Why Many Doctors Are Authoritarians – and Harmful


For several years, I have thought it important to illuminate the authoritarian nature of mental health professionals—especially those who have not rebelled in any way against their professional socialization. In this article, I will summarize a compelling analysis from the Journal of Medical Ethics on the variables in “contemporary medical culture” that produce doctors who are authoritarian and harmful. First, however, some definitions and my personal observations.

Authoritarian is defined as “relating to, or favoring blind submission to authority.” Authoritarians with power demand unquestioning obedience from those with lower rank, and authoritarian subordinates comply with all demands of authorities.

In contrast, anti-authoritarians reject—for themselves and for others—an unquestioning obedience to authority, and they believe in challenging and resisting illegitimate authority. In contrast to authoritarians’ unquestioning obedience, anti-authoritarians assess whether authorities actually know what they are talking about, and whether they are competent, honest, have integrity, and care about those people who are trusting them. And when anti-authoritarians determine an authority to be illegitimate, they resist that authority—no matter whether that authority is their parent, teacher, or doctor.

There is always a tension between authoritarians and anti-authoritarians, and when authoritarians have power over anti-authoritarians, this tension results in various forms of violence.

In February 2012, Mad in America published “Why Anti-Authoritarians are Diagnosed as Mentally Ill,” my personal observations on mental health professionals’ authoritarianism and how this results in harm for their patients. (This article was republished on other web sites with titles such as “Would We Have Drugged Up Einstein? How Anti-Authoritarianism Is Deemed a Mental Health Problem.”) No other article I’ve published has resulted in more emails (which I continue to receive), the majority from people reporting feeling validated and believing their anti-authoritarianism—or their child’s—has resulted in mental illness diagnoses.

In that article, I simply reported my observations about how the selection and socialization of mental health professionals breed out anti-authoritarians. I noted that gaining entrance into graduate school or medical school and becoming a psychologist or psychiatrist require much behavioral and attentional compliance to authorities, even to those authorities that one lacks respect for. I pointed out that those with extended schooling have lived for many years in a world where one routinely conforms to the demands of authorities, and it was my experience that most psychologists and psychiatrists are not only extraordinarily compliant with authorities but also unaware of the magnitude of their obedience. I concluded that noncompliant patients create enormous anxiety for authoritarian doctors, and that this anxiety along with doctors’ shame over their own excessive compliance can fuel harmful diagnoses and treatments.

While researching my current book Resisting Illegitimate Authority, I came across a July 2012 Journal of Medical Ethics article titled “A Long Shadow: Nazi Doctors, Moral Vulnerability and Contemporary Medical Culture,” authored by Alessandra Colaianni. While Colaianni discusses how doctors in Nazi Germany enabled Nazi atrocities, she makes clear that “contemporary medical culture” also enables harm. I briefly mention Colaianni’s article in Resisting Illegitimate Authority, but I thought that Mad in America would be a good place to provide a more detailed summary of her analysis.

Colaianni begins by reporting, “More than 7% of all German physicians became members of the Nazi SS during World War II, compared with less than 1% of the general population. . . . By 1945, half of all German physicians had joined the Nazi party.” Colaianni points out, “Physicians joined the Nazi party and the killing operations not at gunpoint, not by force, but of their own volition” (there is not a single reported case of a physician who was shot, incarcerated, or penalized in any way for refusing to participate in the killing operations).

However, Colaianni does not merely reiterate the history of how authoritarianism among doctors in Nazi Germany enabled Nazi atrocities. Her original contribution is a description of those variables that continue to exist today in “contemporary medical culture” that result in doctors’ authoritarianism and harmfulness. The following is a summary of those variables:

Hierarchy and Socialization: “Medical culture is,” Colaianni concludes “in many ways, a rigid hierarchy.” The essence of authoritarianism is unquestioning obedience, and Colaianni points out, “Those at the lower end of the hierarchy are used to doing what their superiors ask of them, often without understanding exactly why. . . . Questioning superiors is often uncomfortable, for fear both of negative consequences (retaliation, losing the superior’s respect) and of being wrong.”

Career Ambition: Colaianni notes: “Becoming a doctor requires no small amount of ambition. . . . The stereotypical pre-medical student [is] ruthlessly competitive, willing to do anything to get ahead.” She notes that “there is a fine line between being motivated to succeed and being willing to compromise one’s integrity to attain success.” My experience is that for psychiatrists in training, even if they have trepidations about harmful “treatments” such as electroshock (ECT), they recognize that a refusal to administer ECT can threaten their career. The sad reality is that for many doctors, career ambition—and an accompanying compulsion to please authority—trump their moral apprehensions.

The ‘License to Sin’: Colaianni points out, “Physicians and even medical students are allowed to perform actions that, in other contexts, are taboo.” She reports how, in medical school, she and classmates “dissected the cadaver of a 98-year-old woman, cutting her muscles apart with scalpels and cleaving her bones with a saw.” This “license to sin,” she concludes, can result in harmful arrogance.

Inflicting Pain: Colaianni notes: “Doctors must become comfortable inflicting transient pain and discomfort on their patients for their own benefit in the form, for example, of stitches and biopsies.” Becoming comfortable with inflicting pain can lead to, Colaianni points out, “doctors who do not worry enough about whether they are hurting their patients.” This results in, for example, the overutilization of dangerous and sometimes necessary procedures and treatments.

Medical Terminology and Euphemism: Colaianni notes how medicine and scientific researchers use language that protect them from the realities of suffering. “Scientists use euphemisms and the passive voice in journal articles . . . writing ‘the animals were sacrificed’ at the end of the experiment is less jarring than admitting that ‘I killed 20 mice by holding their necks and pulling their tails until their spines snapped’.” Euphemisms also provide doctors with self-deceptions and deceptions to patients about truths that, when clearly stated, reduce doctor authority; she gives these examples: “We routinely use the words ‘idiopathic’ or ‘cryptogenic’ to mean ‘we don’t know,’ and ‘iatrogenic’ or ‘nosocomial’ to mean ‘we caused it’.”

Detachment: Colaianni discovered that “the medical profession requires unflappability in the face of things that others would consider disgusting, horrific, or otherwise overwhelming.” She reports being warned against getting too emotionally invested in her patients; and she was taught to have a clinical detachment or ‘detached concern, which means “showing empathy and caring, but not so much that you burn out emotionally.” Colaianni reports, “It is well documented that medical students become less empathetic and even less ethical as we progress through medical school.”

While there are doctors such as Colaianni who have angst over their professional socialization, many do not.

Among psychiatrists, psychologists, and other mental health professionals, there are a handful who risk their career to resist harmful authority, but most do not; and I believe that anti-authoritarian patients should be especially concerned with authoritarian psychiatrists and psychologists—perhaps even more so than with other authoritarian doctors. While an authoritarian cardiothoracic surgeon may be an abusive jerk for a nursing staff, that surgeon can still effectively perform a necessary artery bypass for an anti-authoritarian patient. However, authoritarian psychiatrists and psychologists will always do damage to their anti-authoritarian patients because anti-authoritarian noncompliance creates anxiety and often even shame for authoritarian doctors, and their anxiety and shame fuel harmful diagnoses and treatments.


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.


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  1. It is all about the language. Psychiatric jargon versus Jungian vision or Hillman deep aesthetics.
    Scientism, “ordnung” is a god for authoritarians (apollonian ego). Human psyche is a kingdom of metaphors, poetry. It is obvious that psychiatry as a child of apollonian ego fundamentalism and theological/monotheistic hatred toward politheistic psyche, won’t defend psychological man.

    For people possessed by scientism, material world is an answer for everything. They don’t need humans, they want biological machines. Because they are biological machines themselves. So they don’t need psyche/ psychology beyond biological theories, because BIOLOGICAL THEORIES OF HUMAN BEHAVIOUR CREATES THE MYTH THEY BELIEVE IN . Thanks that myth they are important and human psyche means nothing.

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  2. Bad idea to have authoritarian shrinks. Knowing nothing about “mental” diseases and having no real knowledge about physical ones are poor foundations for authoritarian types, as there is so little content in their bodies of “knowledge”, a secret authoritarians defend, in lieu of defending a real body of knowledge.

