more important to find the right person.

Because it is the interaction between one person and another that ultimately matters. That is why the Psychological Injury model will ultimately triumph. Not because there are literally thousands of studies that show how either childhood trauma, stressful life events, toxic bosses, or adult trauma result in mental health problems. Not because there is no research at all supporting the myth put out by the drug companies that chemical imbalances cause mental health issues. In 50 years, we will look back and marvel that a notion with no scientific support gained such wide endorsement, just by spending advertising dollars and paying many psychiatrists large consulting fees. The Psychological Injury model will triumph because at our core, we know it is true. Every guy who was molested by his hockey coach knows at his core that he is so depressed and angry because of that psychic wound. And when we ask “What happened to you?” and inquire about each type of psychological injury, then he can tell his story. And feel heard. And then choose the healing he wants. Instead of being given pamphlets written by drug salesmen, and confused with myths, his choice will be respected. And because people heal people, he can get well, and stay well for life.

Show 28 footnotes

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  3. Valenstein E (1998) Blaming the Brain: The Real Truth About Drugs and Mental Health. Simon & Schuster
  4. Lacasse JR, Leo J. (2005) Serotonin and depression: a disconnect between the advertisements and the scientific literature. PLoS Med. Dec;2(12):e392. Epub 2005 Nov 8.
  5. Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF. (2004) Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Disord. Oct 15;82(2):217-25.
  6. Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, Giles WH (2001) Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. JAMA. Dec 26;286(24):3089-96.
  7. Afifi TO, MacMillan HL, Boyle M, Taillieu T, Cheung K, Sareen J. (2014) Child abuse and mental disorders in Canada. CMAJ. Jun 10;186(9):E324-32.
  8. Varese, F. Smeets, F. Drukker, M. Lieverse, R. Lataster T. Viechtbauer W. Read J. van Os J. & Bentall R. (2012) Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin, Volume 38, Issue 4, Pages 661–671.
  9. Shevlin, M., Houston, JE. Dorahy, MJ., & Adamson, G. (2008) Cumulative Traumas and Psychosis: an Analysis of the National Comorbidity Survey and the British Psychiatric Morbidity Survey Schizophrenia Bulletin vol. 34 no. 1 pp. 193–199.
  10. Read J, Perry BD, Moskowitz A, Connolly J. (2001). The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry. Winter; 64(4) 319-45.
  11. Read, J., Fosse, R., Moskowitz, Andrew., & Perry, B. (2014). The traumagenic neurodevelopmental model of psychosis revisited. Neuropsychiatry 4(1), 65–79.
  12. Kendler KS, Kessler RC, Walters EE, MacLean C, Neale MC, Heath AC, Eaves LJ. (1995) Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiatry. Jun;152(6):833-42.
  13. Caspi A, Sugden K, Moffitt TE, Taylor A, Craig IW, Harrington H, McClay J, Mill J, Martin J, Braithwaite A, Poulton R. (2003) Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene. Science. Jul 18;301(5631):386-9.
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  19. Cuijpers P, Hollon SD, van Straten A, Bockting C, Berking M, Andersson G. (2013) Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open. Apr 26;3(4).
  20. Salvi V, Grua I, Cerveri G, Mencacci C, Barone-Adesi F. (2017). The risk of new-onset diabetes in antidepressant users – A systematic review and meta-analysis. PLoS One. Jul 31;12(7):e0182088.
  21. Galling B, Roldán A, Nielsen RE, Nielsen J, Gerhard T, Carbon M, Stubbs B, Vancampfort D, De Hert M, Olfson M, Kahl KG, Martin A, Guo JJ, Lane HY, Sung FC, Liao CH, Arango C, Correll CU. (2016). Type 2 Diabetes Mellitus in Youth Exposed to Antipsychotics: A Systematic Review and Meta-analysis. JAMA Psychiatry. Mar;73(3):247-59.
  22. Maslej MM, Bolker BM, Russell MJ, Eaton K, Durisko Z, Hollon SD, Swanson GM, Thomson JA Jr, Mulsant BH, Andrews PW. (2017). The Mortality and Myocardial Effects of Antidepressants Are Moderated by Preexisting Cardiovascular Disease: A Meta-Analysis. Psychother Psychosom. 86(5):268-282.
  23. Ray WA, Chung CP, Murray KT, Hall K, Stein CM. (2009). Atypical antipsychotic drugs and the risk of sudden cardiac death. N Engl J Med. Jan 15;360(3):225-35.
  24. Kwan BM, Dimidjian S, Rizvi SL. (2010) Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression. Behav Res Ther. Aug;48(8):799-804.
  25. Mergl R, Henkel V, Allgaier AK, Kramer D, Hautzinger M, Kohnen R, Coyne J, Hegerl U. (2011) Are treatment preferences relevant in response to serotonergic antidepressants and cognitive-behavioral therapy in depressed primary care patients? Results from a randomized controlled trial including a patients’ choice arm. Psychother Psychosom. 80(1):39-47.
  26. Kocsis, J. H., Leon, A. C., Markowitz, J. C., Manber, R., Arnow, B., Klein, D. N., & Thase, M. E. (2009). Patient preference as a moderator of outcome for chronic forms of major depressive disorder treated with nefazodone, cognitive behavioral analysis system of psychotherapy, or their combination. The Journal of Clinical Psychiatry, 70(3), 354-361.
  27. Cuijpers et al. (2013).
  28. Krupnick JL, Sotsky SM ,Simmens S, Moyer J, Elkin I, Watkins J, Pilkonis PA. (1996) The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. J Consult Clin Psychol. Jun;64(3):532-9.

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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.

179 COMMENTS

  1. Bravo, Dr Keillor! I have been using the term “injury” for a while to describe my traumatic experiences and I’ll be thrilled to see this humanistic approach to distress take widespread hold of it does indeed help usher out the era of psychiatry as a legitimate medical discipline. It obliterates the validity of psychiatry while validating the many manifestations of deep distress that people do indeed experience.

    I think there is definitely room here for deeper exploration of the societal structures (capitalism) that contribute to the frequency of traumatic events we experience in life. But otherwise I would be very pleased to see a humanistic approach to human distress such as this become the norm as we also work to dismantle the underlying structures that keep so many in a state of oppression. Well done.

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    • I don’t think it’s a good term, as it’s only a shade away from the same logic used to propagate the essentially fallacy of psychiatry, i.e. the idea of “mental illness,” and the ascription of physical terms to the realm of the psyche. Even the concept of “emotional trauma” is illegitimate if “trauma” is defined in physical terms. So it doesn’t help to compound this by adding “injury” as well.

      These are fine lines necessitated by psychiatry’s deliberate confusion of mental and physical, we need to draw them carefully, but we need to draw them. If it weren’t for the way this sort of language is manipulated and turned on its head — with great success — these seeming semantic issues would be less necessary to pursue. Most people understand the difference between a metaphor/figure of speech — except when deliberately conflated by psychiatry with such repetition that, while no one would call the SPCA if told that it was “raining cats and dogs,” they will still call a doctor for someone who is “mentally ill” — or “psychologically injured.”

      So to me this is just another “model” of this elusive “thing,” of which we are all supposed to understand “what he means,” yet which is again unnamed, and which we need the assistance of experts and professionals of all sorts to understand. And the term “injury” reinforces people’s acceptance of a medical/pathological context for the results of social and political oppression.

      So that’s my take, since I stumbled upon this discussion.

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      • I agree that to preface ‘injury’ with ‘psychological’ is not helpful because it’s really not accurate to limit the scope to merely emotional distress.

        The People-healing-people concept would be best implemented through creating strong locally supportive communities rather than continuing an industry where professionals are deferred to as the experts on healing emotional distress. I am not an abolitionist regarding therapy for adults as you know, but it would be better to prevent damage in the first place through an egalitarian and equitable socioeconomic structure that doesn’t create so many stressors in the process of dividing and conquering the people.

        Having said that, the studies done on adverse childhood experiences clearly showed a dose dependent relationship between ACEs and later chronic health conditions that all have an inflammatory nature, such as diabetes, cardiovascular disease, autoimmune diseases, and yes depression through the cytokine cascade effect.

        The real takeaway in my view then is that because capitalism directly contributes to traumatic stress and chronic or repeated traumatic stress causes an inflammatory state in the body, capitalism is therefore physically injurious in the sense that it causes inflammatory diseases and ill health (as we already can likely agree that stress contributes to illness). And in that sense I do believe that physical illness and emotional distress induced by repeated and/or chronic traumatic stress is an injury ultimately attributable to capitalism and its associated destruction of the environment and communities and that this is simply further evidence of the destructive nature of a profit based system.

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        • If the term “injury” is really important to you, you might make a case that trauma is “injurious” to the soul, recognizing it as a poetic/metaphorical abstraction, and that stress and toxins are literally injurious to the body, so that both connotations of “injury” might co-exist here. But it’s a slippery semantic slope, because all these medical-sounding allusions blend into one another; in this case, sooner or later they’d be relabeling “mental illness” as “mental injury” (or “psychological injury”) and we’d be on the same merry-go-round with a different trade name and a slightly different set of concretized metaphors surrounding it.

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          • Oldhead wrote: “If the term “injury” is really important to you, you might make a case that trauma is “injurious” to the soul, recognizing it as a poetic/metaphorical abstraction, and that stress and toxins are literally injurious to the body, so that both connotations of “injury” might co-exist here.”

            Stress and toxins are not “literally” injurious to the body. They can *actually* be injurious to the body. As you wrote above, it’s important to be careful with language.

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          • I get the point about inventing catchy names to describe things that charlatans will jump on.

            All I can say is that as we went through the corrupt MH system with all manner of biobabble thrown at us, I came to the idea that “psychological injury” was the best way I could explain to myself what was happening, and that did successfully guide us. probably not the only way I could have looked at it.

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          • I’ve been calling certain people as having the ‘Pox. The Capitalism Pox. You could label those cold psychiatrists with it and see how they like the idea of having something physically wrong with them because of their enviornment. It seems like people want to leave disease, illness, injury behind. I was thinking about calling addiction a “Generational adaption” because of epigenetics. It wasn’t a bad idea years ago. Maybe you don’t have to label your entirely normal reaction to trauma as bad AT ALL. It’s potentially something which allowed you to survive. When it no longer serves you, there should be a relatively loving way to be the way you want to be. How about……
            Coping Patterns
            Repeated Response
            Behavioral Alerts

            Or even some way of showing this person is showing useful evidence something is up with the world.
            Injustice Evidence
            Abuse Notifier

            I’m not sure I’ve hit on all of them but you could just not…not make them sound negative. Because if you get abused…don’t sleep…are lonely…and survive? That’s fucking tough. Whatever way you made it through shouldn’t be labelled as wrong. No one needs a huge dose of regret with a diagnosis.

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        • The word “pretend” bothers me here. I don’t think people are pretending they are in pain or are confused. Perhaps you could call it “spiritual injury”. Or don’t you think it damages someone to be, say, abused by one’s parents? Do you think they are pretending that it hurts them beyond the physical damage?

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          • Again it’s the fact that most people understand a term such as “spiritual injury” as a metaphorical abstraction, but would consider “mental injury” to be a literal medical condition. It’s programming, so thorough it isn’t even recognized as such.

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          • Does this “injury” exist within a time frame? Permanent “injury”, together with eternal “healing”, strikes me as somewhat, to say the least, over the top. I mean a person can paint him or herself into a corner, however, not painting him or herself into a corner, that might require a little more tact.

            I understand that there are people who make their living pretending to heal those people pretending to be injured, however, I also understand that there are possibilities beyond pretense.

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        • So Anneliese Michel was killed by mother. She was an example of what psychological reality can do with our small ego if that ego is beyond material, apollonian illusion of control.

          The psychology says, that she was killed by orthodox family and evil mother. Psychiatry says that she was mentally ill or send her to devil advisers. The theologians says that she was possesed by the devil

          And antichrist = human, will say – No, stop. Psychological reality is a true reality, hades reality can do everything with your small ego. Small planet in space, this is our ego in psychological realms.

          Psychiatry will tell you, that only this planet is real, that this planet is mentally ok. And the rest does not exists, or it is a form of sickness. And theology will tell you, that when you are beyond this small planet you are in the devil area. That you are possessed.

          We need someone who sees that space beyond our small ego, who will tell everyone that psyche does exists. We need James Hillman, because his eye is a window for the blind.

          Or that girl (AND MANY OTHERS) died in vain.

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        • So we can have real physical inuries but they aren’t real if they are psychological injuries. Is this simply because to you an injury has to have a physical aspect to it.

          If this is the case then there is ample research showing physical changes to the hippocampus and the amygdala in those with psychological damage for which injury is a better term. Pretend implies psychological injuries are not real which takes us back to the fantasy of chemical imbalance. There is significant bias against people with mental health challenges and this expression “pretend” continues that.

          The only pretend that exists is the Chemical Imbalance theory which has been disproven by research and comprehensively disproven but it is clung to with all the fervour of ship wreck victims clinging to flotsam to save themselves from drowning.

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          • “Psychological injury,” like “mental illness,” is a metaphorical abstraction, “injury” is a material, physical thing. There are constantly changes in the body and the brain as they mediate the interplay between mind and matter. The fact that a change takes place in the brain which seems to correlate with an unwanted emotion or state of mind does not necessarily signify “damage”; in fact, it could signal that the physical/nervous system is working appropriately at interpreting the environment and sounding a warning, even if we don’t like the information being provided.

            It is not that the chemical imbalance bs is bad science as opposed to good science. ANY “research” based on the premise that “mental illness” exists is bad science (and bad language).

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          • My work is in promoting egalItarian, social relationships between people with similar experiences in order to promote mental health via strong communities (i.e. “peer work”). I strongly believe in the effectiveness of this approach, as it provides more dignity, understanding, personal autonomy, and respect for human rights than a hierarchical, illness-based view of mental health.