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  3. Bruce, you certainly get your point across for our current times but I have a few thoughts for further expansion and thinking.
    The other side of this is Aesculypian Authority which dates back before Hippocrates in the time of healing temples with rites and rituals.
    Siegler and Osmond in their book of the same title write on this.
    At one time medicine was considered both an art and science and there was a subset subtle community contract Icede power to you to help me heal.
    Emphasis on the I here. This was the so called patient allowing for a certain limited transfer of power.
    What you describe is the complete overtaking of all power and control and intertwined bad care, treatment, and so called chemical help in many areas of modern day medicine so untruths for pure profit. The contract be damned.
    Interestingly the Rod of Aesculpian and the Cadeuceus are two intirely different symbols now used interchangeably since WWI due to human error.
    That no one in the realm of the powers that be has never even deigned to figure this is beyond my ken but makes so much sense to the question of now. Silly docs!
    Coming from a medical family and then working at a teaching hospital I could feel the difference and painfully see the difference between generations. Not at all – all the time but the trend of power and control and willful ignorance of much was apparent.
    And to be fair, medical education play a large role in this
    During WW II certain magnet schools were used to pipeline docs to war. Streamlined classes and new courses and then the war ended and nothing but the vets themselves were left if any wisdom gained.
    I grew up with this doc was a POW in Japan – he came back changed- this doc was Polish but was going to med school in England and joined the RAF, many had seen much trauma then there were the Korean War vets, and Vietnam Vets.
    There was a stream of wisdom gained through trauma – some not all.
    What I observed as an employee and then as a patient for so called MH treatment was what you described.
    But many interns and residents were coming from privilege and the path to medical school seemed set on what neighborhood you entered kindergarten.
    It was like at a family wake an extended family friend was asking me well
    what do you say? And I was like been doing this for decades and yeah it ain’t easy but I worked this out by myself at ten. And maybe family cut offs- total non exposure to trauma- both could be true.
    I don’t know how this evolved in its entirety but change cane and it was bad. May be cog in the wheel and kick the next one in line and Last is the patient and the most feared is the MH patient. Allowable stigma- free ride.
    And those that come in – some of the best never even tried because wrong neighborhood.
    Not to say Trauma is a good thing. Ask any person whose parent or parents endured trauma and even the ones who overcame not easy but it can be used for wisdom.
    I think wise medical treatment professionals are few and far between.
    Also I’d thry are- they too are trapped in the system that is.
    BTW Pharma sales rep massaged the docs giving them treats making them blind and beholden. Great, great sales strategy.

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  4. About the “inflicting pain,” I imagine there are a few cases of doctors turning to sadism. Psychiatry would be an ideal specialty for them since no one will believe people with SMI labels.

    The whole thing is scary. #Notallshrinks But the psych system is a hotbed for this cruelty. Psychiatric medicine is Absolute Power. And you know how the saying goes.

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  5. I gathered that there was this unbridgeable communication barrier between myself and some of the mental health authorities that I had the misfortune to be served by. We spoke different languages. I had definite needs that I had to deal with while to them I was nothing more than a pathology. Ultimately, it came down to putting some distance between them and myself. My needs were beyond their comprehension, and their “sickness labels” made communication on a human level impossible. I don’t know how you tell somebody who thinks of you as little more than an illness that you are a human being. I just had the obvious epiphany, namely, that their services were not for me, and that my own best interests lay elsewhere. Under the circumstances it was one of these “and never the twain shall meet” type deals.

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    • First, thanks for all the comments, which I’ve read.

      Thanks, Frank. Yes, this is really a major point of the article – to help people, as early as possible, to achieve confidence in precisely the “epiphany” that you had.

      After the anger at one’s victimization, after defending oneself from insulting labels pretending to be diagnoses, my sense is that an important next step to liberation from oppressive forces is to detach by, in a sense, diagnosing the oppressive forces and grasping what caused it — diagnosing their authoritarianism and examining some of its “etiology.” This, I believe, helps make it easier to achieve the obvious goal: staying away from dangerous people!

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      • Good points. We’re not talking about “bad” people here. We’re talking about “sufferers” from Authoritarian Personality Disorder, and the following, afflicted with Blind Obedience Disorder and Selective Ignorance Disorder, that make them possible.

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      • I am commenting here just for the heck of it.
        The idea of keeping folks down and dependent- in the DD field parents were also involved but I never got the icky affect I felt in some of the NAMI contacts I had.
        Folks wanted and where pleased with their independence.
        Getting a job was a good thing. Again the monetary factor and DD is easily identifiable because it’s real and kids are a good PR for levy’s.
        In fact, the DD system went bad in the opposite direction. One could not stay at the county workshop – costs money! One had to progress to private employment whether that was in the best interest of the human being involved. Workshops also had a devoted rec staff and off time activities.
        Voc rehab for those with MH issues in my locale closed down or streamlined .
        There were groups of physically challenged folks who protested and eventually got public transportation. It was a hard fought gain.
        When humans make other folks uncomfortable because of their distress and the raison d’entre is unknown or very complex and with our fear based society the control freaks can jump right in.

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  6. What Bruce doesn’t mention is the support for murder of psychiatric inmates in the U.S. during the same era:

    The 1942 ‘euthanasia’ debate in the American Journal of Psychiatry

    This paper discusses and analyses three articles appearing in a 1942 issue of the American Journal of Psychiatry. In the first, neurologist Foster Kennedy argued that ‘feebleminded’ people should be killed (an act which he referred to as ‘euthanasia’). The rebuttal was written by psychiatrist Leo Kanner, who argued against ‘euthanasia’. An unsigned editorial discussing these positions clearly sided with Kennedy: that ‘euthanasia’ would be appropriate in some cases, and that parents’ opposition to this procedure should be the subject of psychiatric concern. The arguments are analysed and discussed within the context of eugenics and the murder of mental patients in Germany. Finally, the author points out that currently ascendant genetic theories in psychiatry could be a precursor for future proposals similar to Kennedy’s.


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    • Yes, Oldhead, this is important, and I discuss this elsewhere.

      The major point of this article was not to address the 1940s’ atrocity-enabling actions by German and American doctors, but to address CURRENT professional authoritarianism and harmfulness and the variables in contemporary medical culture that continue to produce this.

      While psychiatry is embarrassed about their past and ignore it – and so it is good that Oldhead reminds of it – they hate anyone who asserts that they CONTINUE to create harm because of their CONTEMPORARY culture, which is rarely rebelled against by mostly compliant professionals.

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      • No arguments, I just think it’s important to keep pointing out that American psychiatry was complicit with Nazi psychiatry, as the tendency is always to point “over there.” What’s happening today is simply a “kinder, gentler” version of genocide, so it’s important to be aware of the historical context. Good article, as always.

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        • And it’s all about the same fraud based banking families controlling the US monetary system, just like they wanted to, or did, control Germany’s banking system in Nazi Germany. And those banking families’ post 9/11/2001, whose goal was to create never ending wars, to gain control of all countries banking systems.


          And our psychiatrists and psychologists did attack us ethical, non war mongering and profiteering, fiscally responsible, non bailout needing, anti-war, antiauthoritarian, US banking families proactively. As did their GD pedophiles. Because we knew in our gut that the wrong bankers were in charge, and going to try to take us into a WWIII, in 2001.

          Now many know about the fraud and fiscally irresponsible behavior of our current banking system, and are sick to sh-t of their never ending wars, thankfully. Not to mention their sick, twisted pedophile control systems of our government officials is now coming out.

          Yes, us anti-authoritarians, and “insightful,” were attacked by the “mental health professionals,” because money is their god.

          “Medical culture is, in many ways, a rigid hierarchy.” It functions as a caste system, which is quite un-American. Actually, everything our “mental health professionals” believe in is not just scientifically “invalid” and “unreliable,” but downright anti-American. They believe their clients are diseases, as opposed to people.

          I might be heading down to the Cincinnati area in the near future, I’d love to meet you, Bruce, and take you out to lunch, if you’d consider such a meeting. It’s always nice to meet and speak with like minded, truth speaking people.