            Admittedly, I still have much to learn, in this field. I was very interested to read that the chemical imbalance theory has been scientifically disproven, many times. Showing evidence of this would certainly help me to promote peer work as an alternative. But the author states, “there is no scientific evidence of a chemical imbalance resulting in any mental disorder.” When I was in school, studying psychology, many professors admitted to many of the limits of the chemical imbalance theory mentioned by the author. Yet, they explained that this theory is used because of patients’ responses to drugs. Drugs meant to increase serotonin levels in synapses resulted in heightened mood… Therefore, low levels of serotonin are reasoned to be involved with depression, etc. They explained that psychiatric research is based on assuming causation based on the effectiveness of manipulating levels of various neurotransmitters in neural synapses. That’s the basis of the chemical imbalance theory, as far as I can tell. I’ve worked in a neuroscience lab, a bit, and know that this thinking guides a lot of research, not just in psychiatry, but treatment for neurological disorders such as ALS and Parkinson’s, as well. Can anyone please refute this basis of the chemical imbalance theory? Again, I fully agree that the chemical imbalance theory has been used in pervasively harmful ways, which is why I’d like to better understand arguments against it. Currently, in my work, I simply focus on arguing in favor of the more effective trauma-based peer models for mental health support, and reference the psychological harm and ineffectiveness of an illness-based model. Being able to scientifically refute the concept of chemical imbalances would make my arguments more compelling. Thanks.

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          • For one thing, many “antidepressants” don’t affect serotonin and still are considered “antidepressants.” For another, studies back in the 80s showed that lots of “normal” people have lower serotonin levels. For a third point, no one knows what a “normal” level of serotonin is – serotonin levels vary widely from moment to moment. Have you read Anatomy of an Epidemic yet?

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          • Anechidna,
            I think you are going to find different opinions about ‘psychological injury’ on this site. To me it’s a perfectly good analogy between a severe broken leg and a severe traumatic injury suffered to the mind. With proper care both injuries can be healed and the sufferer can go on with life relatively none the worse. But if either injury is ignored, it is likely it will never ‘self-heal’ and then that injury will stress the greater system and if that stress is enough in the future, at some point it could begin to cause other issues.

            To me dissociation is the biggest physiological result that comes from mental trauma, though that may simply be because of my wife and my experience. I’m not an expert, but I wonder if the dissociation is what causes all the differences in brain mapping (though I take all the hoopla over those mappings with a grain of salt!) Anyway, I believe dissociation in the mind is similar to what happens to the body when a broken leg is never healed. From that point on the body will do all kinds of things to get around the natural use of that leg. Sure, some body parts may even grow stronger as a result of having to take over for the leg’s function, but doing so will also stress parts of the body that simply were never made to walk. In the end, the person may even learn to be relatively mobile, but that doesn’t mean that was the way the body was intended to function: it’s just a testament to our ability to adapt.

            But even decades later, as in my wife’s case, once the mental trauma is addressed and with a lot of help (kind of like physical therapy to strengthen the atrophied body parts), her brain/mind is healing. It’s just a lot more work to undo all those ‘workarounds’ caused by the dissociation than if we had know about it in our 20’s.

            Sam

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        • I get the problem with “psychological injury”. I just needed something to explain how we the family regarded “it” in the face of debilitating, inaccurate and insidious labelling from psychiatry.

          Our firmly held belief was “you are not broken, there is nothing wrong with your brain, we all of us believe utterly in you even though what you are going through is seriously crap, and we are begging you to hang on as we throw the kitchen sink in to help you”.

          All the bio-crap is defeatist nonsense to make you take the meds.

          So I remember thinking “ok it’s bad, but it’s like an injury you can get over, but because there’s nothing wrong with your brain or you as a person, in fact it’s a fantastic and beautiful brain and you are widely loved in the family, it must be psychological or something that is core to life itself, not some neurotransmitter problem”.

          But other ways of talking about might work also so I’m interested in what people think.

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          • Concerned Carer,
            I see that no one ever addressed your concerns. Perhaps I can try.

            I think you can see the resistance that the survivors have on this site to suggesting that anything is ‘wrong’ because our culture weaponizes that admission. For my own wife it took 20 years before she felt safe to do so with me and only AFTER I made it clear to her that I loved her unconditionally. Until that point, anytime I would make the suggestion, she would spit back that I was the one with a problem. And so I don’t expect any less of the survivors on this site.

            And I think that’s why talking about mental health ‘trauma’ in the same way we talk about bodily trauma is so valuable. If we see someone with a cast on her/his leg, typically we think ‘oh s/he broke it’ but there’s also an assumption in there that with time to heal, and maybe some physical therapy if it was a really bad break, the person will be back 100% when the process is over.

            But there’s another assumption that while the person is in that cast, there will naturally be things s/he can’t do until the healing has been completed. Most of us don’t assign value judgments to those things that can’t be done, we just accept them as part of the trauma and convalescence period. And if we love the person, we don’t take umbrage that we have to ‘pick up the slack’ while our loved one is healing.

            I feel all those points can be seamlessly transferred to our loved ones who have suffered mental trauma. And the manifestations that occur from that trauma, whether it be ‘extreme states’, excessive triggers, ptsd symptoms or anything else, should just be viewed the same as in the list of ‘currently can’t’ when a person has a broken leg.

            I rarely talk about my wife’s list of ‘currently can’ts’ even though there are a lot of them and some of them cause me extreme stress. And when she begins to berate herself over that list of ‘currently cant’s’, I tend to just say, ‘that’s the d.i.d. and it will get better once we get thru it.’ I tend to focus her and myself on the positives, like a good coach. We both know the negatives are there and we don’t pretend like they aren’t there, but we try to stay forward focused, knowing that what ‘currently can’t be done’ is not our final destination.

            Sam

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          • “I think you can see the resistance that the survivors have on this site to suggesting that anything is ‘wrong’ because our culture weaponizes that admission.”

            Sam, as a “survivor” (so to speak) of all this, I never resisted saying that anything was wrong with me. I volunteered to go to counseling when I was in college because I thought something was wrong with me! I felt terrible as I’d never felt before–crippling anxiety, mental confusion, really bad self-talk and scared to death of life. This was back in early 80’s, and I was very open about it, had no shame or self-consciousness at all about calling myself “mentally ill” at the time. So? There are drugs that can regulate this, was the mainstream thought at the time, and I was mainstream. So I took them, and went on with my life, with usual ups and downs, and a lot of hassle because of this, but I thought it was a fair trade off, if I could live my life. I had no idea how this would come back to haunt in 20 years, which it did, but that’s the next stage of my story which I’ve told repeatedly on here and in public.

            I finally, through the years, figured out what it all was about to begin with, and I worked hard to correct this in my life, but in the meantime, I was diagnosed and put on psych drugs–at the time, I called them “medications,” because that’s the world I grew up in.

            I dropped out of college and went to work, where I stayed full time until I moved to Austin to go back to school and finish my degree, which I did, in film. All the while, I was on a few “meds” and seeing a therapist and “med checks” with psyciatrists, etc. First thing I did when I moved was to set myself up at the local “mental health” clinic, called MHMR (Mental Health Mental Retardation). Isn’t that a pip?

            While attending classes, I was also in a research study at the time with the psych grad dept, regarding panic attacks, which began a couple of years after having started “meds” in the first place. That was an interesting experience, but it did nothing for my well-being. I was trying EVERYTHHING I could think of, including volunteering for studies in trade for some kind of “treatment.” Best I could do at the time, other than taking by then, I think, 4 different pills, for anxiety, depression, panic attacks. Elavil was one of them, xanax, klonopin, and lithium.

            I’d have panic attacks driving to school and would have to pull over for about 10-15 minutes until it subsided, then on to class. Sometimes in class I’d get a panic attack and would bite my pencil to stay grounded. I got through school with a 3.8 GPA and had a great time, really enjoyed my major. This is how I supported myself through it.

            My partner at the time was working in Kansas, he was a sales rep. So we’d see each other every couple of weeks, but for the most part, I lived alone, went to school, did work study where I ran cameras for a studio, and took a “meds cocktail” and got counseling. Some days I suffered and most days I had side effects, but I felt good about how far I’d come and again, thought this was the best I could do.

            After graduating from college, we moved and we both got jobs at a local natural foods store, where I became manager, and my partner’s boss. He then went to school, and I supported him, happily.

            Then we moved to San Francicso so I could attend graduate school, and within a year, my “cocktail” was turning on me, grad school was an abusive and disillusioning experience, and my partner was HATING San Francisco, which had been my dream to live there. He turned angry and resitant to everything, while at the same time, I was drowning in side effects and all kinds pressures. We had hit a wall.

            It was at this time we began our dual-dark-night-of-the-soul journey, and we were both dissociating big time. We researched DID to the hilt, and this was part of our story. Things got very complicated here.

            The ONLY reason I am writing this all out like this is because you made that generalized comment about “survivors,” and I wanted to not be part of that generalization. I respect your story and all that you and your wife have been through, and I read with interest how you support her.

            My story is my story, not to be compared with others, and I’m not insinuating anything about anyone. Our stories are unique and unto themselves. To me, that is the missing element here.

            In my case, my family was terribly dysfunctional, and I was the one carrying the burden of it. That’s not the case with everyone, but it is not terribly uncommon, either. I’m speaking for myself, sharing my experience, not comparing it to that of others nor saying that is the sole cause of extreme distress and post traumatic stress. Still, it is common and largely still denied.

            My partner is an SO, and I’m also an SO. We’re mutual SO’s. We’ve also both had issues, and we’ve dealt with them in different ways over the years. We do not categorize ourselves here in our home as an “us and them” partnership. We share all the burdens, and all the credit.

            “For my own wife it took 20 years before she felt safe to do so with me and only AFTER I made it clear to her that I loved her unconditionally. Until that point, anytime I would make the suggestion, she would spit back that I was the one with a problem.”

            Interesting. This could be me and my partner, but in reverse. He was the spitter and blamer. He’ll tell you the very same thing. He’s owned this over the years, and he has done incredible integration healing work. We share this disctintion, as we share our lives on equal terms.

            Anyway, you and I are both into supporting our spouses unconditionally and I think that’s a good thing. I hope this clarifies from where I am coming, speaking as a “survivor.”

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          • Alex,

            I apologize for making the generalization. I try to read and re-read my responses so I get them ‘right’. I try to not make over-generalizations because, of course, not everyone fits in a neat category. So I apologize to you and any others who felt my response mis-represented them: that was not my intention.
            Sam

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          • Thanks, Sam, very appreciated. And you’re right, although I would say that not anyone fits into a neat category, other than “human being.” And we do the best we can with what we know at each moment in time. End of story!

            Oh, and btw, in the energy healing world, DID is translated into something called “transmediumship.” It’s a gift we can learn to utilize, and it’s also a healing path. You can research this if you’re interested. If you have any questions about it, feel free to ask.

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          • Hi Alex,
            you are welcome to tell me, but I’ll be honest, this journey my wife and I have taken the last 11 years has pretty much knocked out ALL of my ‘practical’ beliefs of the supernatural. I grew up a very devout evangelical Christian and got deeply into the charismatic movements and such during my young adulthood, but there was a part of me that always wondered what was wrong with me when “God” seemed to move in people all around me, and nothing happened to me…

            And then when my wife and I started this healing journey, I just didn’t have the emotional strength for anything that wasn’t ‘real’ or didn’t work, and so many of my Christian beliefs simply didn’t work out into real life, especially my expectations of some kind of supernatural intervention to help me and my wife get thru the hell we were going thru…

            And so I’ve kind of ended up with a humanistic Christianity, which my evangelical friends would call a heresy. I have a theistic worldview, but I don’t expect any help. I personally call it a Narnian Christianity: all those times that Aslan was absent for ages and ages which aren’t in the books by Lewis. I believe the moral codes, I believe there is more, BUT practically speaking, it’s up to me to help my wife heal, not some awol deity that I was never good enough to earn favors for answered prayers.

            I do understand that I’ve said a number of things in this response with which you would strongly disagree, but it’s where I’m at, and so far it’s been pragmatically useful in helping my wife and me survive the trenches we’ve traveled together. I’m sure this is far more than you expected, or wanted, especially as I can tell that for you, your journey seems to have taken you in the opposite direction toward more openness to ‘spiritual’ things.
            Yours,
            Sam
            (edit: and I guess I’ll add I’ve become a lot more socially, religiously and politically moderate from how I was raised…I’m kind of a pariah now to all of my family who are ardent Trump supporters, lol)

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          • Sam, I never “disagree” (or at least I don’t argue about it if it doesn’t ring true to me, personally) with a person’s personal belief. Your beliefs are your beliefs, as with me or anyone. I believe the idea is to live by our beliefs, that would be aligned with our integrity. Otherwise, I think we cause ourselves to split, and that’s where imbalances come in and problems eventually arise. But if we are true to our own word, then we are living our truth with a certain amount of clarity and power.

            Regarding transmediumship and energy healing, there is nothing “supernatural” about it. It’s quite natural. And it’s not based on any “dogma” or belief system, other than the belief in energy, which to me, is everything.

            As far as my path leading me to be “open” about spiritual things goes, I followed whatever path led to my feeling better, clearer, stronger, more integrated and alive, and to where I could manifest what I wanted, namely, my dreams. And in the process, I did just that. I was open to ANYTHING, once I determined that the mh world had failed me tremendously, and I had a big hole to dig myself out from.

            I’m also a very real and practical person, with good relationships in my life. I am grounded and on Earth, even though I may speak about this stuff as I do. It’s not easy to introduce such concepts as real healing in a sea of academic cyncism!

            How could I not believe in energy as our greatest resource? That’s really all I had to work with. It’s a step by step process, and true and authentic healing does, indeed, challenge our most core beliefs. How we respond to that is what determines the next step for anyone.