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  7. to be a “mental patient” is to be a “weakling” of some degree, in the psych “professionals’ ” eyes, at least. one comes in with problems and leaves with a stigmatized identity, plus bill$.

    my best guess is that psychiatry attracts not only the more authoritarian MDs, but also the mediocre and more potentially dangerous ones, as well. they completed 4 years of undergraduate study, medical school, and now they’re going into a specialty that treats faux “diseases” with real pills, real shocks, now and then real brain operations. factor in the relatively low compensation psychiatrists receive (too much for my tastes, but considerably less than, say, dermatologists) and their incredible power, in society as a whole and within the legal realm, and…

    it is a proven recipe for absolute disaster.

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    • Yes, I think that the less real value a person has to offer others — and at some conscious or unconscious level, many psychiatrists know that they are only glorified drug dealers who have no valuable skills -– the more one is going to be insecure and have shame. Insecurity and shame make it more likely that one will not be open to truths and that one will simply attack truth tellers. So, we have the former president of the American Psychiatric Association, Jeffrey Lieberman, proclaiming Robert Whitaker as “menace to society.”

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      • BUT, Mr. Robert Whitaker *IS* a “menace” to persons such as Lieberman, in exactly the same way that good, honest cops are a “menace” to dangerous criminals….
        We can use all the Robert Whitakers we can get, and as few Liebermans as possible.
        The IDEAL number of Liebermans is ZERO.
        But, sadly, seen from another perspective, the “value” of Lieberman, to PhRMA, is measured in $BILLIONS$….
        ….as is the CARNAGE wrought to civil society by the Liebermans of the world….
        Psychiatry is a pseudoscience, a drug racket, and a means of social control. It’s 21st Century Phrenology, with potent neuro-toxins. Psychiatry has done, and continues to do, FAR MORE HARM than good…..

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      • Well,I have seen psychiatrists hand over to us precisely the same.Shame,guilt,it,it’s all in my head,no questioning them,don’t ask for a better deal.They can even shout at you,criticize you.You lose faith in them.And when in a country where there are less than 3500 psychiatrists for 1,3 billion people,how do we get the treatment?They want only submissive patients.They are no different from street drug pedallars.Swallow these pills,and that’s all what you got to do do,when your life breaks down one after the other,despite taking the medicines.They will switch over to another class of drug,but won’t make any difference to our lives,but more side effects.Their effects are for short term and our lives are longer than that.It’s guess work that guides them to select a drug.Psychotherapy has to bridge the gap between the drugs and the patients.

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    • Physically disabled are living a very comfortable and luxurious lives.They consider physical disability as a genuine disability and psychiatric illness as some kind of nuisance or malingering.And nobody is willing to change this perceptual distortion of the society and psychiatrists alike.You know it’s very easy to practice psychiatry,because these patients can be manipulated by anyone,including the psychiatrists and no questions are asked.If they act smart,then he will get some dangerous drugs.Whether the treatment is bad or good can only be defined from the perspective of the psychiatrist.I went to the court to challenge this general apathy and callousness and filed a public interest litigation to change the way psychiatry is practising.But the courts and the democracy are all hand in gloves with their traditional believes about psychiatry.They don’t want to change the image of a patient who is tied with a chain or being given an ECT,or being lynched.

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      • I have known plenty of people with physical disabilities, and very, very few ever lived lives of luxury, and none did so on the government. The amount provided by SSI is generally barely enough to survive, and many of the “mentally ill” who are so disserved by the “system” have physical disabilities, too, many induced by their “treatment.” I don’t think it’s proper to make generalizations about people with physical disabilities – they are an extremely diverse group!

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        • I have symptoms of Chronic Fatigue Syndrome myself. Every so often I need iron infusions and B 12 injections thanks to years of psychiatry. My body can’t process micro nutrients anymore. At least my heart arrhythmia has stabilized.

          $770 a month is not enough to rent anything but HUD. (A lot of those are slums.) Even in Indiana.

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          • Rachel, that’s a little more than I received last I was receiving disability. That’s why I say that the system is designed to keep people in poverty. There are only two ways to not be impoverished on disability. Apply by age 22 and receive it based on your parent’s income. I would not have been so poor if I’d applied six months earlier as it would have been based on my father’s many years receiving a federal paycheck. OR, become disabled at a later age when you have accrued enough work credits to receive a full SSDI check. But then you will have to pay your Medicare premium and copays and that often brings people who don’t meet the poverty threshold otherwise back down into poverty.

            I remember being responsible for half the bills and not having enough left for almost anything else. I have had to use food banks and remember clearly the time I went, it was right around the recession, and there was no food but they had plenty of Easter candy. So my “food” from the food bank was a grocery bag filled with various chocolates.

            When I started looking for subsidized housing back around 2008, there was a five year waiting list in Maryland. Last time I checked around 2015, the list had been closed for years because the need was so great and the supply so short.

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          • People do not realize that HUD and all the handouts are not a free ticket. In order to qualify for HUD your income is already so low you cannot afford a decent place, or any place. Once you get in your chances of ever moving out are very little. You will not be able to “transfer” to another HUD if the one you are in sucks. They put you through the worst hoops if you want to do that. You have to apply, and then wait and wait. Unless you have a Section 8 certificate you can’t relocate. Ever.

            Living conditions…well, if you are in senior housing you might like a nursing home more. I hated senior housing! I hated living with people I had nothing in common with. It felt very institutional.

            The handouts cause dependency. I heard that fewer than 0.5% ever get off disability. If you are on disability your chances of a landlord accepting you are next to nil. I had to lie and say it was “retirement.” It worked!!! But that won’t work unless you are over 50. Once you get a good history with one landlord then moving to a better place will be much easier, since you are not reporting to the landlord that you currently live in HUD. If you work locally and tell your employer your address you will be giving yourself away…and your chances of getting a job, again, are fewer.

            Some people do manage to sell on Ebay or Etsy. I knew a guy who cut hair on the side. Massage is not hard to learn. Getting paid gigs as a musician (weddings, etc). Sewing clothes, selling your art (photography is likely the one visual art that could be very profitable) or selling your psych drugs. Fortune-telling (i.e. “readings,”) if you can convince other that this is valid, will be instant money. All of this must be done illegally, that is, without reporting to the gov’t, or you are screwed unless your business is pulling in enough to live on. That is, if they find out you’ve been doing what you must do to survive, you’re a criminal.

            The key is to get out. Get away from mental health social circles and quit the mentality of dependency. Do not use the System’s language. These are the hardest things for many of us. Learned dependency takes years to shake off.

            This is weird…I feel that I have ditched the mentality well enough. One day, roughly a month ago, I came home to find my keys were not in my pocket. For a split second I was transformed back into a dependent mental patient. I was suddenly thinking of “staff” that would somehow rescue me. Or a therapist who was that instant paid friend. I’m so glad that sudden flashback to the old days only lasted a second until I realized my keys were in my other pocket.

            I believe this will happen again if I am ever in a really scary situation. It would have to be extreme though. Like if I was hit by a car or beat up.

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          • I’m of the opinion that being interdependent upon one another is a good thing. I think living in family units is far healthier for us than our current notions of stable independent and singlehood. I also think that we’ve been subjected culturally to an extreme amount of shaming and “bootstrap” thinking if we need help.

            Where the problem seems to arise most for people is when there is a mismatch between family expectations and individual needs or desires. Some families are extremely closely connected, live near each other, all pitch in during times of need. Other families are spread out geographically like mine, not well connected, and value independence over cooperation and don’t mind leaving an individual member out to die if they can’t survive on their own.

            I think when we talk about disabled people, whether or not they have a psychiatric diagnosis, having “learned dependence” we also need to identify where we fall on this spectrum of belief about whether we’re part of a team or lone agents as were in all likelihood projecting our own values on others which they may not share.

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          • I agree, Kindred, but for the most part people who have been in the System are told they cannot work or are in some way incapable. Most of us have has been brainwashed to believe we are less capable than we really are. In fact I do not know a single person who was treated in the System with expectations that were too high. Whatever capabilities you had were treated a symptoms of a disease, so they weren’t capabilities anymore. Some of our capabilities were a threat to them. God forbid, an artist might capture the scenes in mental hospital. A writer will write about what it was really like. Were in in law school? Well? What were we good at now? Being good in “group”? ugh.

            Because we were brainwashed to be more dependent than we needed to be, I generally stress trying to reach a point of increased independence, especially dependence on psychiatrists and therapists, or at least stop seeing them as gods on high.

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          • On top of which, the system is hiring people who have been in the system. What the system is slow about doing, what the system is not doing, is getting people jobs outside the system, and thus, the system expands and it doesn’t contract. The so-called “epidemic” of “mental disability”, “chronic disability”, paying even more people’s bills, grows ever larger and larger.

            Self-reliance is good thing provided you haven’t been in the “mental health” system where self-control, anything other than debilitating-drug and paternalistic bureaucracy control, is seen as non-existent.

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          • I don’t agree that having a job is a good thing or that self reliance is a good thing. Neither is good or bad in and of themselves. It’s the way the system leaves vulnerable people behind that harms us. I think we need less bootstrap mentality and more collectivism.


            To be honest, I don’t really give two shits what anyone thinks of the “chronic disabled”. The fact that someone has received disability for a psychiatric diagnosis does not preclude them from having a physical disability as I do, and as so many who spent many years medicated have disabling conditions related to the years of drugging. I’m with Oldhead on this – consider it reparations. I’m not receiving disability anymore, but even if I weren’t physically disabled, I sure as shit am not about to labor for a pittance in order to generate profits for large corporations. Even on my best days, I wouldn’t stoop to that level. I’d end my life before I’d stoop to being a slave for the corporate state.

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        • Julie: “Some people do manage to sell on Ebay or Etsy. I knew a guy who cut hair on the side. Massage is not hard to learn. Getting paid gigs as a musician (weddings, etc). Sewing clothes, selling your art (photography is likely the one visual art that could be very profitable) or selling your psych drugs. Fortune-telling (i.e. “readings,”) if you can convince other that this is valid, will be instant money. ”

          First, I could not, with a clear conscience, sell psych drugs. “Right Livelihood” is a principle I have to live by, and causing harm to others is not in that department. I would sell street drugs before I would sell psych drugs, even though Gabapentin has street value now. (and it’s not easy to make a living selling street drugs – the profits increase as the harm and danger increase)

          Next – all my life, I’ve known people whose goal was to be “off grid,” and utilised the methods you list to try and make a living. These people are dying young now because they cannot afford to go to doctor for a heart attack (for example) and “wait until morning” is a death sentence. Their teeth are falling out. They have untended tumours. They live in dirt and teepees, yurts, and cobbled together housing on other people’s land. It is not a “living,” by any stretch of the imagination. There are a few who “make do” with the festival circuit, buying and selling as merchants, having a table at flea markets and such.

          I do know photographers who win awards, etc. etc., and sell their work – but they are retired from a profession which pays their bills. I do know **one** artist with an MFA who is completely independent and can paint as she wills, and pay the bills, but I think many of her customers are rich elites and corporate (she also teaches part time at a local university). She is extremely skilled, educated and talented. We can’t all be her.

          One friend of mine quotes his father, who said, “Your value in life is your ability to be productive.” Learning a craft – like house painting, carpentry, plumbing, auto repair, hairdressing, and yes – massage – is one way to produce off-grid income. The more skilled, conscientious, and hard working you are – the more likely you are to make a living. Being able to produce something which is a needed service is essential.

          The most successful job for some of these people is apartment turnovers – cleaning out the apartment, painting, carpeting, repairing, getting it ready for the new tenant.

          I do know a few people who make a living off of eBay, but Etsy’s model actually prevents people from making more than a dribble of income. And again – eBay can be hard work! I don’t know anyone who makes a “living” (roof, food, and possibly transportation) off of “fortune telling,” though I do have a friend who makes a good living from combined services of storytelling (at schools and libraries), writing books, and handicrafts as well as offering readings. By combining all of these services, he is very busy and hardworking (as well as skilled with his woodworking) – and very independent.

          What I am saying is – I know many people who dream of being “off grid,” but who do not have the wherewithal – whether that is drive, ambition, or skill – to do more than be a dirty hippy living off the well being of others.

          I know even more people who are stuck in the system – to quit their drugs – to undiagnose – would be homelessness and worse. If you are over 50 years old, and it is winter – “take your pills and shut up” is a strategy for survival. The fear of losing home, pets, possessions, everything is a strong motivator for staying on system. The older you get, the harder it is to just walk away.

          I’m with kindredspirit in that we need to form communities. Many of my hippy friends do live better – not in communes – but supporting each other as best they can, helping each other out with a place to stay, or sharing meals, etc. BUT – I had one hippy “friend”/family staying in my house in Indiana. They still owe me $6000 in back rent, that I will never see (and the house was trashed). They felt entitled – as “hippy friends” – to walk all over my goodwill. You can’t get blood from a turnip.

          Just some stories about independence for your entertainment and thought.

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          • Communities of what? Self-identified crazy people using euphemistic self-descriptions? I already live in a community, and don’t want to be pressured to live with “my kind”; we need to jettison the capitalist structures which create an enforced state of alienation across the entire social milieu, not play into this idea that “we” are “special cases” who need separate “communities.” Though a sense of community is vital of course, for everybody.

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          • Not the kind of communities I meant, Oldhead.

            I was thinking more organically – we like each other, we have common goals. I have a job baking bread, but you have a gift in childcare – how about I work while you watch the kids?

            This becomes more important as we age. When I was young I fantasised that all my friends would be in the “oldies home” with me. As I rapidly approach that situation I’m realising that is not only unlikely, but damn near impossible. I will be paddling upstream as fast as I can to avoid any sort of “care.”

            Churches are often organic communities. There are organic communities online – but are not practical in the day-to-day. I saw a “prepare for self sufficiency” meeting, but couldn’t get my hubby to go – this was a collection of people where one would grow oranges, while the other would raise chickens, another doing aquaculture, and all of us purifying our own water from our rainwater tanks. Together we could all be independent of the system, and survive its immanent collapse. Community.

            I’m not talking about “care!” I will probably take my own life before I submit to it. (Sssssh! Forbidden topic!)

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          • Actually, Jan, we live in different countries so maybe the situation is different. People have to get by somehow on the unlivable “disability” income. Most of them are working and not telling the government. You get in a lot of trouble if you’re caught. My friend who had her own very successful business decided to claim “depression” as disability but kept the business going. She put the business in a family member’s name. Not legal but people have to get by and they do what they can. Many I know on disability also get money from their families, but in the US it has to be done in cash. You can’t have a penny going through your bank account. My friend ended up so broke she had to cheat on her taxes.

            There are also people who end up with an enormous amount of money from these side-jobs. There was a big news story about a local fortune-teller who made huge amounts of money but something wasn’t legal about it (can’t recall) so she got caught. I believe that happened when the justice system got wind of her activities and they had an undercover cop pose as a customer.

            I know a lady who sells her own specialty laundry soap and she has made good money doing this. My coworker sells veggies from her garden. I have a neighbor who has a tiny garden where he raises these amazing flowers. He regularly cuts them down and gives them away. He gave me some and I was so touched by this I almost cried. Home chicken coops are very popular here, even in the city, though you’d need a lot of laying chickens to make anything substantial.

            I suck so badly at selling anything at all. However, I’ve made a point of studying how to sell. (What is a job interview but advertising and selling yourself, and of course, lying a little….) I hope to get skilled enough at it to get my book to sell, which I hope will be this year. I’ve also studied how to delegate “nuisance” tasks. It’s a win-win because whoever you hire can use you as a reference, you pay them, the job gets done. You save time and they get a another sale to add to their accomplishments. That, in fact, is community.

            I couldn’t possibly do this if I was still in the System. MH is a fail-fail situation all around. You won’t live well if you’re living as an inferior, subhuman creature. You’ll be lucky if you’re still alive after they get through with you.

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          • Jan, you remember how many people signed up to live in a cave with me, right?

            I do think that this is a viable model and my husband would love to join an intentional community – has been pushing me in that direction for years – but I want to create an intentional community with people I know and not join a commune of strangers.