            I truly believe that whatever is appropriate for us appears on our path when it is most useful to us. Stay on your path. We all have things to learn as we go. I’m sure that is a never-ending process. Healing blessings to you and your wife.

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          • Alex,
            I almost missed your longer explanation that you added after your initial post. When I googled transmediumship I only saw stuff in there about, essentially, being a medium. I certainly could use ‘energy’ if it were for real. I don’t have time for pie-in-the-sky beliefs like so many I grew up with. I ONLY care about what practically helps me and my wife…especially because her last ‘alter’ has almost exhausted ALL of us, trying to help her heal and connect because she’s different than ALL the others. She has very little long term memory, and so even though we’ve made progress securely attaching her to me, it’s like that movie of the 50 First Dates, and I have to start from scratch over and over and over, and so it’s hard for her to feel safe, which means it’s been monumentally hard for us to get her connected to the rest of the group, and she was/is so terrified as long as she disconnected from the others that ALL intimacy, emotional, physical and otherwise has ceased for more than 3 years, and we’re all really struggling right now…and I’m just so overwhelmingly tired, and hoping I/we are going to make it especially when we’ve all come so far..and yet I just don’t know how to help her past this…I’ve never had a conundrum like her lack of long-term memory has presented to us on this healing journey…sigh…oh, well, enough of the online therapy session, you didn’t ask for it…I just don’t have any one to talk to about this kind of stuff…we are so far past anything you would read from ISSTD or the popular lit…and I feel like I’m going to break if we don’t get a breakthru… 🙁

            Sam

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          • Thanks Sam and Alex! I think we are on a similar page? I must admit I don’t look at this at high a spiritual level, I just felt at the time that I had to, then and there, decide in my mind, what the truth was for the incredible difficulties. The bio-broken brain model doesn’t fit the facts on the most logical of levels. A psychological pain, an existential crisies, a psychological injury can account for the troubles. And whatever it is, the route to recovery is psychological and social – we all agree meds are at best just a suppressant. So, I haven’t got time to put this properly, but ask you yourself if are committed, you love and believe – and then communicate that and be there all the time. Sorry that sounds soppy.

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          • “Sorry that sounds soppy.”

            No, it’s not soppy, concerned carer. That’s what I’ve learned from attachment theory. For us, it’s mostly been a repudiation of the Western independence that is beaten into all of us from the time of birth when parents are foolishly taught to let their children cry themselves to sleep…and the myriad of ways we are told to let others suffer on their own and ‘tough it out’ or ‘pull ourselves up by our OWN bootstraps”. We are all systematically shamed by this culture of deranged independence, and my wife and I simply reject it.

            I make a concerted effort to, essentially, weave a ‘cocoon’ of attachment points between her and myself throughout as many aspects of our lives as I possibly can. And each of those attachment connections strengthens BOTH of us. Just because I don’t have any massive trauma in my past, doesn’t mean I don’t need the deep connection to another human, and even if she can’t give me what I most deeply need at the moment, I’ve still learned to soak up the connections that she is able to give me.

            I really do love the song, “Lean on Me” because it’s so true. Don’t ever feel it’s soppy. Interdependence is what we were all ‘wired’ for: it’s far more healthy than this independence garbage we are all force fed our entire lives.
            Sam

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          • What I’d say to anyone who is supporting a loved one who is suffering like this is to make sure and take care of YOURSELF if you want to be effective support. Otherwise, everyone’s energy gets drained. Especially if you are one person supporting another person, I’d recommend getting some emotional support for yourself. Even as a counselor, I have my own support to help me stay present. I heal and grow along with clients, it is a symbiotic process. We’re all on a path.

            And I know it can be hard to find others who can relate to some of these issues and situations, but really, all you are looking for at this stage is simply to be grounded. So if there is no one around to help you help someone else, I’d suggest getting on YouTube and doing a search for “grounding and centering.” Tons will pop up that will help to guide you along, and all kinds of different videos, so hopefully, something for everyone. Some will speak to you more than others. It’s a worthy endeavor, however, because I know in all certainty that this is vital and first and foremost in any healing process.

            Whether you are the person in need of support in the moment, or you are the one doing the supporting, everyone in the equation is human and needs to stay grounded and balanced. People in extreme distress need time to find their center, that will take a while because that is the core problem, being out of center. That’s what makes everything seem “crazy” (out of control). Anything can be addressed and processed so much more easily when in a grounded state of being, by far.

            At least one person in the healing support community HAS to be grounded and centered, hopefully everyone is. But without that, there is no actual effective support and everyone is just dragging everyone else down. And of course not intentionally, but that is the nature of things when no one in sight is grounded and centered.

            What I tell all family members when I work with them is to do their own work, first–like ground, center, come into balance, find your own clarity and get in synch with yourself. Then, you help your loved one do the same, to the best of everyone’s ability. But if you are trying to help someone and you are feeling tattered, then you will be limited, at best, in your ability to help someone else. Could even lead to more problems if everyone in the family or community is out of center, which is the case in family dysfunction.

            On an airplane, they say if the oxygen masks come down, put yours on first before you help your child. That’s the rule of thumb for good caretaking support. If you are not feeling in balance, then get that taken care of, first. That will benefit your loved one more than anything else. We are all human and need nourishment, not some more than others.

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          • Ok Alex,

            I want to honestly explain my struggles to you IF I were to do what you and everyone else suggests and “take care of YOURSELF if you want to be effective support.”

            After journaling for more than 10,000 pages these last 11 years during this journey, to help me deal with my own issues, to deal with the inherent stress of this journey, and to help me figure out how best to help and support my girls (as I phrase it on my blog), I’ve got a pretty good handle on what makes me tick.

            IF I were to take care of myself first as this culture suggests there are two things I would do: 1) I would have a healthy, intimate adult relationship, and 2) I would enter the field in which my college degree is, mainly ministering to others…these are the two things that rip at my heart every single day of my life: the void in my life of these two things is overwhelming…and yet to do so, would probably mean leaving my wife since she and I have NEVER had a healthy or especially intimate relationship (emotionally, physically, or otherwise) even though we both love each other. Her past trauma has simply truncated so many of those desires in her: so if it’s ‘me first’ do I leave?

            And the same about my vocational desires. She married me knowing exactly who I am, what my chosen vocation in life was, and within a few years, she made it clear that she would never allow me to follow that desire because it struck at her ‘safety needs.’ Again, if it’s ‘me first’ do I leave her?

            I’m really not trying to be dismissive or argumentative, but one’s marriage vows are there for a reason despite our culture’s infatuation with rewriting them to say not much of anything nowadays. I love my wife: no this isn’t the life I would have chosen or the vocation of my dreams (being in a factory), but I’m trying to make lemonade out of the lemons that we were both dealt. She certainly didn’t choose this. No one says, “please rape me repeatedly when I’m two until I break and fracture and never know what it means to be healthy” (her words not mine). But I love her, and I choose US even though I know it means I’m choosing heartache and stress each and everyday until we get thru this…

            But trust me…that heartache and stress is a great motivator. It pushes me every single day to help her in every and any way that I can. It teaches me to be in tune with her so that I have learned never to coerce her, but how best to create an environment that feels safe and loving to her so that she can heal, truly, deeply and fully as I believe is still possible.

            Again, I am not trying to be dismissive, but what you have shared, which many, many other people have shared to me as well…I just don’t know how to do that AND be true to some other core values in myself and be true to my one and only love. It’s one of the things I truly think the new testament in the Christian bible got right: the idea of sacrificial love and giving up oneself and one’s life for another as the true sign of love and friendship.
            Yours,
            Sam

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          • Ok, I hear you, Sam. If something clashes with your beliefs, then go with what you believe. What I offer is what I know from my own experience, and is what informs my belief system at present. Perhaps you will discover something that will work for you which will not be in conflict with your belief system, and you can share it with others who have the same beliefs as you do.

            I get that you have been in deep struggles for a good long while now, and it sounds like you are looking for some kind of relief, something to shed a bit of new light on your situation. I hope you both can find something encouraging sooner than later. I do very sincerely wish you and your wife the very best as you move along in your lives.

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      • For what it’s worth OH, Dr. Kuelker puts the lie to the notion that the drugs actually fix something and correct any brain problems instead of creating new ones. Because of this I’m posting this article on Facebook to educate my friends and family who believe psych drugs are “safe and effective meds.”

        My argument against the a priori assumption of Psychiatry: “If the problem is not in the brain it doesn’t exist.”
        “If what you say is true that still does not justify random acts of brain damage on those you consider already impaired.”

        Osteogenesis Imperfecta is undoubtedly a disorder of the human skeleton. But it does not justify taking a crow bar to the limbs of someone suffering from it.

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        • We still need to develop more of a “duh” response to all this talk about “new models” of this or that alleged “mental thing” based on rephrasing what we already understand as no-brainers, and unnecessary “studies” (even careers) based on reinterpreting the implications of water being wet.

          (This is not directed towards anyone in particular.)

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    • KS-it is rare that I find myself in polite disagreement with you, but this is a case when informing is constructive. Capitalism is not the only “for profit” economic model. In the US, we are led to believe that we are a capitalist country based upon “the ‘pursuit’ of happiness.” There has long been barriers to entering the market place, and these barriers are maintained by the collective interests.

      This “for profit” model is called Corporatism. . .the corporatists determine who can take part in a the market place as well as put barriers in place to prevent competition. Review the wiki page on Corporatism, please.

      A pop culture example . . . The Simpsons. . .when Homer had a back ache and he fell over his trash can and rolled, his back was fixed. He started helping others fix their backs with his trash can. One night, the Chiropractors show up . . and beat his trashcan with their plastic spinal columns. Killing their competition.

      Chiropractors and other body-workers had long been marginalized and maligned by conventional medicine. It was not until they kowtowed to Insurance companies and their requirements (move away from patient centered to protocol centered), that they gained current medical establishment acceptance.

      Once you understand Corporatism, especially Neo-Corporatism, American history since the Civil War will take on new meaning. There are direct correlations to “Mental Health” establishment.

      KS- keep sharing! Your insights and experience are invaluable to all here!

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      • I follow a libertarian blog called “Economic Freedom.” Dan Mitchell, the blogger, has written a book called Cronyism. In it he decries the bribery and other dishonest tactics major corporations use to get Big Brother eating out of their hands. He doesn’t know much about psychiatry because he has never mentioned how the APA stays in power no matter how much damage they create.

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        • Rachel777 – if you are interested in free-market/libertarian economic theory, I recommend https://mises.org/ – The Mises Institute. I was turned onto them by CATO members I used to work with pre-internet. Start throwing keywords in the search, ie “mental health” or “psychiatry.”

          One must not forget, all relationships are economic (in some shape/form). Those involved in the “Mental Health” system as a patient/client are defined by their DSM diagnosis for billing purposes. These PEOPLE are essentially COMMODITIZED in the perpetuation of the false DSM based system.

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          • OH – Marxist terms are an extension of the Darwinist movement. While the masses (around the world) were dealing Thesis/Antithesis -> Synthesis dialectic between Marxist/Capitalist ->America we have today, the Corporatists laughed their way to the bank.

            Corporatists (https://en.wikipedia.org/wiki/Corporatism) transcend national boundaries and governments. They make a profit by marginalizing competition and maintaining barriers to the market place through complementary governmental regulations (barriers to market newcomers) and monetary policies. It is ultimately about CONTROL . . . sound familiar?

            Where did it all go wrong in the US, it began with the Civil War, but the tipping point was the 17th Amendment to the US Constitution. That was the death of the “Great Compromise.” Up to that point, the States were represented at the Federal level, the US was a Representative Republic based upon Jeffersonian democratic principles. With the popular election of Senators, the US became a Representative democracy. As most know, democracy = tyranny of the majority . . . and is also referred to as socialism-lite.

            OH – there is more to this, but I do not like straying too far from the article’s IMPORTANT topic. I felt the need to comply with your question because you “asked.” -Cheers : )

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      • ds_ghoste, I appreciate your critique of my anticapitalist position and your assessment of corporatism. It’s not the first time I’ve heard the term of course and I can’t disagree with anything you’ve written. I see this is clearly an area I should spend more time reading and developing my position. Thank you for the feedback.

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        • KS-I have always found your comments full of personal reflection and contributory understanding. It is clear you have asked many important questions of yourself and the world around you. I have done much the same over the years.

          I am sure you have noticed the adage, “History Matters,” is true. I would also add to that, “Context Matters.” Whether it be personal, subjective history or the history of current events, there are lessons to be learned – in the scope of historical context.

          The efficacy of Dr. Kuelker’s proposed PI Model acknowledges (one’s own) subjective history within subjective context. The current DSM/biomedical model promotes disconnection from one’s subjective contextual history as a matter of course.

          The unfortunate reality . . .in order to bring “professionals” over to the new/original way of thinking, the DSM semantics must be co-opted. In doing so, the DSM definitions, within scope of the PI Model, need defined.

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          • ds_ghoste, here’s where we might have some disagreement and I’m curious how you’ll respond. While I do understand the need for defined terms, especially in clinical settings, I’m far less convinced that copying any part of current psychiatric nomenclature is helpful. I’d like to see the current field of psychiatry go the way of other forgotten medical arts of old.

            In my view, the DSM really only serves two major functions. It categorizes groups of behaviors into specific pathologies to identify populations of patients for treatment, research, and political/law enforcement purposes. It also serves as an insurance billing code. Both of these major functions determine how patients and their “illnesses” are viewed and treated by clinicians/helpers/law and the availability, or lack thereof, of specific kinds of care to different patient groups.

            I have no small amount of concern that whatever the next paradigm of care ends up being, and the branch of medicine that sprouts from it, may end up being just as poorly executed with drugs developed and pushed and protocol based therapeutic care continuing to be profit driven and coercive. With that in mind, I’d like to see the disorders as defined in the DSM dropped entirely, and I don’t know what to propose instead since my basic position is that of an abolitionist but I have some thoughts.