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          • Hey Julie – all of the people whose stories I told are in the USA. (mostly Midwest – is it harder to be cottage by region?)

            Australia supports its people a little bit better. You don’t have to be “disabled” to get a pension – just be poor, old, or be a single Mum.

            In the USA I worry about people dying without medical care, because they are below the line, below the radar. Here I worry about people going to the doctor TOO much!

            A good case for Universal Income … (but that is beyond the scope of this forum!)

            Kindred – my intentional community would include people from Israel, France, Pacific Northwest USA, Australia, UK, Belgium, Midwest USA. Is there a cave that connects beneath all these continents? My point being – the intentional community with people you know & want to hang with – might not be in a single locale. Got an uninhabited island somewhere in the Pacific?

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          • I do think that this is a viable model and my husband would love to join an intentional community – has been pushing me in that direction for years – but I want to create an intentional community with people I know and not join a commune of strangers.

            That’s fine on an individual level, but don’t people already tend to live and associate with people they get along with?

            I was thinking more systemically. “Intentional communities” are fine, but they don’t contribute to ending psychiatry; it just felt like an “alternatives” discussion.

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          • My understanding of “intentional communities” is that their original purpose was, in fact, to undermine the capitalistic assumptions underlying our culture. I could be wrong, but that’s what I associate with the concept.

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          • And the essential misconception in that case is that there is an individual solution to capitalism to be found within a capitalist system. It may work for some people in some limited situations, but on the whole capitalism must be defeated, it can’t be ignored.

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  8. Bruce, I am loving your book! I wanted to tell you that. I have reviewed it on Amazon (posted as JG) and I’m not even done with it. I also wanted to write a review of it for MIA but who knows if they’ll let me.

    Anyway, I have to laugh. I started a new position. At work we only have bits and pieces of downtime, during which the workers either chat with each other or, oddly enough, play with children’s fidget toys. I decided I was not going to waste my mind. I would sit there and write but that is not allowed. I brought a hard copy book with me but the boss said I can’t read during work, with the exception of their stuff, which is kept in a looseleaf notebook at my desk. Rules rules rules!

    I am sure you will not mind my creative solution to the dilemma. I have the Kindle copy of your book. I managed to print out a bunch of pages. I brought those pages to work and when the supervisor wasn’t around, stuck the pages into the notebook. Now, while I might appear to be studying that darned notebook an awful lot, I’m actually getting my Bruce Levine fix!

    I have challenged authority for as long as I can remember. I remember being in a playpen and when my parents weren’t looking I ripped a hole in the playpen mattress. I “decorated” my furniture with blue crayon during nap time. My mom left the room while she was cutting my hair. Oh how fun it was to snip snip snip! My mom had to take me to a professional hairdresser to fix the mess.

    I have challenged what I felt was illegitimate authority here at MIA (favoritism) and also when I was on the ISEPP mailing list (failure to acknowledge the harms of “therapy”).

    All my life I have been shocked and disappointed in my fellow humans who insist on not saying speaking up, even when they’ve known something was immoral. However, it took me decades before I ended up speaking up at the hospitals about the obvious wrongs. Again, I was shocked and disappointed that my fellow patients didn’t just insist on remaining silent, but they turned against me. They called me psychotic even.

    For instance, when I spoke up about the lack of telephone privacy on an eating disorders ward, I got the following responses from my fellow patients: “But we don’t have human rights.” “But you have to follow what the staff say.” “Who cares if they aren’t following the law. None of the hospitals do!”

    These are all logical fallacies.

    The “staff” were far worse. They said the human rights laws that I pointed out did not exist. I pointed out that there was a private phone in one of the rooms that they commonly called “The Yellow Room.” I asked to use the phone in the Yellow Room and they told me “We don’t have a yellow room!” insisting I was psychotic. Then, when I showed them the policies that were in the way, way back of the patient handbook, they had to take a different tactic. One of the nurses said, “These human rights are only for some patients, not for all. We will let you have your way. But you’d better stay quiet about it.” Finally, I said that patient rights laws applied to all patients, not just the “good” ones.

    I had a home inspection a while back as my rental home was being sold. A couple of local cops showed up. It felt like a home invasion. Their report was full of exaggeration and disdain for the way I choose to live. It’s my choice, and my right, not to have fancy furniture! It isn’t messy in here but one or two empty boxes lying around constituted “trash strewn all over the home.” Not quite! I got a letter from the rental people saying the inspectors are coming back in 30 days and the place better be cleaned up. They never came.

    I have been inspired by your book, Bruce. If they ever contact me to tell me the inspectors are showing up, I’m going to ask them to show up in plain clothes, not uniforms. If they show me their badges I will tell them I do not need to see proof of their elevated social status. They’re not arresting me, for godsakes!

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    • Yes. And who is listening to people with diagnosis, since they are perceived as persons without a real human identity? Who will listen? Victims of psychiatry want justice. But this world can not help them, because justice is connected with truth and wisdom. Normal people are not noble just because they do not have a diagnosis. People perceived as mentally ill are no more bad than they are. To be outstanding in this society, you need only fame and money.

      Wisdom is too much for this society, so we have religion and psychiatry.

      We have no wisdom, we have religion and psychiatry.

      People without wisdom think that Obama is an antichrist. Bahahaha. Mental health and normalcy is equal to lack of wisdom.Because people who knows who is antichrist are outcasts.
      You must be beyond this stupid mental health agenda to know who is antichrist. You must think more humanly than normal people…..

      Psyche is the antichrist, and Christians will have to revise their thinking about the human psyche if they want to remain human. Because spiritualism is not psychology, and overcoming death is rather childish activity. Death is psychological reality, and religion prohibited it, which means that god and religion are anti human. God and religion are more important than human psyche which is absurd. This is catastrophe!

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  9. Hi Bruce, as always, thank you for your insightful articles and support of those who reject illigitimate authority.

    I wondered if you might be able to make the time to read the Atlantic article I posted elsewhere on this site. I think the author hit the nail on the head with detailing *some* but certainly not all of the ills afflicting modern medicine and how you would incorporate that into your narrative about how doctors become so authoritarian.

    I think the issues are systemic and that a large number of doctors who genuinely want to help heal their patients in a collaborative manner are being driven out of healthcare for a variety of reasons.

    Yet I have personally witnessed behavior from a psychiatrist that would have caused a patient acting similarly to be restrained, drugged and isolated and I do wonder why the other medical staff witnessing these events don’t speak up more often, and why the good guys are simply packing up and leaving the field instead of fighting back against the corruption taking over the healthcare field.


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      • I think the general public just isn’t really aware of how many doctors leave the field every year and how severe burnout has become in the medical profession. A 2014 survey showed that 4 out of 10 doctors surveyed said they planned to leave medicine within the next year, either because of retirement or a career change. A full fifth of “doctors” treating patients now are not doctors at all, they’re physician assistants and nurse practitioners. They get paid less than doctors, often with similar levels of student debt, and take the same shit that is causing doctors to ditch medicine.

        As Alex pointed out, it takes a certain level of empathy and compassion to look beyond your own circumstances so that you can begin to attempt to heal a broken system. We must be willing to analyze all the different factors causing the deterioration in patient care and not just blame each other. I want to remember that doctors are people too. And so while patients are rightly angry with the piss poor treatment we often receive, especially when we have a psychiatric label attached to our records. We must as patients be willing to see what is driving some (many?) doctors to such despotic behavior.


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        • NP’s – I was first seen by a Psych NP when I began to cave in to the diag-nonsense. She was scary – and kindredspirit you’re right they’ve proliferated in the name of bottom line profits.

          i have a doctor friend who – as a family practitioner – might refer a patient to, say, a dermatologist, thinking that it was beyond her expertise – only to have the case handled (and poorly) by an NP. She snorted, “I should’ve just treated them myself!”

          But here’s the thing, where there is hierarchy up, there is oppression down. The nurses take the brunt of the profit centre. There’s nobody out there trying to reduce their hours, improve their shifts, offer them benefits. The whip cracks on their backs, too.

          And it makes numbers of them just as authoritarian as they’ve been treated. You know the way the abused become the abuser?

          Hierarchy up/Oppression down.

          And the diagnosed are at the bottom of that heavy pyramid.

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          • DIAGNONSENSE! I LOVE it! Thank-you!…..
            “Iatrogenic Diagnonsense”
            No, it isn’t really funny at all, but if I couldn’t see any humor in it, I might have to start crying at the sad truth of it….

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      • Oh and Julie, as for nurses…

        I was in the emergency room a few years ago when a nurse came to take my blood pressure. The reading was 55/40. Her response? She told me to get up and walk around because she’d get fired if she wrote that down in my chart and didn’t call a code blue. And she said it all with a chuckle.

        I was a known cardiac patient with known syncope due to precipitous drops in blood pressure (which incidentally, I now know was neurally mediated due to the damage the Lyme was doing to my autonomic nervous system). She’s damn lucky I didn’t pass out and injure myself when I stood up to accommodate her demand that I raise my blood pressure.

        I felt like such an inconvenience to her. So no, I absolutely do not let nursing staff off the hook.

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        • Yes, KS, I too have met very cruel nurses. Many were just plain incompetent. I remember ages ago helping the nursing staff write notes with proper grammar. Some did not know how to spell the simplest words. Even words like schizophrenia. They couldn’t spell it. You wonder about the quality of care in such circumstances. Yes, they can do stuff like take blood pressure, but many weren’t too good at critical thinking. Or they didn’t even know what critical thinking was. We were the ones who with the broken brains, remember?

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  10. Thanks for a good article on authoritarian doctors Dr. Levine. Some doctors let their power and hierarchy go to their head and they become very narcissistic. I’m very lucky I have an honest, caring family doctor who continues to give me tremendous support to battle damaging psych labels given by authoritarian doctors during cancer treatment. An oncologist proclaimed I had a dire cancer prognosis and expected me to be part of a clinical trial, adding a 4th drug to a toxic chemo cocktail. My participation would make him an ‘associate doctor’ on the trial and I believe be a large monetary benefit to him. The waiver I was required to sign for the trial drug stated side effects I had to agree to were: heart attack, stroke, vision loss, intestinal rupture, etc. In my own mind I questioned his dire prognosis/threat of death. Relying on my intuition, common sense (plus valid, logical reasons that included relevant pathology) I politely declined the trial. The doctor went berserk, threw his pen across the desk, and with eyes blazing in anger got up and stormed out of the room. After a few minutes a nurse came in and said “He can get his knickers in a knot”. No kidding.

    I didn’t do the trial drug but became deathly ill while taking the 3 other chemo drugs. His abuse continued and through a patient advocate I tried to get switched to a different oncologist but he put all the blame on me for his abuse and my request was denied. He was such a narcissistic bully he later phoned me at home to threaten me he better not hear another word that I have complained about him. That was just the beginning of the abuse. There is much more and it got much worse. I began having insomnia and was then duped into seeing a psychiatrist on the pretext of “getting help with sleep meds”. The young female psychiatrist was also arrogant and very cold-blooded, and totally in collusion with my cancer doctors. As revenge because I tried to make my own decisions about my body and health (and do what was right for me) she put unfounded damaging labels, lies and absurd accusations and speculations on my permanent electronic records that continue to very negatively affect my health care to this day. (I made a good decsion to quit chemo early and then I later found out the clinical trial was terminated due to the fatal side effects – so much for their ‘doctor-smart, patient-dumb’ attitude)

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  11. I saw a doctor at Johns Hopkins back in the 90s. My psychiatrist sent me there because I’d taken a number of antidepressants and none of them were working. My shrink threw my file onto a table and said, “I’m sending you to Hopkins. They deal with people like you all the time.” So the Hopkins doc read my file, asked me questions for about 30 minutes, and when he found out that Elavil made me feel really good for a few days after a previous 18 month depression, he diagnosed me with “mild, atypical hypomania.” That’s all it took for everyone else to treat me for bipolar I…….After I read Glenmullen’s book Prozac Backlash, I decided to discontinue all psych drugs and got off of them. I’ve been drug-free for 17 years with no occurrence of depression. I think the docs had me on so many drugs that it was impossible to tell a drug reaction from my real personality. They did the same thing to my mother back in the 1950s, so not much has really changed.

    The worst part for me? No doctor believed anything I had to say because who has to believe a psych patient? I can’t wait to read your book, Bruce. Bravo for your work. I didn’t realize it at the time, but I am an anti-authoritarian, which is why I had so much trouble in the mental health industrial complex.

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    • Hi Annie, I have to tag onto this because my own doctor who specialized in Dissociative disorders had herself graduated from Johns Hopkins medical school. She was very clear in her instructions to be cautious about seeking treatment from Hopkins hospital because they wouldn’t believe I had DID and they’d change my treatments. She told me the director of psychiatry (Paul McHugh) had been her advisor and he didn’t believe in DID. The two primary diagnoses she treated me for were DID (which she later changed to DDNOS) and Bipolar 2, because I experienced hypomania in response to SSRI antidepressants. (Although she threw almost all the codes in the whole damn DSM at me at one point or another over the years trying to make something stick.) it’s pretty comical when patients are placed on a stimulant and an antipsychotic at the same time. Do they think too much or not enough? 😀

      So when my relationship with her started to deteriorate when I still wasn’t any better (or in practical terms more stable) after ten years of treatment, I did eventually get seen by Johns Hopkins Mood Disorders Clinic, and lo and behold, they didn’t just say I didn’t have DID, they removed the bipolar diagnosis too, saying that I had major depressive disorder clearly caused by complicated and prolonged grief over the loss of my children. I have the treatment and discharge summary with axis 1-5 diagnoses for proof.

      Sadly it took another two and a half years of bipolar treatment before I was willing to ditch my own belief that I was seriously mentally ill.

      When people ask me what it’s like to be off meds, I say “I can think again”. And what a precious gift that is. Of course, one of those thoughts is: if someone tells you to do or not to do something, consider if they’re reaping a financial benefit from keeping you in the position you’re in.

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      • Bravo to you and screw the JHU Mood Disorders Clinic. I volunteered at JHU in a depression support program back in the 90s and all they cared about was finding a gene for each illness. Now that we know the DSM is bs, the challenge is to come up with a new label—–I hate the term mental illness–which implies some kind of brokenness……I think emotional distress or appropriate sadness/confusion is a much more apt description. I never met anyone with any kind of emotional struggle who didn’t have a darn good reason for feeling the way they do.

        I am more and more on the side of a humanistic approach to trauma and distress. We need to support each other and care for each other, not drug each other.

        And yes, I can think again and feel again as well. My biggest complaint when I was on psych meds was that I couldn’t feel—no one told me that was due to the drugs—I thought I was just too depressed to feel anything. Just awful what docs do to people. And what drugs do.

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        • Annie, I’m totally with you saying screw the JHU Mood Disorders clinic. I am definitely not singing their praises, more like shocked how hard a doctor will try to keep her patient from hearing a second opinion. The revenue stream is a powerful motivator. I certainly don’t believe it was out of concern for me. (Though I think she was otherwise a nice person.)

          But I’m absolutely with you that emotional distress has a cause. Being fearful of someone who puts a gun to your head in front of your child and having your attempts to get away from that violence labeled as an extreme state/response is what hurt me the most. The fact that my ex husband can still buy a gun but I can’t just boggles my mind.

          It’s totally true that trauma (and an inherently traumatizing culture) is the number one source of emotional distress and we need fundamental changes to our cultural response to those in distress. What good is help when the helpers harm?

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          • Afterthought: thought I should add that I don’t actually want a weapon. I abhor guns. But I am left feeling like the systems which aim to help us end up doing harm a lot of the time by penalizing victims worse than those who traumatized them . And this transcends psychiatric practice to many other areas of society when it concerns notions of help.

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        • The DSM-5 is really nothing more than a catalog of billing codes…. All of the bogus “diagnoses” in it were INVENTED, not “discovered”….
          If so-called “mental illnesses” were any more “real” than presents from Santa Claus, then they would have existed before they were discovered.
          Instead, the so-called “mental illnesses” in the DSM-5 did not exist until they were INVENTED, and PUBLISHED….
          Think about it….