            I am in favor of changing the narrative regarding mental distress from “what’s wrong with you?” to “what happened to you?” But I am hesitant to make alternative propositions beyond that when it comes to treating emotional distress in the medical system, or billing for such. Perhaps the real answer is that we shouldn’t have codes for payment, that the concept of an insurance based medical system has outlived its usefulness. (And by extension the insurance based social care system which includes the helping professionals could be eliminated as well in favor of putting those supports under community services.) The actuaries will still be crunching numbers of course so getting rid of insurance and moving behavioral care out of the medical system when it isn’t medical in nature won’t be a panacea, but it seems like a good start to say let’s get rid of insurance and let’s get rid of judgmental codifications and medical treatment of human behaviors rather than coopting any parts of the current harmful system and trying to somehow fix it.

            As for bringing the professionals over, I think it will help to capitalize on how unhappy the professionals actually are. It doesn’t take a rocket scientist to understand why so many doctors are burnt out and leaving clinical practice, and by extension anyone who practices patient care within the insurance based system in the era of managed care, electronic health records and stupefying amounts of time that all care providers spend per patient outside of the office visit. And on top of all that, they have massive amounts of student debt and the constant fear of malpractice suits. Hang out in doctor spaces online to get a feel for that from people who just want to go back to practicing medicine. So from my vantage, a multipronged approach with a goal of upending the current system of care and compensation with the support of fed up doctors and care providers, while also separating social responses to distress from medical responses to physical illness might be the best path forward.

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          • a multipronged approach with a goal of upending the current system of care and compensation with the support of fed up doctors and care providers, while also separating social responses to distress from medical responses to physical illness might be the best path forward

            “Approach” by whom?

            Part of the theoretical advance made by marxism-leninism was the conclusion that the machinery of the state must be smashed, not just taken over. This is the attitude I take towards the idea of instituting “evolutionary” changes as applied to psychiatry using the same intellectual “approach,” regardless of content. The whole professional/academic mentality that concerns itself with competing “models” of misery overlooks Marx’s observation that, while philosophers have historically interpreted the world, the point is to change it. (This is not specifically addressed to KS, though it was prompted by her post.)

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          • KS/OH – all very good points. Anyone taking a first glance at this discussion we are having will not readily understand that these are the discussions that take place behind closed doors. These are the exact discussions that DO NEED TO OCCUR.

            Educational costs, insurance and the ability to pay, transactional taxes, and getting paid for services rendered in a modern world all play roles in the makeup of the current reality. Add to that, the numerous lawsuits, frivolous and otherwise, have complicated the therapeutic provider – patient/client relationship.

            We are long past the days of a Doc Baker from Little House on the Prairie. We are even long past the days of the MD I am so fond of . . . he fought his office manager (his wife and bookkeeper) in raising his office visit price from $10 to $12.50 in 1986. He even kowtowed to his malpractice insurers as he stopped providing house calls in the early 70’s and stopped compounding his own medications in the 60’s.

            What he realized and made clear . . . he had to make trade-offs. In order for him to maintain his office doors open to those without access to medical care, he had to play their (the industry’s) game on his own terms. That cannot be done anymore . . . with a very few exceptions.

            In the Amish and Mennonite Communities, they have a religious exemption, up to a certain point. Their practices revolve around (physical/psychological) injuries suffered in their communities. Some do offer outsiders (the English) care. One has to remember, they have a different set of circumstances, a different reality than those of us in the everyday world. They also have a real “Community.”

            What Noel Hunter found out in her journey from Survivor to Psychologist, a substantiated diagnosis was necessary for insurance payment, to keep her doors open. Even though the diagnosis exists, she could still proceed down the road of her trauma focused model of care. She bent enough to industry requirements to keep helping as the MD example did earlier.

            In me, you are dealing with a Gen X Realist . . .not a pragmatist or a pessimist, but a Realist. These situations, such as the DSM Model, take generations to develop and will take just as long to overcome. There is no silver bullet to fix the current DSM model based trauma, but there is a cluster bomb of individual practitioners/therapists that can make real differences in their clients lives.

            I know my comments probably added nothing, but there is a way out of this state of affairs.

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          • If people assumed their collective responsibility to create the social and political changes needed to eliminate this misery there would be no reason to categorize it and treat it as an abstraction, which is a way of kicking the can down the road. Until everyone sees their generational responsibility to do this there will be no real answers, and people will keep on hacking at the branches rather than the roots.

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          • I would rather suggest that the new/old way of thinking is not at all compatible with the DSM or any of its definitions. If things defined as “mental illness” are to be considered common reactions to difficult circumstances, we need to dispense with the idea that a particular emotional/behavioral reaction is in any way a “disorder” or “disease.” Moreover, the idea that lumping people together based on their particular reaction to their particular history and context and saying they all are “suffering from the same disorder” is, to me, inherently invalidative of the very context it seems you and I both want to see brought to the forefront. I hope that makes sense!

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          • Steve McCrea – you make perfect sense. I agree getting away from the disease/disorder/biomedical model is imperative, especially in achieving “legitimacy.” The disease/disorder/biomedical model characterization is intellectually dishonest and malpractice. It totally invalidates subjective experience.

            The goal is achievable, but will not occur overnight. I still find myself using the “mental illness” term . . . as to why I always try to put it in quotations.

            I still am finding myself using the CPTSD/PTSD nomenclature as just saying trauma and the resulting coping/behavioral adaptions resulting from said trauma, doesn’t get traction. By using the CPTSD/PTSD as the wedge to get interests, I bridge in the trauma model top-level explaination.

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          • I often do the same. If we’re going to use a label, I use the ones that indicate damage from trauma. Though I talked to a psychiatrist once who said “PTSD” was not caused by the trauma, because not everyone who was traumatized got “PTSD.” What? So being hit by a car doesn’t cause broken bones, because not everyone’s bones break when they get hit by a car??? The problem is apparently “vulnerability,” because I guess everyone should be able to handle being traumatized without having flashbacks or nightmares. Very weird!

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          • I honestly have never met anyone who didn’t have some kind of “post traumatic stress” going on, it’s kind of a fact of life in the world at this point, I do believe. It’s not always overt nor projected outward, and it can show up in many ways to which we’ve become accustomed.

            Life on this Earth as it has been for generations, is traumatic at one point or another, and often quite early on. We interpret and deal with it in a variety of ways–some people seek help and feel something is wrong with them and some people throw themselves into work and have, for example, repeated issues in relationships that aren’t really clear, but which are borne from seemingly inexplicable anxieties. There are all sorts of ways pts can manifest in our lives that intefere with our well-being in the long run if we do not wake up to it and actually do the healing for it.

            The problem which makes it worse and potentially chronic is not only when it is called and treated like a permament disorder, but even more so, to my mind, and I believe socially crippling, is when it is used divisively and to “other.” Everyone has vulnerabilities and triggers one way or another, and can experience crises in their lives. I think the idea is to learn from them, so that we do not repeat them time and time again. What is there to diagnose? That’s life.

            “Post traumatic stress” are three words which can describe myriad experiences regarding the reverberation of past traumatic events which make the body feel stress in the moment. That is a reality of being human, so I see it as simply a discriptive phrase which is literal, and which can apply to anyone at one time or another.

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    • I agree, Lady Q, it is a well written, logic based article. Thank you, Dr. Eric Kuelker, for speaking common sense.

      Just curious, Eric, do you envision your ‘Psychological Injury Index’ replacing the DSM? If not, people in your industry should, at a minimum, be working to make helping child abuse and rape survivors billable DSM disorders. Since currently no “mental health professional” may ever bill any insurance company for ever helping any child abuse or rape survivor, unless they first misdiagnose them with one of the other “invalid” DSM disorders.

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

      Which, of course, is why staggering percentages of child abuse and rape survivors have been misdiagnosed with the other DSM disorders.

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

      And, of course, contrary to the psychiatrists’ belief system, the psychiatric drugs don’t cure distress caused by a crime, traumatic event, or other injustice.

      But when a society has a multibillion dollar, primarily child abuse covering up, “mental health” industry … that society does end up having enormous pedophilia and child trafficking run amok problems, as Western civilization has today. Because, industries that cover up child abuse, are also at the same time aiding, abetting, and empowering the pedophiles and human traffickers.

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      • THE EVIDENCE WITHIN THE UK

        If a “normal person” takes Valium they will eventually develop an Anxiety condition (regardless), and it’s the same only worse with “Antipsychotics”.

        A 2nd Generation African Person in the UK is at least 10 times more likely to be diagnosed with “Schizophrenia” as a White UK Person. The reason the majority of these Misdiagnosed People do not recover is because of the brain damaging effects of the “Antipsychotics”.

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        • Fiachra – I recommend you review the term “involuntary intoxication.” As all these medications are habit forming, withdrawal symptoms are often not acknowledged. Many of the MI meds cause the symptoms they are meant to alleviate as part of their withdrawal . . . even missing or being late for one dose.

          Valium and the more commonly/widely used pharma’s, this is accepted.

          The FDA does not acknowledge much in the way of withdrawal symptoms of Antipsychotics/Antidepressants/Mood Stabilizers.

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      • The glaring defect in the DSM system was pointed out so well by ‘Someone Else’ above. Even though sexual abuse in childhood has a terrible impact on so many people, it is not asked about in DSM. I sat with a client just a few days ago who was working through this pain from decades ago, and although it was the single most important factor that shaped their mental health, the DSM approach would not ask about it, or necessarily record it. Hopefully, the Psychological Injury Index will replace the DSM, and put the person’s experiences front and center.

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        • Thank you, Eric, and I too hope to see an ending of “the dirty little secret of the two original educated professions’,” century old, not just child abuse covering up, but profiteering, fraud based “mental health” systems.

          https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo

          Since I know from personal experience that concerns of child abuse are not just “not asked about in DSM.” But concerns regarding the possibility one’s child may have been abused are outright denied and misdiagnosed by today’s DSM believing, iatrogenic illness creating, primarily child abuse covering up “mental health” workers.

          Then when the medical evidence of the child abuse is finally handed over, the idiot psychiatrists want to drug one’s child. Which, of course, is when a person with common sense has to walk away from the lunatic “mental health” workers.

          But what’s good is when a mother gets her child away from the child rapists fairly quickly, and keeps her child away from the DSM deluded, one’s child can largely heal with love and self esteem building.

          My child went from being accepted into a preschool for “gifted children,” to remedial reading in first grade in a public school, after the abuse. My concern about my child at this point was when I was attacked and misdiagnosed by child rape covering up “mental health” workers.

          I did escape them, thankfully. And did scare that “school for gifted children” into closing down, since the child molester was one of their board members. But the police and CPS do not investigate into actual cases of child abuse in this country, unfortunately.

          My child healed enough by 8th grade, that he got 100% on his state standardized tests, which freaked the school social worker out. It was eventually confessed to me this was because “the school district was not equipped to deal with the brightest children.” It would have been wiser to be honest in the first place, rather than sicking some psycho social worker on me.

          I agreed to send my child to a private high school, he graduated as the valedictorian. He ended up graduating from university with highest honors, Phi Beta Kappa, as well as winning a psychology award. After a couple of years working, he’s now applying to grad schools. He’s been offered two full rides so far, but is still waiting to hear if he’ll get an offer that comes with a fellowship and stipend as well. He’s a wonderful young man.

          The bottom line is child abuse survivors can heal, with love, and if kept away from the insane DSM deluded. It’s quite disingenuous for our “mental health” workers to now be claiming that child abuse creates their disorders, as a way of explaining why such high percentages child abuse survivors are mislabeled with their DSM disorders, rather than pointing out “the glaring defect in the DSM system.”

          I will say, I believe our country should go back to arresting the child abusers, however. Because a country can’t survive when the adults are attacking the children. And that goes for the child rapists, as well as those industries that are covering up the abuse of our children, and attempting to drug as many children as possible in the schools today.

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  2. I think we start out in life very weak and vulnerable, but if we get what we need and are not injured before we reach maturity, which is somewhere in the mid 20’s, we are then quite strong and able to handle what comes. I think the mistake society makes is to make us grow up too soon. We need the time to form our minds without them being overwhelmed during the process. I think the belief that stress as a means of making resilience is misguided, even though it is universally believed. What counteracts stress is a deep belief in our own worth and value, and it takes time to put that in place.

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  3. Thank you Dr. Kuelker! I agree with LadyQ. This is a very validating article for everyone who has suffered traumatic events or abuse while they were simply trying to live life. It is profound and crucial information that every mental health professional in the world should be acknowledging ASAP. To have psychiatry keep ignoring this research and information while people’s lives continue to be destroyed and people are dying is really criminal. Is this research and information not getting any mainstream media coverage, because it certainly should?

    You have a helpful and informative website. It is great to know you do online counselling and I’m glad you are located in B.C. as even the short flight would be worthwhile to have a discussion. Thanks again.

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    • I wanted to present the Psychological Injury Model on MIA to start the dialog, and get the idea out there. As far as I know, I am the only one who has put it in this language. Hence the lack of Google hits on the term ‘Psychological Injury’ The next step is a book, and I am working on consulting with large organizations, as this has major implications for how we think of health and how to improve it.

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      • Psychiatry is not an issue of health but of social control. There are no “mysteries” as to why people are miserable, and we don’t need more books, we need fighters against psychiatry and the systems it supports. Acting as though there is something that needs to be “figured out” simply prolongs and mystifies the situation.

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      • Thanks for clearing that up, Eric. I felt misled because I assumed others were also using the concept since it wasn’t clearly stated this is your baby. Now I feel clear about it.

        And thank you for joining the discussion here.

        I wish you success in getting support for your model.

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      • My hope is that you can consider peer support as people helping people, too, not just therapists. Even in peer support, the professionalism is currently co-opted by clinical psychiatry.

        You claim that therapists can help consumers reach their goals. Why can’t a per coach do the same? Do you know many therapists who admit at the beginning that they may not be able to help? Where is the humility?

        I don’t see a spiritual emergency fitting into the category of “psychological injury.” What about people who are happy the way they are, don’t want treatment or therapy, but others feel threatened by their behavior?

        Since many good comments deal with the language you use as still pathologizing, I will not go into that, except to say that I agree.

        George Brenard Shaw once said that professionalism is the bane of society. Until we find a cure for materialism, I am doubtful that therapy can fix things.

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  4. I remember the episode of The Honeymooners where Ed Norton goes to the psychiatrist and gets hypnotized. Looked it up I think it was called the sleep walker.

    Anyway growing up in the 70s as a kid thats what we thought psychiatrists did was to hypnotize people and figure out what their psychological injury was and try and fix it. More then one TV show portrayed them that way.

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    • They still often portray psychiatrists as talk therapists or hypnotists on TV and in movies. There are some that show what the current reality is, but I’m sure it’s a PR effort by the APA to make sure psychiatrists are shown as kindly therapeutic types rather than drug front people.

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      • Yes. There’s some ER drama (can’t remember the title) where the resident psychiatrist is a kindly older man. Equal parts psych therapist, neurologist, and wizard.

        Not a Peter Breggin type, since he never challenges the “truths” of the pseudo science. More like a Dr. House but with the bedside manner of Dr. Kildare. Few of the cases are actually “mentally ill” but have some mysterious malady–neurological or otherwise–he struggles to solve.

        In real life few shrinks can diagnose a case of Lyme Disease or other legitimate disorders. Too busy inflicting fresh brain trauma in hopes it will somehow produce a cure.

        Like the old cartoons of Tom and Jerry or The Flintstones where one good whack to the head causes amnesia or a bizarre character change–but gets fixed by a second whack. Psychiatry–the “science” of cartoons! 😀

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  5. THREE STYLES OF DENIAL( of the psychological reality)

    1 NOMINALISM

    The first of these we may call the nominalistic denial for its focus on the words, on the naming and classifying of psychic complaints.All through the eighteenth and nineteenth centuries it was high psychiatric vogue to isolate specific disorders by inventing new names. Almost all the words now so familiar were made up then- alcoholism, autism, schizophrenia, claustrophobia, exibitionism, homosexuality, masochism, schizophrenia, and also psychiatry…. It was a fond dream of the Enlightenment, as it is of the rational person in any period, to classify the world of the mind, like the word of plants and animals, into categories, with subclasses, genera and species. Soon disputes broke out between regional schools, as French, British, and German MEDICAL PSYCHOLOGY USED DIFFERENT TERMS. A typical and famous dispute lasting into Freud’s time was between the French and Germans in regard to hysteria, the Germans insisting that it could appear in women because the word hystera meant uterus and that if French psychiatry found hysteria also in men this told more about Frenchman than about hysteria.

    The classifying approach reached its monumental culmination, as did much else in the human effort to force rational control upon nature, at the time of First World War. Then Emil Kraepelin of Munich presented a new edition of his comprehensive four volume textbook of psychiatry in which the seams joining his observations wit his prejudices shows so little and held so tightly that his system of classifying every known form of psychopathology has permeated, if not dominated, psychiatric nomenclatures the world over into our own day.

    The main attack upon the nosology and taxonomy of psychic pathology has been directed at the relation between words used and the events they are supposed to signify. These words are empty nomina, they have no intrinsic connection with the conditions, or underlying reasons for them. which the labels so carefully describe.

    Whether cynical or not, this approach is the main attitude behind psychiatric nomenclatures. The technical terms – sketches of symptoms, their onset and course, and their statistically expected outcome. Nothing further about the nature of the person exibiting the syndrome or about the nature of the syndrome itself is necessary for applying one of these psychopathological labels.

    Schizophrenic behavior can be precisely described and attributed to a person independent of whatever might be its underlying reasons;;genetic, toxic, psychodynamic, biochemical, social, familial, semantic. The empirical nominalistic view calls for nothing more, nothing deeper than MASTERING A TECHNICAL VOCABULARY.

    JAMES HILLMAN RE -VISIONING PSYCHOLOGY

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    • 2 NIHILISM
      Eventually the inventions of ever — new empty names leads to a second style of denial, anarchic nihilism. The anarchic denial goes like this –
      classifications are linguistics conventions deriving their authority wholly from a consensus of experts, from tradition and textbooks. These words become power words, political words, words of a psychiatric priesthood… They help the names and hurt the named….

      Karl Jaspers,Michael Foucault, Laing.

      But the psychopathology still remains. It is merely found a new false home. They regard the sickness as resulting from the system that deals with it. These critics all deny the pathologizing and would get rid of it by getting rid of psychopathology.

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      • 3.Transcendence.

        As third way to refuse psychopathology is to stand above it. This is transcendental denial. It comes in several varieties, one of which is humanistic psychology. In attempting to restore his dignity to man, this psychology idealizes him, sweeping away his pathologies under the carpet. By brushing pathologies aside or keeping them out of its sight, this kind of humanism promotes an ennobled one sideness, a sentimentalism which William James would have recognized as a tender -mindeness.

        It shows immediattely in the words favored by contemporary psychological humanism. Unlike the terms of professional psychopathology. these resonate with positive glow – health, hope, courage, love, maturity, warmth, wholeness, it speaks of the upward-growing forces of human nature which appear in tenderness and openness, and sharing and which yield creativity joy, meaningful relationships, play and peaks.

        Besides the fact that notion of growth is simplistic, of nature romantic, and love, innocent – for it presents growth without decay, nature without catastrophes or inert stupidity, and love without possession – besides all this, its idea of the psyche is naive if not delusional. For where is sin, and where are viciousness, failure, and the crippling vicissitudes that fate brings through pathologizing?

        IT IS OUT OF TOUCH WITH THE STOIC TRAGIC VIEW OF EXISTENTIAL, IRRATIONAL, PATHOLOGICAL MAN.

        Whereas tender minded humanism uses the baby and growing todler fir its
        developmental model of man, the tradition of depth psychology sees the same child with a more perverse, tough-minded eye. Depth psychology builds upon the darker perceotion if Freud and Jung, their well – tempered pessimism and eye for shadow. By insisting on the brighter side of human nature, where even death becomes “sweet”, humanistic psychology is shadowless, a psychology without depths, whose deep words remain shallow because transcendence is its aim. To transcend, it leaves the lower, baser, and darker behind as “regression – values”.

        Order can always encompass disorder…We can each move up and out of our pathological conditions.
        In actualizing and realizing higher needs, lover ones become integrated.

        Like “Peak experience” by Maslow. Oriental denial of psychology.

        By going upward towards spiritual betterment they leave its afflictions, giving them less validity and less reality than spiritual goals.

        IN THE NAME OF THE HIGHER SPIRIT, THE SOUL IS BETRAYED.

        James Hillman, Re -visioning psychology.

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  6. Hi Eric,

    I did a search for the psychological injury model and didn’t find anything other than this article on MIA. We’ve had some other articles in the past about collaborations to move to a more trauma-based model, and I wish you well. I appreciate much of what you said. I think things will change only when their reaches a critical mass of enough people who no longer accept the various cognitive dissonances that you described. Our understanding that people heal people, not drugs. The understanding that trauma is at the heart to so much mental distress, not some mythical biochemical imbalance. And more.
    Sam

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    • I also searched the term “psychological injury model” and didn’t find anything else.

      So I feel pretty misled.

      And I looked at his “psychological injury index” and was pretty disappointed in it.

      To me, it looks more like a marketing tool for Eric. One reason I say this is it seems you have to put in an email and a postal code to even see the questions. Also, this is what you see when the page opens:

      Take control of your mental and physical health!

      This is in very big letters, and notice the exclamation point.

      There are also several claims on the page such as:


      For the first time ever, you will get a clear picture of the psychological injuries that you have experienced.

      I also feel a little loss of respect for him since at least so far I haven’t seen him reply to any of our comments. If I missed something, please correct me.

      I did like the article quite a lot, btw, so I feel sad that these things I have mentioned caused me a significant amount of what I will call emotional injury/pain.

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      • Do you realize how many people are making good money with their academic/professional “models” of this or that “mental thing,” rather than risking actually confronting the motherfuckers responsible for all this human misery? There’s not much money in that, in fact it might even involve personal danger or sacrifice. And now we’re talking about what “model” will “triumph”??? Nothing “triumphant” I can see here except the status quo.

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  7. Not sure I agree with injury almost a vortex / Cascade event or events. Very similar in thought but not in vocabulary to Sarah’s blog.
    There needs to be a type of Paris Table Peace talk with at least two diverse voices dialoguing in real time. A person with triworld experience in this family/ self/ MH professional world would be extremely invaluable.
    Once a word and concept framework is agreed upon maybe even have a vote here. Which words are acceptable or not?
    Then go for exposure st all the various CUE professionals are mandated to attend and do a traveling show with that. By working as a group rather than individual effort the safety fears of psych survivors would be somewhat assumed. If someone does do a Mental Health call on you at the conference it will be observed by friends instead of strangers who know what to do.
    Folks are usually bored to tears at these conferences so at worst their thoughts will be when does the party start after the evaluations are turned in?
    Then I would add legal and media supporters and then aim for a White House Conference or Congressional hearings or testimony.
    Until I can see dialogue happening and cross referencing between blogs and ALL folks nothing ain’t goin to happen.
    Breggin and others need not only to write but dialogue and in the oldblig oneboringoldman as interesting as it was. He discriminated based on profession and survivors barely got a glancing nod.
    If one is fighting Leviathian one will not win with one harpoon or a Captain Ahab in charge. Ishmael was the only human left from the Pequad and he was saved because Queque sensed doom and built himself a coffin.
    We need a type of Shakelton for our times with a band of merry not pranksters but commingled voices of strong resistance and ultimate action.

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  8. I think it stands reason, and it’s about time. Any emotional wound can heal if we can shift the negative self-beliefs which originate from social abuse and relationship trauma. Post traumatic stress can be temporary and needn’t at all be a permanent condition.

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    • Excellent truth!. There is an amazing study on how treating PTSD healed breaks in the DNA of people who had been traumatized and fled the Middle East. I cover it briefly in my TEDx talk, and the reference to the research is on https://psychologicalinjuryindex.com/ A crucial point was that psychotropic drugs had no impact on healing the breaks in the DNA that traumatized people had. It was only when they received therapy that their DNA became as healthy as people who never had a major trauma. This validates that people heal people.
      There is a huge need for more research on how treating emotional wounds improves a person’s physical health as well. I have found a smattering of studies that found that therapy altered methylation patterns in DNA, and Pennebaker did some good work on expressive writing, but if anyone knows of more research, please let me know.

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      • OMG. Being freaked out may affect DNA and getting over it may reverse those changes. So what? Getting angry spikes your adrenalin and it subsides when you calm down. This has nothing to do with “healing injuries,” except metaphorically, but that’s not what you are referring to. Every “mental” state has a physical correlate. There is nothing to “study” except the effects of alienation under capitalism, which must be resolved politically.

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      • Eric, I watched your Tedtalk, thank you. There is a lot of truth in what you say, and I believe this is a valid and potentially effective approach to healing, from this perspective of injury on this level. There are, indeed, many consequences to it, some obvious, some not so much.

        There are sooooo many reasons why people are not open about this, it’s not just self-consciousness or self-judgment or shame or whatever, but also because of the risk of repeating the injury when being open and vulnerable about it. In my experience, psychotherapy was injurious over and over again, and I have a very exhaustive story about this, not just as a client but also during my MFT training and grad school, regarding professors and supervisors. They could be extremely abusive, controlling, and cutting in so many ways, and some of us felt it, and felt a bit shell shocked by it, but not quite awake to what was happening. For me it was utterly surreal and kicked off my wild ride through the system, where this became utterly systemic.

        I believe there can be good “psychotherapy” out there, although that is such a catch-all now and no one really knows exactly what this entails, it varies so much from clincian to clinician, and some are quite abusive causing same injury, without a doubt, so it’s very risky. Many stories about this, and it kind of makes sense when you think about how we repeat injurious relationships until we finally wake up, that is a common occurrence.

        People can help people to heal, but I believe we ultimately heal ourselves, by showing ourselves kindness and compassion, first, which can be quite a challenge with those abusive voices in our DNA and cells–which I agree, we store so much of that in our bodies, and then we dissociate and forget about our bodies, leading to self-neglect.

        From working on showing ourselves the kindness we deserve (what I call “the inner work”) then, I believe, we can naturally attract kinder people more and more, because we are treating ourselves kindly, which is a big change in our overall mind/body/spirit energy.

        Eventually, it would become a kind and supportive community, just by nature, and we no longer need to think about it as, “I’m going to heal you.” That’s where the power dynamic comes in, and here we go again, repeat of the past. That belief is where the dysfunction and co-dependence begins, which is insidiously inujurious.

        We don’t heal others, imo, but we can hold a loving and healing space for people to heal themselves. Changes our entire relationship with ourselves and we see, feel, and practice our own power, rather than being blinded or taken by the projected power of another, which, in the end, is an illusion. To me, that’s the healing because it dissipates the fear to know we can take care of ourselves.

        Overall, I think you’re on it, and it is tricky because of the beliefs which form from repeated trauma of this nature. I think whatever combination of tools and effective support one can utilize would be highly individual, but the goal is the same—to heal those wounds! Indeed, it can be done, I know this from experience.

        And it is an incredible process that involves many unknowns. Getting over fear of the unfamiliar is part of the process. I had to be in the world with all that uber-anxiety on my own, post psych drugs withdrawal, and face down a lot of self- judgments. That was imperative. While we do heal ourselves, it doesn’t happen in isolation.