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  12. I am researching the medical industry in the US, particularly the form of government under which it operates and the political relationship between medical governing entities and the institutions created under our state and federal constitutions. The term “medical fascism” has been coming up more frequently in Google searches lately, so your article is very timely.

    In the US, the medical industry taken together, including the pharmaceuticals and insurance, has some powers of a sovereign state. For example, in 1986 Congress granted the industry a nationwide exemption from liability under state and federal product liability laws for vaccine injury. This unusual protection is akin to the “sovereign immunity” from suits that legitimate constitutional governments claim for themselves. Another form of sovereignty is the de facto ability of the medical industry to “seize” citizens for the purposes of treatment, especially children. For example, in 2015, a Connecticut teenager 4 months shy of her 18th birthday was arrested, brought to a hospital in handcuffs and forced to undergo chemo against her will and her parent’s will. The industry also has the ability to levy a form of tax through the ACA. Failure to pay medical insurance premiums to an ostensibly private industry results in the public authorities exacting a “Individual Shared Responsibility Penalty,” which is a fine by another name.

    If big medicine has political sovereignty it must have a political system. “Authoritarianism” refers to a form of governance with four qualities: 1) intolerance of political pluralism, 2) claimed legitimacy based on emotion instead of fact, 3) minimal social mobilization (aka civil society), 4) vague or unlimited executive power. It’s fairly easy to shown the 1, 3 and 4 apply to the US medical system. Regarding 2, medicine has always claimed that it is a science-based endeavor, but is it? Dr. Richard Horton, the editor-in-chief of the Lancet stated in 2015 that “The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.” Dr. Marcia Angell, a physician and longtime Editor in Chief of the New England Medical Journal famously said that: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine.” The fear-based emotional appeals and the industry that “sells sickness” is well documented. Hence we have each element of classical authoritarian political system.

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    • TMcLeod – I applaud your efforts in trying to put what has taken place in the medical industry in perspective. I do have a little insight to share that might make your linkages go from anecdotal, to factually based.

      Number 1 – Universal Commercial Code – that is the “legal” basis for all that has taken place. It is recognized by the Federal Government and most state governments. That portion of code actually renders our Constitutional Rights useless.

      Number 2 – ICD Coding .. .Essentially “International” Insurance Coding – When referring to the Medical/Psychiatric systems, it is not just in the US, but Most of Western Civilization.

      Number 3 – this is the hardest one to grasp initially, but ends up putting it all in perspective. CORPORATISM
      Capitalism is not the only “for profit” economic model. Corporatism is one also and has been alive in one way or another for 100’s of years.

      If you think more in terms of Guilds . . . Barristers (BAR), Masons, Bankers, Doctors (AMA), Psychiatrists (APA) . . . essentially a trade of sorts that requires levels of approved achievement before allowing full entry. Review wikipedia for a gloss-over on Corporatism, especially Neo-Corporatism.

      If one reviews the history of powerful families and interests (US and abroad) and the way they maintained power, and wealth, it becomes clear. . . governments serve them and their interests. This is why you see all the immunities given away for corrupt corporate behaviors. These families and corporations outlive politicians and even at that, politicians aren’t their real target.

      The Judiciary on both the Federal and State levels are the targets in the US. It has been long known, at the State level where many Judges are elected, they are the targets for lobbying groups. There are relatively few judges up for election, yet their are often over a 100 elected officials in each State’s House and Senate. It is considerably cheaper to buy a judges bench.

      Besides that, the Judges interpret the law . . .who can bring suit . . . who goes to Jail . . . who gets Committed. They become the gatekeepers . . . forcing the LAW now to be similar to a Corporatist Economy. Whereas a Corporatist economic model puts up substantial barriers before entering the marketplace. . . Sound familiar? . . .the only way to enter the marketplace is to create your own niche. The Judges are the barriers to the exercise our redress of grievances.

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      • @ds_ghoste yes, corporatism and is a type of classical fascism (not the ethno-state type that the Nazis created) where corporations aka “syndicates” share power with a powerful central figure or group. The western medical model is a corporatist model.

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    • Well to be clear, and I don’t think a lot of people are aware of this yet, CMS has changed the HIPAA rules to allow so-called “interoperability” between providers. No longer does a provider have to get your written permission to share your records with another provider. In fact, your EHR is now populated with the record of all doctor visits you attend automatically. There is no such thing as privacy anymore. Want to get a second opinion without telling your current doctor? Not anymore. Additionally, because all this data flows through CMS, the federal government is now keeping a detailed record of all doctor visits of every American citizen. Think on that for a second. How did I find this out? Not here on MIA. Here are some relevant links:

      Why Patient Privacy Rules Should Not Be Eroded: https://www.lymedisease.org/hipaa-privacy-rules/

      A Dissapointing EHR:

      CMS Finalizes Changes to EHR Interoperability Rules:

      This is medical fascism, yes. The answer is to boycott medicine for anything that isn’t urgent like a broken bone or heart attack, or chronic that requires actual medicine like insulin. You no longer own your health or the services you receive.

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      • Wow. Just wow, KS. I think you are right. I personally do not see doctors for anything. I had my eyes fixed because I had to. Yes they had some old info. They knew I had kidney disease. They didn’t access my old Boston records and now it’s been so long (six years since last shrink visit) that I doubt they will. They had access to ophthamology records from 2016.

        This is what I do, and I recommend it to anyone. Do not use insurance! As KS said, do not see a doctor unless you get shot or hit by a car. I do get blood tests but I pay out of pocket for them and I don’t go to a doctor to get them prescribed. The results are not shared. They might send an email telling me my levels are off, but that is it. Like I don’t know this already!

        Most naturopaths will not share with your doctor, but beware of the ones that insist on it. They aren’t real naturopaths! Any alternative practitioner may advise but you aren’t obliged to take that advice. That is the beauty of it. You decide, and you take responsibility for your own decisions.

        Read up on stuff on your own. Take everything with a grain of salt. Ask yourself if what you are reading is logical. If it sounds like a scam, it likely is.

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        • Not using insurance is not good enough. I paid for an urgent care visit last summer with an HSA debit card (the equivalent of paying with cash). I found out about two months later that they still attempted to bill Medicare for the visit.

          I’m sure there are underground physician networks (likely in communities of color) that I may have to explore. Ever watch that episode of Weeds where Marvin got shot and U-Turn gave Nancy directions to drive to the doctor that doesn’t keep records? This is what those concerned about their privacy are going to be driven to do.

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          • Oh sorry that I wasn’t clear. Do not go to doctors that take insurance. I also went to Urgent Care one time and I knew that they’d find out that I was on Medicare at the time. I left the ER AMA when I realized they weren’t going to do anything good for me medically.

            There are plenty of naturopaths that you can find if you look for them. Not ones hired by hospitals! Ones that work entirely independently. No real naturopath will go along with the insurance system. Contact me if you want the names of a few. There’s no reason to see a Western doc if you do your own research, including reading what various naturopaths have to say. You choose! This, by the way, is why I’m alive and not dead. I make my own choices, allow myself room for error, adjust when necessary, and lo and behold, I’m far more healthy and energetic than I was the entire time I was in the MH system. Even with kidneys that don’t really work.

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        • And Julie, something else you may not be aware of: you cannot sue a provider for violating your HIPAA rights anyway. So what is the point of having rights? ‘You’ have ‘rights’ so that the government can extract fines from providers they determine have violated the rules. This amounts to a tax and has nothing to do with your privacy or remedying the harm that comes to specific patients.


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          • KS – I generally agree with your assessment of HIPAA. As a former HIPAA Auditor, I am well aware of the efforts to maintain compliance for compliance’s sake.

            The important takeaway in the HIPAA Case I noticed, under #3, ” [the patient] has failed to state a claim upon which relief can be granted”

            All civil actions require harm to have occurred and that harm be traceable back to the action(s), or inaction(s) mentioned in the complaint. That is not the situation in the displayed case.

            Now, let’s switch over to a HIPAA violation that is real, but not quantifiable. In Long-term commitment scenario’s, many times a patient’s psychologist will confer with other staff psychologists about said patient. Carry this over into what happens inside these places, a patient REPUTATION gets created. As many psychologists in these places are in charge of group interventions, they deny access to the interventions to said patient based upon REPUTATION. . . even though interventions are considered “treatment.”