        That’s my take on it, in any case, and also my experience. I’ve had quite a few of those traumas in my life and went through a grandiose healing process. I’m in my late 50’s with no health issues of which to speak and grounded in my life just fine, no issues at all like that at this point. I can certainly get triggered into bad feelings, but it’s nowhere near what I’d call a PTS episode or panic attack, that’s long gone. Basically feeling like a whole human being at this point. About time! I plan to enjoy my “golden years” on whole new terms with myself.

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      • There is also great work from the “decade of the brain” which is largely ignored, showing that the BEST thing to reduce the damage from early childhood abuse or neglect is, wait for it… a positive relationship with a caring adult!

        It’s not brain surgery, but they apparently want to make it into brain surgery. Sometimes literally…

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        • Steve, to be clear, I’m not talking about “reducing the damage,” I’m saying the damage can heal completely. So many ways to approach this but by no means do we need to carry childhood baggage all our lives, nor any aspect of that in our bodies.

          And yes, a caring adult can help in that process, and is highly beneficial and at some point would be expected to show up, if we are focused well on our healing.

          But a mutually supportive relationship is the result of good healing from relationship trauma. Otherwise, it will be a co-dependent relationship where one person is basically the caretaker of the other. That is still a power imbalance.

          I can’t tell you the lengths I went through to get my partner to do his healing from his own trauma, so that I could focus on my own healing without his sabotage. It wasn’t purposeful on his part, but he had issues and blind spots to which he would get so defensive and angry from my feedback, even though it was totally appropriate on my part. I knew we were off balance in the relationship, and he took it personally rather than as a problem to solve.

          I was the one labeled from before we even met, but he was the energy drain, and he would tell you that himself. He has since done wonderful healing work and has woken up the way I have. He knows the negative impact he had had on my well-being, and he finally got it, and went through his own transformative healing, which to me was extremely humble and courageous of him. It takes two to tango. That was a huge process for us, really fascinating how it all played out and created transformational shifts for us, inside and out.

          So I have the mutually loving supportive relationship now, and it sustains us both. But that was not my main healing agent. That was me, tending to my heart, mind, and spirit, and learning to set good boundaries for myself out of self-care and self-respect–all that was new to me. And it worked. I was the one going from healing programs to healing internships to setting up my own practice, and then jumping on the stage for the first time in my life as a creative outlet, and speaking publically around town about my healing, despite the psychological risks, which are all too real when we open a vein in public. That was me following my inner guidance toward healing. It was a path which opened up for me, and I took the opportunities as leaps of faith.

          A relationship per se doesn’t automatically heal things. First, we have to have a good relationship with ourselves. Otherwise, we will give away our power yet again. That’s what abuse survivors need to change in order to find mutually supportive interdependent relationships, and not one in which one person would have power over the other.

          I know I’m at odds with a lot of people here regarding how we heal, and I respect that. But this is exactly my/our experience. He’d tell you the exact same thing, we’ve processed this for years, and it informs our life path now.

          We get all sorts of projections regarding our relationship when we talk about it in healing terms, and they’re always way off base. I will tell you this–I believe we are atypical in many ways, and deeply, mutually committed to each other out of very deep love. Before we knew this consciously, and could embrace it in our lives, we BOTH had to find our healing, separately and together.

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          • I don’t disagree with what you’re saying. The research in question is about children healing while still children, and the ability to have a safe dependency on a caring adult appears to be the most important aspect of their psychic healing, which apparently manifests in the brain as well. When we get to adulthood, we have to figure it out on our own if we are not fortunate enough to have had such a person, but similar considerations still come into play. What is quality therapy but a person listening to and caring about another person in a safe space? And why can’t non-professionals do the same for each other? Of course they can, and they do, as you (and I) have observed.

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          • I’d like to know how an outside party, however loving and present they may be, can help a child to heal without expecting some changes from the family dynamic. In my experience with myself and with clients with whom I’ve worked over the years, that is by far the most challenging aspect of all this.

            Do you think a therapist will point out that the child is being scapegoated by the family system? If so, then I’d consider this to have the potential of being “good therapy.” Otherwise, it will be same ol’ same ol’ for that kid, and indeed, they’ll have to figure things out as an adult, as in, to wake up and start making some internal changes to their self-beliefs, so as to stop playing that treacherous role from relationship to relationship.

            Healing from trauma like this would require a “good therapist” to challenge the family system. That would be brave, truthful, and groundbreaking. I’ll be impressed when I see that happening, that the therapist actually would help the child to break the family system. That would be a true ally, which is what that kid would need most at that time, to feel empowered, safe, and supported.

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  9. Dr Eric,

    I consumed neuroleptic injections for a number of years in Ireland (a country without compulsary treatment in the community), and over this period of time (according to my medical records) was getting worse and worse. Then, I came off this medication with extreme difficuly; and a Dreadful Terminal Diagnosis.

    I owe my basic survival to One Tool:- and that’s recognizing that when I’m “stressed” I think a certain way, and when I’m not “stressed” I think differently (and productively).

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    • “recognizing that when I’m “stressed” I think a certain way, and when I’m not “stressed” I think differently (and productively).”

      This is awesome, Fiachra, I relate totally! That is the kind of self-awareness I’d like to see people cultivate more, I think it’s vital and not said enough. This discernment led to core changes for me, too, inside and out.

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  10. There appears to be more flaws:
    1. They prescribe antipsychotics for differing conditions like depression,anxiety,bipolar,hiccoughs,unexplained vomiting,mania.How do they explain this?They will similarly prescribe antidepressants for depression,anxiety,peripheral neuropathy due to diabetes or pain syndromes.They seem to be telling us that the neurotransmitter projections are interconnected so for serotonin deficiency they will prescribe antipsychotics which will improve serotoninergic pathways.This is nothing but market place speculation.Trading during bullish and bearish trend.They got to sell the stock of the drugs from their ware houses,so create a fake hypothesis to convince you.They got no proof whatsoever.Let me make a blind guess.The medical representative informs the psychiatrists that so and so class of psychotropes are lying in their ware house and their expiry date is due.So make all the patients who eneter your OPD or ward swallow it.They will hand over a nonsense journal article to justify the use of the drug concerned.All these psychotropic drugs can be substituted interchangeably for any condition.It is the subjective mind of the psychiatrist that selects the drug in favor of the drug company.And not for the patient.Mood stabilizers are not being marketed as membrane stabilizers which is their primary action.They will market it as bipolar drug,antiepileptic drug,antipsychotic drug,diabetic analgesic drug etcetra.
    2. How is it that there is a delay of nearly a month or so in resolving acute depression,whereas the motor symptoms resolve earlier?

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  11. 1. Now they have borrowed the term from the telecommunication industry namely,”SPECTRUM”.You got depression spectrum disorder,schizo-freniform spectrum disorder,mood disorder spectrum disorder,anxiety spectrum disorder,autism spectrum disorder…..Do they have a tie-up with the silicon valley engineers??We must be getting auctioned as to which spectrum bandwidth should be allocated to us!!
    2. There is more to the medical jargon getting electronic and electrical so much so that biological ,social and the psychological side is being buried.You got the signal transduction cascade mechanism.Is this the railway signalling system where patients often commit suicide.Then they got the serotonin,dopamine accelerator system,braking system,clutch system.Again the railway engine model,although the clutch system may not be there.
    3. They are not talking about the patient at all.

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    • About No. 1: Due to its associations with Silicon Valley, “spectrum” sounds nice and scientific. Wrong branch of science–since these people CLAIM to be experts on neuro-chemistry–not airwaves. But it sure sounds impressively scientific.

      N. 3: It’s not about the “patient.” It never was. A psychiatrist helps his “patients” the way an exterminator helps termites.

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        • A lot of fast food places are being replaced by kiosks.

          “Mental health” centers could easily be replaced by arcades of vending machines. Get a “diagnosis” and recommended drugs from an online app on the website owned by the franchise. Then hustle down to the center, swipe your Medicaid/insurance card and select the drug and dosage out of the proper machine. A week’s worth of drugs pop out in a box. Set for the week!

          The APA wouldn’t like this of course. Machines lack the “human” touch. They’re not arrogant, spiteful or into sadism. 😀

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  12. Why are the cities being cleaned off plastics,solid and liquid waste?Why are there Euro norms for controlling air pollution?Why do you they want to keep their cities,air,water,food,environment clean?Why are they trying to eradicate germs,vectors and diseases?Why are they propagating healthy lifestyle attitudes?Why can’t they simply drug the people when they fall sick,instead of preventing it like they do unto the psychiatry patients?It will reap more profit.Surely,because the government and the pharma company have signed a memoranda of understanding,on who will be provided health and who will be victimized and made to suffer for no fault of theirs.
    Its only to keep a c class of people healthy,comfortable and lead a secure and luxurious life.But what have they got to offer for psychiatry patients,other than these toxic drugs?

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  13. I had been to an international conference on OCD,Some 500 kilometers from my house.One of the former HOD of the psychiatry department confirmed that there is no association between OCD and ASD when somebody posed this question.But later,during the break while I was going through the photocopies of the literature displayed outside,I found a reference in small print of an author having reported a case of OCD transforming into ASD.I called a Japanese delegate,who spoke,I guess on psychotherapy stuff to look at the my observation.But he was in a hurry to board his plane,but somehow I whisked him towards the display table and showed him the article.This HOD probably weighed more than 100 Kg,probably he could be on some psychotropes,if not due to any other causes of morbid obesity.I think once they become psychiatrist,after some years they start acting like pharmacists.They are only concerned about the drugs,its dosage,it’s mechanism of action and so on.They should be selling medicines inside their pharmacies.
    If you have seen the movie,THE FUGITIVE,where Harrison Ford plays the lead role,who finds out in the end that the research company was using the same pathological specimen of the liver,but with thousands of different names,age,sex,address etcetra to prove some hypothesis and also to promote a drug to cure this liver disease.It could be horrible with psychiatry,because nobody is really aware about anything in the field of psychiatry.The only tool,psychiatry has is the subjective mind of the psychiatrists and several conflict of interests that involves the pharma companies,the govt’s budget allocation (which is almost nothing here)the interests of the pharma companies,the interests of the psychiatrists and their association.
    Society is a bit too much aware of the difficulties faced by communicable diseases and lifestyle diseases and degenerative diseases.Why have they excluded us?They want primary,secondary,prevention,then tertiary level treatment.Then rehabilitation and compensation.The govt does not pay compensation to a suicide victim’s relatives.But such compensations are given to other patients if they suffer even from complications arising out of the disease.That is outright discrimination.
    DSM 4 atleast found out 9 stressors which needs to be addressed.Social support,education,occupation,peer support,easy access to health care,legal support,economic impact of psychiatric illness,…and 2 more.But DSM 5 has removed it.Why?
    In our country,we have reservation in jobs for persons with mental health illness.But most often they do not get this job.Someone else like the physically disabled gets it.Also if you want to get a disability certificate,you got to wait for 4 years.This is utter nonsense.Whom are these psychiatrists actually serving?

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    • OK one answer: they are serving the need to keep people in line and on the assembly line. IN other words social control, nothing else.

      Your problem here is in trying to understand these contradictions rationally. It’s not possible, because the ARE contradictions, they just want to make it sound so complicated that people won’t notice the bs.

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  14. Excellent. I completely agree, and I have proposed a model that uses five factors for the causes of emotional distress: The Threat Response, Fear of Social Exclusion, Shame, Trauma and Attachment/Developmental Trauma. More at http://www.HarperWest.co. Have you considered adding the trauma of the narcissistic and emotionally abusive parent? I find this is far more prevalent than the abusive boss. Narcissistic parents are subtle, but in their demands for attention the child learns his/her needs do not matter and learns to submit in unhealthy ways to the parents. Children then disconnect from a sense of self and over-attune to the needs of others. Notably, narcissistic parents lead a child to feel rejected (Fear of Social Exclusion), feel low self-worth (Shame), feel unlovable (Attachment Trauma), and these all trigger the Fear response in the brain and body. Best of luck. It sounds like we have many common approaches.

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  15. Dr. Kuelker – Many Thanks for compiling your work/research into this model. There is no doubt this is the correct forum as you have access to many that have suffered at the hands of the trauma inducing conventional DSM-based “Psychiatric” model.

    What you present was used by MD’s pre-DSM and during the early years of the AMA. Doctors then had much better understanding totality of care. . . . what broke everything? Employer supplied medical insurance, post WWII.

    Historically, the Trauma model was the original model. Jean-Martin Charcot pioneered this but due but his methods for recovering traumatic events (hypnosis), he was marginalized. Right along with his hypnosis method went the model of the root of “hysteria,” trauma. Although Freud added much, his culturally acceptable inclinations (women traumatized wanting to be traumatized) fit right in with the social climate. This further distanced the cultural acceptance of trauma caused “hysteria.”

    I recommend a whole sub-section to Trauma in Adulthood as Psychological Injury. This would be the numerous traumas (physical, psychological, pharmaceutical) inflicted upon those involved in the Current Psychological Model.

    There should also be a reasonable discovery of contributory medical conditions . . . such as sleep disorders. As many in this forum know, sleep is essential to stability and dealing with the trauma and behavioral adaptation, initiated anxiety.

    On a lesser note, those who care most about these individuals. We are helpless to do little more than listen to our loved ones and when they get hospitalized, we are absolutely helpless. When our loved ones are discharged, we are left to deal with our loved one’s most current round of traumatic events. Although this is clearly indirect, in those of us that truly care, our lives revolve around our loved one’s subjective reality.

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      • OH – My interests are my own. I understand the historical parallels and competing factors that resulted in why this false DSM model exists and continues to be perpetuated. There are competing forces, not always clearly understood as most individuals, while highly knowledgeable, are most knowledgeable in specific subjects. I have broad exposure to many different areas of interest (Medical, economics, politics, culture, psychology, technology). Part of my investigative spirit is to not take what has been given to me at face value . . . every action a reaction, every crisis a cause.

        Then you ask yourself, how did all this happen? Now multiply that by the learning over a lifetime with broad exposure since 5 years old.

        I am the loved one . . .who never questioned my partners diagnosis and in doing so, allowed her to be damn’d. It wasn’t until she ended up in jail, a member of the psyche staff explained to me how she clearly was suffering from PTSD/CPTSD. Add to the medical component of 3 generations in her family that could not sleep without medication/alcohol. Putting these together proved to me that I had let her down even though she herself never questioned her own diagnosis.

        Does that help clarify my motivations?

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      • OH – additionally. . .when I first started down this road, I read and viewed Bruce Levine’s works. They resonated deeply. One of his book recommendations, Trauma and Madness in Mental Health Services by Noel Hunter, made a really distinct impression on me with how it directly related Trauma to the generic term Madness. I could see my loved one’s trauma history playing out in those pages.

        What I have learned going down this path I have shared with my psychologist. He was very interested and comments how he was never taught any of this. Me teaching him is giving him the tools to help others. Plus, he is sharing what he learns with other therapists.

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  16. One thing I thought about regarding childhood “psych injury” and sound psychotherapy. If a child has a trauma that is not from within the home, and everyone can see that there is some kind of post traumatic stress going on and that it would stand to reason if the child has experienced a traumatic event that leaves them in extreme anxiety from fearful thoughts, then I imagine that a skilled and heart-centered psychotherpist could work just fine with the child, and with the support of the family. IF, AND ONLY IF, there is no “medication” involved, nor diagnosis, other than simple (as opposed to complex) post traumatic stress which, indeed, tons of loving presence and kindness would totally create healing, no doubt about it. And even more so, it would be a fantastic model for the child, they’d know how to be present with others, as an adult–and so and and so on.

    However, if psychological issues arise from trauma at home, then that is where I question how a psychotherapist would handle this. And seriously, how often is this the case? Do we really need studies to show it is rampant? I imagine there is some kind of research on this, I’d be curious to know. So I think that’s a huge issue to consider.

    This is why I say that when post traumatc stress is from home abuse/trauma–and it is totally injurious in so many ways, to my mind–for the kid to have any chance at all to heal before going off into the world with all of this crap interanlized, just waiting to show itself in all kinds of ways, the family system would have to be challenged. How could this safely occur, and by whom?

    There are signs and there are stories and there are assumptions and there are projections. How are these discerned? But at least start with keeping out the drugs and disagnoses. All that does is to create more business by embedding the trauma–potentially for life–and of course, the goal is to help the child to heal and be safe, and to be free to live the life they want, hopefully, of their dreams. I’ll give a hardy and hearty nod to anyone who makes this the absolute priority, bar none.

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    • In addition, there are misunderstandings and personality misfits between parents and children which contribute to later “mental illness” diagnoses. Moreover, there is research showing that sibling relationships can do a lot of damage, especially in families where feelings are not processed and problem-solving is done in a mostly unconscious manner. No overt abuse or trauma need necessarily be present. For instance, I was assigned a role as a “scapegoat” in my family and was picked on by an older sibling. I became seriously ill and was no longer an acceptable target, and my youngest brother was born about the same time, so my next youngest brother got the job of “scapegoat.” I suddenly became aware, though I could not have verbalized it, that I wasn’t the scapegoat because of some flaw, it was an assigned JOB.

      Anyone looking at my family would have thought that all was well. There was very little in the way of overt trauma per se, but plenty of subtle undertones of hostility and unspoken emotion and unspoken rules and defined roles, all of which caused a great deal of emotional damage without any discreet “trauma” on which to hang one’s hat.

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      • Steve – thanks much for sharing that. I had no overt “trauma” while growing up. I never realized what defined my being more than while I was asked while being hypnotized, what’s the earliest words I remember. My response to that question, “Please don’t let him be like (my sister’s name here).”

        My sister had earlier that year, started suffering from grand maul seizures almost immediately after getting the oral polio vaccine. My mother took her to the local Children’s Hospital, while pregnant with me, and the recommendation of the doctor was to let my sister die and for my mother to get and abortion, then sterilized.

        A good Catholic Mother, took this deeply and became depressed beyond measure. That same doctor prescribed dilantin for my 3 year-old sister and proceeded to poison her with that medication. During my mother’s pregnancy dealing with the trauma of the news her beautiful daughter, and being pregnant with me, then my sister being poisoned by dilantin, crying for days at a time and not sleeping my mother staying with her the whole time . . .while pregnant with me. . . .I am getting a little depressed while typing this.

        Then, growing up in a world that had no idea about the physically and mentally handicapped. Me being in the baby seat traveling to schools daily, sometime the next state over to keep the State from taking my sister. The battles my parents fought . . .conventional medicine offering no answers except surgeries to alleviate symptoms and failing. My mother was forced to venture out into the world of Alternative/Complementary care to offer my beautiful sister some comfort in her condition, continuing to look for answers.

        I think you can see why I kick myself when I let “Mental Illness” go unquestioned for as long as I have.

        What I can say about my family, I had several older brothers and a sister that cared for me in addition to my parents, as well as the rest of the younger siblings. My parents were always present as much as they could be.

        BTW – the MD that told my mother to get an abortion and sterilized, I was doing a HIPAA audit at that same Children’s Hospital. While taking a walking break with the IT Support staff, we walked by a Bronze Bust of that doctor and the wing named for him. >: /

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          • For a lot of us, the function of a family is to raise capable and empowered children and to support each other in surviving the insanity that is our modern world. Admittedly, it would be a lot easier if we had much bigger units than “nuclear families,” but I see that more as a symptom of the larger problem of intentional community destruction by our “leaders.”

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          • “’Dysfunction’ is a robot term.”

            I think that’s fair, in that it became a buzz word a while back. I recently began using it again, after having used words like “toxic, abusive, marginalizing, oppressive, corrupt” etc. Still, I do feel the word “dysfunction” covers it, and I’d like it to have the same punch in energy as those other words, which perhaps it feels tame given how abiguously defined this can be, as in, “my family/community/fill-in-the-blank institution is dysfunctional because it made me unhappy/afraid/feel insane.” That’s what I mean by it, and indeed, there are a lot of questions to ask at this point. Where to begin? Like a generic case study!

            I think a powerful aspect of “dysfunction” is that it HATES truth, repels it at all cost, and for good reason, since dysfunction is based on keeping active all the deceit and false projections, one way or another. So when truth does start to break through a bit, and then more and more because, perhaps, people are starting to wake up, the dysfunction is what is threatened, as it should be!

            Soooo, I think waking up is what will go a long way in resolving these issues, and so on and so on. I think that’s how to “bust up the system.” I imagine this would mean different things to different people, but “waking up” would be the common thread, to my mind. Just the thought of going from dysfunctional to functional–and getting the true ramification of these antithetical ways to operate–gives me a great deal of relief. Hmmm, wonder why?

            And I agree with Rachel completely, that would be FUNCTIONal, for love to be the motivating factor, as opposed to fear and extreme rivarly. Oh, that makes it so toxic! Someone pays dearly, and it shouldn’t be that way. Waste of energy, resources, PEOPLE, brilliance, creativity. The difference is vast, between Dark Ages and Renaissance. This is what blows my mind the most, and I’ve drawn this conclusion after hearing all of these 1000s of stories over the years, along with my own experience. Big core shift, everyone is affected. Then maybe we’d have a world of problem-solvers as opposed to problem-creators, as it seems we have at present, and have had for a while.

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      • Steve, I always appreciate your balanced and insightful comments. Your comment on family dynamics resonated, thanks for sharing. As the youngest of four girls (a boy was younger than me) I experienced some of what you describe from my two oldest sisters but it didn’t get nasty until we were well into adulthood (forties). I chalked up their mean behaviors as “normal sibling rivalries” and usually let it go. Years later I learned just how nasty my eldest sister can get and that I should not have deemed her mean behavior as “normal” and overlooked it. I also realize now and agree with Alex and Fiachra, that unfortunately family dysfunction is more common than I thought.

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    • “…it’s so insiduous it’s often difficult even to identify.”

      Yes, this is what is happening now. Subtle and insidious, yet well placed comments, statements, insinuations, innuendo. That’s how it’s done. Reacting to it can make one seem off balance and “crazy.” Calling it out directly can make one seem delusional. This is what the abuser is after, how they get their sustenance from feeling “powerful.” Of course, it is an illusion, this is not true power.

      Then there is the negative and false gossip to other members of the community, to destroy a person’s credibility and to form alliances against a person, to marginalize them. Backstabbing and betrayal are so often justified by abusive people from fear and paranoia, and are common ways to abuse people insidiously. That is the essence of a dysfunctional community, when that absuer/gossip is believed without question, and everyone is playing into the fear now.

      So many ways insidious abuse can occur, and some people are masterful at it. I don’t think reason ever works with this, although someone subjected to these can usually put 2 and 2 together. But it wil not be acknowledged in a dysfunctional community, and in fact will be denied up and down all day long, and with insults and shaming to boot. I call that “feeding the vampires.”

      I believe this is best dealt with on an intuitive level. If you feel you are being abused in these or other insidious ways and cannot quite put your finger on it or everyone else tells you you’re crazy, TRUST YOUR GUT INSTINCT! That is your truth! Don’t ignore that voice.

      This is a hard spot to be in, but more and more people are awakening to insidious abouse from a dysfunctional environment. We have many examples now in the news, gaslighting is front and center in politics at this point. That’s why we call it “the norm.” I would love to see these systems break and fall into little pieces in favor of integrity and social/community/family functionalism. That would be tremendous change in the world, and I believe people would be healthier, in general. Stands to reason.

      If you really want to dig into this, do a YouTube search on “Narcissistic Abuse,” and tons and tons of videos will pop up from all kinds of every day people recovering from this. Many of us have had to.

      PS–I had a brother and a boss like this. Keyword: HAD. I am estranged from my brother and I sued my former boss, who was president of a non profit voc rehab agency which served people in the “mh” system. Next…

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      • The hard part for people being subjected to this kind of abuse is that very often, the “head abuser” is functioning behind a well-polished and established veneer of “philanthropy,” which, in reality, is false, they create and project an illusion about themselves. That was the case in, both, my family, and without a doubt, in the “mh” system. This is where the norm is way off, I think, when it buys into this kind of illusion and “functions” around it. Whomever calls it out becomes scapegoated, because it does not want to change–at all!

        Extreme passive-aggression and deceit, with complete disregard for another’s well-being, can be a blatant abuse of power, depending on the roles being played in a relationship. To me, this is the nature of insidious oppression and keeps people in a state of “injury” to the point where it feels like “normal.” Whereas in reality, it is causing suffering on an unseen (by the dysfunctional system) level. That would be a matter of those in the system waking up.

        One last thing I can’t resist adding, just occurred to me as I was thinking about this–when the abuser cries victim at being called out. That is a powder-keg of oppression. Yeah, been there, over it. It’s a bad, bad game and does a lot of deep damage to unsuspecting people. It’s a potentially lethal double-bind, no joke

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        • If you ever pay a little visit to NAMI’s forums for “supportive family members” who run the whole show a lot of them whine about the “emotional abuse” they put up with from the “mentally ill” kids in their 30’s and 40’s. Boo hoo. Who crippled them and forced them to live in the basement to begin with?

          The “mentally ill” never complain since they believe everything bad that happens is always their fault for being crazy.

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      • That is the title of the last chapter of my book: “Trusting your gut!” We all have intuitive knowledge that we can’t explain regarding other peoples’ priorities and intentions. When we learn to trust that knowledge, it is much, much harder for others to get away with this kind of subtle control.

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        • The idea of intuiting others’ intentions and motivations doesn’t sit well with me, Steve. In the end, that can lead to false projections and chronic misunderstandings. Easy enough to ask a person if something is unclear, rather than to speculate.

          That’s one thing I don’t like about “psychotherapy,” when it ends up being about those projections because they are assuming so much and not asking the right questions, or any at all in most cases. No truth will come from that, only chronic frustration, I think.

          I’m talking more about an anxiety we can pick up when we are being drained of energy in a co-dependent relationship or dysfunctional situation such as what we’re talking about, that causes what we’re referring to here as “psychological injury,” at least how I am understanding this. It’s not just about “control,” it’s about thriving at the expense of others. EXACTLY what we complain about re psychiatry, et al.

          From the inside, it can be very hard to pick up, especially if that is one’s familiar. A covert abuser is not only subtle, they are also inconsistent and explain, rationalize, and justify things well, and keep people on a string one way or another–sometimes with money, that is one common way, but there are other carrots one can dangle to achieve same purpose–which essentially drains a person of their life force energy. Certain relationships make us more tired than nourished, I think it’s important to be aware of this in our lives, it affects our health and well-being.

          What to do about it can be not so clear. Those videos I talk about on YouTube are about healing from this kind of crazy-making abuse, which, as I’ve heard described by someone, and from my experience it’s true, can feel like an eggbeater in the brain. After talking to certain people, I’ve known the feeling.

          This is something that can heal, and needs to. It is extremely debilitating to be on the wrong end of what many call “narcissistic abuse.” Until one gets it, it does not appear so clear cut, for many reasons including believing we have no choice. Definitely an important awakening in one’s life, can lead to amazing life changes to discover and then heal from this. From feeling exhausted, fragmented, and powerless to feeling vital, whole, and powerfuand FREE–is the experience.

          I talk about this hoping to bring clarity to at least some. I’ve known so many people who have had this experience and so many online talking and writing about this, it’s not uncommon as we’re saying, and I think the info is really good. Helped me in all ways. Good to know one is not alone, as that is part of what gets programmed.

          It’s an extremely challenging situations because of the programming which becomes internalized. People can plant seeds in all kinds of ways to keep others dependent, and those beliefs become internalized, creating a negative field of focus from negative self-beliefs. That is way unhealthful in so many ways. And people can actually inflict this on another, it’s simply how they operate, learned from the previous generation. This is passed down if not healed.