            Of course, the patient’s staff psychologist never gets permission from the patient to talk about said patient. This REPUTATIONAL harm is directly acknowledged by HIPAA, but rarely executed Civilly.

            THIS SHARING OF INFORMATION is A KNOWN AND ACCEPTED requirement in Private Practice Psychologist.

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        • Ok last link. This one with more information about how the government is collecting and aggregating this data – the author calls it the “government EHR”. (The notion that it’s for greater patient access to their data is a myth and propaganda used by CMS and ONC to sell it to the American people and legislators via the ACA and then further in 21st century cures act.) It also reinforces what I’ve been pointing out about physician burnout and the contribution of the EHR in that, because I think most of us are familiar with a doctor having their head in a screen for 90% of an office visit. (I haven’t had an actual physical exam by a doctor in years. They don’t touch their patients anymore as far as I can tell. No sink to wash hands, often not even hand sanitizer in exam rooms. Where on earth would they find the time?) I’m definitely buying the book that was mentioned: Big Brother in the Exam Room.



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          • Kindred, the naturopaths that I know are far removed from all this. You have to have a certain amount of self-preservation around these Western medicine folks. Yes I still flinch when I have to walk past an urgent care center and every time I thank my lucky stars that I am walking past….as fast as I can!

            I agree, they actually justify the HIPAA violations. I did call a hospital once to point out the HIPAA violation they did and they apologized. That happened at the surgical center when I had my eyes done. They said some stuff to me when the guy giving me a ride home was in the room. An apology was enough. Plenty enough. They admitted fault and said they would be more careful next time.

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          • Julie – I’ve found you have to be careful with naturopaths and alternatives, too. Especially if one is trying to come off the psych drugs – naturopaths, just like all practitioners, have their favourite modalities, and not all of them apply to all people.

            While it is less likely that a naturopath will poison you, there is still a good deal of harm in the name of “natural medicine.”

            My approach is to do my own research, and my natural practitioners are partners. I may or may not take their advice, depending on my knowledge, history and experience in my body, but I am thankful to have someone to consult with when I get confused about symptoms.

            Sadly, because of what psychiatry and medicine has done to me – I have a lot of confusing symptoms.

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          • I also find that a good percentage of alternative practitioners have adopted the DSM “diagnostic” terminology, which affects both how they talk to people about their difficulties and the kinds of strategies they tend to employ. I’d keep clear of anyone who is still talking about “natural remedies for bipolar disorder” and the like – they are still steeped in the medical model, just coming up with other “magic bullets” within that model.

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      • Kindred – you are a gem!

        This is stuff I was unaware of.

        Australia has something similar – because it’s roughly a single payer system (with a tier for “private insurance”) – the government knows nearly everything.

        This year they rolled in MyHealthRecord which is a record that goes across all platforms. All labs, all visits, all tests, everything goes onto this massive database. You can opt out of it – but it’s tricky, and they don’t make it easy. I have opted out.

        I first noticed it when my Orthomolecular doc ticked a box on my labs that said, “DO NOT SEND TO MYHEALTH” so I looked it up, you had until a certain date to opt out – after that date, too late, you’re in the system…

        It sounds similar to what they are doing in the US. The only advantage I see in the US is that it paves the way to socialised medicine. There would be a small advantage for people travelling to be able to access records about epilepsy or allergies.

        But on the whole, I’m with you. Don’t use the system unless you have to! (the problem is, unless we all boycott, the beatings will continue!)

        THANK you for all of those resources!

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  13. Dr. Levine – I highly approve your book also. I do have reading recommendations and I left them in my Amazon recommendation. Your insight not only in your books, but your lectures and all your writings have inspired me to be here at MIA. I would love to buy you a cup of coffee sometime as I am only about 40 minutes away and am in your area regularly. I would like to discuss an opportunity that may benefit MANY. Your experiences and abilities in the spoken and written form could help correct a societal evil off exit 9.

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  14. Bruce, the article you cite and link to mentions “shift in responsibility” under the part about the willingness to inflict pain.

    This is why psychiatry is inherently cruel to its “patients.” The psychiatrist is not responsible to those he diagnoses as “severely mentally ill” but to Society as a whole. He is no more working for us than a prison guard is working for prisoners or an exterminator is working for the rodents he kills.

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  15. This is an excellent article; thank you Bruce. I would like to add that psychiatrists are often more authoritarian than other “doctors” because they do not know what they are doing, have little success in their “practice”, and resent their patients for not affirming their medical school “expertise.” This is also the reason psychiatrists have a higher rate of suicide than other “medical” professions.

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    • Has anyone ever studied the Suicide Rate of Patients under a specific specialist doctor’s care? I am sure the rate of General Practice doctors (those we all see at one time or another) is much lower than that of Psychiatrists.

      Generally, many uninformed individuals would come to the reasonable result that is due to the nature of the patients seen.

      Informed individuals would realize that is the result of unethical methodology, harmful meds and an unwillingness to acknowledge individual patients’ suffering and coping adaptations.

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  16. I think what sort of misses the mark here is that the use of the term “authoritarian” is problematic in the same way as is often the case with “racist” — it can be used as a noun, to identify a person as embodying or embracing such a characteristic, or as an adjective, to describe an attitude or behavior. There is no “Authoritarian Party” as there is a Libertarian Party or a Democratic Party, so one is not “an Authoritarian” in that sense either; “authoritarianism” does not embody an ideology but a style of behavior. All governments exert “authority,” ultimately via force (violence).

    Psychiatry is more than an expression of “attitude”; it is a tool used on behalf of governments, corporations, and other institutions holding up a specific world economic order — the one we live under. Whether or not it can theoretically be used to prop up some other system is academic, because THIS is where we are RIGHT NOW. So I would zero in here to be a little more precise — psychiatry in 2019 is an expression of corporate monopoly capitalism, not “authoritarianism.” Again, ALL governments are “authoritarian,” even those one might support; that’s the definition of government.

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    • Self-governance need not be authoritarian.

      I don’t think use of the word antiauthoritarian misses the point at all.

      Synonyms for authoritarian include autocratic, dictatorial, totalitarian, despotic, tyrannical, autarchic, draconian, absolute, arbitrary, oppressive, repressive, illiberal, undemocratic, and antidemocratic.

      When speaking of a sun king, perhaps it is high time that sun best set. Caesar’s infatuation with Alexander need not infect the rest of us.

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      • Authoritarian is an adjective, although person or government might be the noun authoritarian describes.

        They have a saying in France, usually applied to the sexes, “Vive la difference”. As applies to the sexes, so too governments and people. Forget the distinctions between them at your own peril.

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    • @oldhead In psychology authoritarian may be a behavior pattern but the word authoritarianism also describes a political system. The sociologist and political scientist Juan Linz described this system in 1964 as having four primarily characteristics that distinguish it from other systems. It certainly is a political ideology. If you doubt this please read up on National Socialism’s Führerprinzip or Stalin’s cult of personality.

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      • the word authoritarianism also describes a political system.

        The fact that someone has a pet conception (again with the “models”) doesn’t change a whole lot. Authoritarianism describes a style of governance, based on obedience as a “value” perhaps, but that doesn’t constitute an ideology in and of itself, and has characterized fascist as well as (at least in name) socialist states.

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        • I have always viewed authoritarianism as more of an attitude as a system. An authoritarian believes that some people are above and others below, and that those above get to give orders and do as they please, while those below have to follow orders and do as they’re told. Of course, one can be below someone and above someone else, so the basic rule of authoritarianism is “fecal matter descends to the area of lowest gravitational potential.” Those higher in the structure have entitlements and different rules, but any frustration the authoritarian may feel can be dumped on those lower than them in the structure. It’s all about in-groups and out-groups and hierarchies and entitlement and force and power.

          As Oldhead properly observes, any political party or structure, as well as commercial and religious groups, or really any group of people can have an authoritarian set of social expectations. It is more about how people interact with each other and how decisions are made in the group than it is about political orientation.

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