          That’s where I’m hoping people don’t “get away” with something for too much longer, it’s gotten out of control at this point–that is, making people believe they are lesser than they are, exactly for the purpose of controlling them. That can make a person sick, crazy, or even kill them eventually, it can run so deep and pile on if unacknowledged. Happens all the time.

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          • Steve and Alex you both make good points. If my gut tells me something is off I don’t immediately ACT on it. I investigate. Like someone accusing someone of a crime. Innocent till proven guilty. But you carefully look at the evidence being submitted.

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          • I think when our instincts are on track, the truth tends to reveal itself if we follow that intution. The problem with covert abuse such as gaslighting and backstabbing–and also chronic avoidance and snubbing, which can feel like abandonment and rejection (on purpose)–is that the abuser will twist reality in their favor, and relies on “group think” and the insecurities of their “victims” to create a false reality which is detrimental to the one person who is challenging the system, to “other” and marginalize them one way or another.

            When one is reeling from “psych injury,” it can be hard to think straight, the feelings can be so overpowering and disorienting. Kids and adults, both, can have a hard time convincing others they were or are being abused, even when it is right in front of their eyes. It can be denied by the community to protect the system. When the person complaining about abuse shows the evidence, it is twisted into something against the one taking it all on. (“You shouldn’t have said that to them,” “you are thin-skinned,” “it is your imagination,” and on and on). Mind fuck upon mind fuck.

            That is what I’d call “systemic abuse,” and is exactly to the letter what happens in the mh system and it happens in families. Knowing our truth is an important first step and not letting anyone in the system throw us into a state of self-doubt, which is what happens. Living by our truth in an oppressive situation is impossible, until we get out of that situation.

            It’s important, I think, to find someone who will believe you and who perceives it as you do, that you know you can trust and who will understand what you are up against. It’s a very tricky situation, and rich with healing and social change possibliities.

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          • Rachel and Steve–I’m specifically talking about someone who feels confused and disoriented in a relationship, not realizing they are getting drained of energy. This is so common and the epitome of oppression (has to start somewhere), and for so many reasons having to do with “psych injury,” they believe they have no choice but to accomodate this dysfunction. All kinds of health and life problems arise from this, it is pure chronic stress.

            This is the intution I’m talking about, to trust that little voice way down deep inside, beyond the panel of critical voices, saying, “This is not your fault and you deserve better than this!” That is the first step to real freedom.

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          • Alex – I was not going to bring this up in this line of conversation, but when you referred to “intuition,” I find it necessary to do so. I relate intuition to the term, “gut feeling.”

            There is growing MEDICAL evidence that the bacteria found in the gut, the digestive system, have a direct impact on how one feels and functions (including one’s “mental health”). If one really thinks about the bacterium in the gut, they begin to understand this an ecosystem unto itself.

            Do a quick search of “gut bacteria mental health” and you will begin to see this idea gaining greater acceptance and study. Gut bacteria and its condition has been understood as the beginning and end to both physical and “mental health” issues by the Complementary/Alternative medical communities.

            In the Convectional Medicine community gut bacteria supplementation is only now gaining acceptance. This is due to the prescribing/ taking of broad spectrum antibiotics which don’t distinguish from Gut bacteria (good) and sickness related bacteria (bad).

            I recommend you do your own research.

            To OH – there are those trying to gain a profit from these new revelations about Probiotics. But, that does not discount their effectiveness. The secret is, if the probiotics (gut bacteria) are not purchased from a refrigerated display, they are pretty much useless.

            That’s where the profit “takers” exist. They add probiotics to multivitamins and/or are sold at chain retailers in the BOGO free sections.

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          • Ds_Ghoste, my gut no longer functions. I can’t absorb micro nutrients after 23 years on one SSRI or another. Pretty sick all the time. It started 3 years before I went off, though I notice the pain more.

            If the damage can’t be reversed at least the thing causing it has been stopped. My heart arrhythmia is better now. And I can lose weight again.

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          • Rachel777 – in response to your point and an effort to bring around the discussion to the PI Model, the individuals’ MEDICAL aspects need addressed in depth.

            Once someone has taken many of these pharmaceuticals, both their bodies and minds get altered. The longer and broader the usage, the more involved the damage. This damage can distance an individual from their subjective trauma, if not nullify its existence. What fails to get nullified, the coping/ behavioral adaptations that were resultant of those traumas and leading to psychiatric hospitalization/diagnosis.

            My loved one commented the other day, she wish she had amnesia. . . as opposed to a photographic memory with an emphasis on reliving rather than just remembering. My comment to her was, “then you would NOT know why it is you do the things you do, feel the way you feel.”

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          • ds_ghoste, I’m glad you brought this up and I’m way ahead of you.

            Years ago, as I was healing from psych drugs withdrawal, a medical intuit with whom I worked for a while taught me about gut health and good/bad bacteria, acidic vs. alkaline foods, inner ecology and how it relates to our mental clarity, grounding, and auto-immune system. And, yes, it correlates to “gut feeling.”

            I did The Body Ecology Diet by Donna Gates for 9 months pretty strictly, which is high alkaline foods to lower body acid and probiotics/cultured veggies to build healthy gut flora, which was not easy for a foodie like me! I love to cook, bake, and eat.

            But indeed, my gut was tattered from the psych drugs I had been taking, and also anti-biotics which had been prescribed to me (last time ever I took those or anything pharmaceutical, other than the occasional acetometaphine), and I worked hard to rebuild my inner ecology, which I did. It was amazing how it contributed to the clearing of the fog of withdrawal, and gave me sharper focus, while calming down my nervous system so that I could slow down my thinking a bit and relax in my body. That was an almost immediate result of starting this regimen, and it was a great relief to me right away. I could totally see and feel the value of tending to my gut health.

            This was about 14 years ago and to this day, I drink kefir every morning, and a raw veggie green smoothie. Rest of the day I eat what I want. I hardly ever get sick–an occasional allergy which clears up pretty quickly with a nettie pot and a few drops of collodial silver–and overall, I am healthier and more grounded and clear than I’ve ever been.

            So I agree with you, gut health is vital, core and basic. It effects our inner workings in many ways, so it’s good to keep healthy, balanced, and tended to.

            Also, in Chinese Medicine, there are warming foods and cooling foods, referring to how it affects our energy. Also great information when it comes to calming the nervous system by way of what we can naturally ingest, and what to avoid at certain times. Our systems can change and adapt, so we don’t always have to be so strict. But intially it requires diligent focus and strong intention.

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          • I’d still put “psych injury” as priority because it is much easier to self-care and self-heal when you feel good about yourself, at the core, or at least that intention becomes a priority. Otherwise we can get discouraged more easily, continually think of reasons why “I can’t,” and generally get in our own way, to the point of self-sabotage, albeit unwittingly.

            Emotional abuse and the injuries thereof call for healing in this regard, to my mind, to higher self-worth and self-regard, and bringing the critical voices at least into perspective, if not shifting them altogether. Step by step process.

            Overall, though, healing from psych injury would be a mind/body/spirit issue. All 3 are vital components to our well-being. Different people’s process will dictate what to address, first, and then a natural process will unfold, like a thread to follow.

            The challenge is all the resistance to healing and the doubt that one can heal, which comes from those negative voices, thanks to the trauma in the first place. That’s why I say to, at least, start there, then one can support the body better with that intention, and things get taken care of simultaneously, and one can turn a corner where healing is happening quite quickly and noticeably, and more and more manifests to help and support us in the process. But the intention does have to be TO HEAL.

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          • Alex – I cannot disagree . . . “psych injury” affects all of us, it’s just how much our coping mechanisms are out of step with accepted cultural norms. Additionally, talk therapists can begin practicing the PI model now, irrespective of their client’s/patient’s situation in the current paradigm.

            I have been witness to many who have gone through a system of denial and are alone in their suffering. They have been so harmed by the “system,” there is little hope of a functional recovery. Add to that, no family or loved ones for any level of support. The only support offered is that which comes with more pills and misery.

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          • True, some people are buried deep in their trauma and oppression, thanks to being chornically mistreated and/or misguided, which creates a great deal of resistance due to overwhelming fear and lack of trust. Wherever the light can start to come in, hopefully it will reach as many as possible.

            “‘psych injury’ affects all of us, it’s just how much our coping mechanisms are out of step with accepted cultural norms.”

            That is a very interesting statement. We’ve said in this thread that we need a “new normal.” Perhaps coping mechanisms should be taken into account when envisioning and creating a new system or society, like part of social evolution, having morphed into a new way of being, based on a new understanding of what it means to be human.

            Would it lead to greater social functionability, empathy, and inclusivity? Would it lead to reduction and eventual elimination of psych injury from family and social abuse? Quite possibly.

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          • A bit OT but an interesting tangent, I think–

            Frankly, if you want a model for social change through heart consciousness, watch the movie 9 to 5. Interestingly enough, the 3 oppressed women in the film get their ideas for “mutiny” while smoking a joint. And what they imagined and desired to happen became a reality for them (which was not real but the three of them thought the same thing, and acted on that group delusion) based on a series of synchroncities, and it led to revolutionary change in the workplace, which worked for everyone, and for the greater good, and the asshole got what he deserved, simply by a twist of fate.

            Fun movie, at least, and some basic truths to it, early 80’s style. Can life imitate art? I wonder…

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    • I believe there is the possibility of one if people can acknowledge the “psych injury” factor in all of this with the focus to solve the problem with reason and compassion, rather than blame and judgment–which NEVER solves a problem. Even “abuser” and “victim” and the like are labels which are flexible. I think most of us have played various roles from time to time, without even realizing it. We’re not only human, we’re multi-facted. Besides, this can be a matter of perspective, but that’s another focus.

      But as long as an entire system revolves around draining unsuspecting people for the gain of the elite in the system, at all cost to the non-insider because it fights dirty and relentlessly when mirrrored accurately, then the system is status quo, regardless of the rhetoric of change, it is inauthentic. The prognosis for success here would be negative, to my mind.

      A more enlightened and functional system would mean acknowledgment of and healing these injuries, and certainly not making them worse with blatant insensitivity. That, in and of itself, would be instant change, because that would be a new system.

      But it cannot exist in conjunction with any dysfunctional system. I believe these two would be irrenconcilable because the dysfunctional system lives in denial and pretense whereas a functional system is based on truth and authenticity because it is safe to do so. All of this stress would just drop away in a system which were functional and trustworthy, because the people leading it by example would be.

      I think that lends itself to a lot of good potentials, but as far as “victory” goes and if there is one here, that remains to be seen. I do think it’s a relevant and practical inquiry, however, because it can lead to a newfound sense of personal freedom, when we free ourselves (individuate) from a dysfunctional system and heal the wounds from the injury caused by such negative and fear-based programming, which certainly takes its toll on a person. That basic shift can ripple in a good way in the world while at the same time, the old system would become disempowered because its “victims” are waking up and doing something about it, starting with taking back their power. That is where the healing begins, for all concerned.

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        • I’d categorize behavior very generally, as respectful vs. disrepectful with respect to boundaries and personal space. It’s exceedingly challenging to be around people with no sense of boundaries. To do so would require a person to have a very strong sense of self, and to be individuated.

          Where we cross the line, I think, is when we *diagnose* behavior, or use it to assume something about a person based on speculation or projection. That, I think, is presumptuous, oppressive, controlling, and marginalizing, and is based on a bullshit “standard” of behavior which, as we all know, serves the elite to keep people under control, by cutting people off from their own truth.

          Overall, I think “behavior” is a category of communication. We can say more with our behavior than with our words. Still, it doesn’t necessarily tell the whole story, and often people so wrongly assume it does, starting with and especially mh clinicians. That’s where they go way wrong, I think, and end up sending people down a treacherous path, based on this false information to which they hold onto as though their living depended on it–which it does!

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          • I believe that, too, which is why I said, “Where we cross the line, I think, is when we *diagnose* behavior, or use it to assume something about a person based on speculation or projection.”

            If someone’s behavior gets my attention, it is usually because I am confused by it. And if I’m puzzled by someone’s behavior with whom I’m in some kind of relationship where communication is important, or it feels out of synch with what they are saying, then I tend to ask about it, for the sake of mutual clarity.

            If I find the behavior to feel assaultive, I go by that feeling and get out of the way. Maybe it wasn’t intended to be, and I’ll give that person the benefit of the doubt once. But more than once is enough clarity for me, to just walk away. There’s no good reason to put with repeatedly assaultive or invasive behaviors, REGARDLESS of the reason for it. Best medicine for that is distance.

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  17. It should be mentioned, acknowledged by everyone in this discussion, that drugging children and trapping them in the psych system is an ACE itself; a life-shattering and truly traumatic one as well in my experience, which I’m sure is not unique. Especially when the child is practically (if not literally) kicking and screaming to be off the drugs, but gets forcibly drugged anyway. And of course these drugs are almost always being used to try to sweep other physical or sexual abuse under the rug, especially when they are used for behavioral control, which is very common. In some ways, that can be considered worse than rape. The “side effects”, the feeling of being harmed that last for days, weeks, months on end to which there is no escape, not even when you’re alone and in the safest physical space you could be in. A torment with no respite, not even for a moment, until at least the child becomes an adult and discovers alcohol and/or herion, such as I did and then that’s a relief followed by a suffering that’s at least a good distraction. The permanent brain damage — it never goes away, especially if you develop an involuntary movement disorder, or vision focusing problems, dystonia, etc. Psychiatric drugs can and often do harm children in ways that they literally can not possibly recover from, not with all the therapy in the world. At least with psychological harms there is hope. But the brain damage caused by psychiatric drugs, particularly neuroleptics, produces permanent damage to the most important organ in the body, and I’m sure the total count of in what ways this has adversely affected children for the rest of their lives will never be fully assessed, it’s undoubtedly a countless number of ways. Yet it’s rampant and I’ve almost never heard anyone writing articles like this address it, let along explain the atrocity of it.

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