The Australian Productivity Commission (APC), which is a division of the Federal Treasury, is holding an enquiry into mental health. The APC functions by “providing quality, independent advice and information to governments, and on the communication of ideas and analysis.” It has extensive powers of investigation of government but is not a judicial body. At present, they are looking into why youth incomes have stagnated and setting up a policy for Integrated Water Management, so mental health fits neatly into their portfolio.
Normally, the APCĀ brings outside experts to assist in its studies. In this case, Prof. Harvey Whitefordof the University of Queensland, was invited to sit as a commissioner of the mental health enquiry. There is no question that Whiteford has the CV to qualify for this post, including having served as Director of Mental Health Queensland, Director of Mental Health for the Commonwealth Government in Canberra, and holding an appointment at the World Bank in New York.
I sent a lengthy submission last year, available here. It has several appendices and concludes that psychiatry is a mess but nothing short of a revolution will fix it:
The institution of psychiatry wants everybody to believe that they have the matter firmly in hand, that theirs is the only conceivable approach to mental disorder and that all criticism is malicious: “Move on, nothing to see here.” Nothing could be further from the truth. We have reached the point where we have to ask: Is psychiatry doing anything useful for society, or has it degenerated to an insatiable, high-cost and self-sustaining rentier gorging on the public purse? It is to be hoped that this honourable Enquiry will assist in the process of uncovering that truth.
In particular, I emphasised that a lot of what passes as standard practice in psychiatry is little more than institutionalised corruption. I was gratified to see another, anonymous submission, which detailed a case of frank corruption at the highest levels of psychiatry, here, and hope something comes of it.
The APC has been holding hearings in major cities and, on December 3, 2019, it was Brisbane’s turn. I was lucky enough to get a slot and ended up with nearly 45 minutes to give the following presentation, followed by questions from the panel. Audiences at these sorts of hearings are never large; in Melbourne and Sydney (both of which are considerably larger than Chicago), they attracted only a half-dozen stalwarts, but in Brisbane I had an audience of about twenty people. To my surprise, at the end of my presentation, I got a brief round of applause from the audience.
With a few minor explanatory amendments, this is what I told the Commissioners:
The overview of the draft report crams a lot into a small package. There are many recommendations, most of which are uncontentious, but they won’t come cheap: the bill for specially-trained teachers in every school is nearly $1 billion a year. That item is part of a very large expansion of the bureaucratic, regulatory, and research machinery governing the institution of mental health practice. This is not surprising: if you ask a group of bureaucrats, lawyers and epidemiologists for their advice, their answers will automatically orient in a particular direction.
The only surprise lies in the fact that they are suggesting something we already know won’t work. Fifteen years ago, in a review entitled Do nations’ mental health policies, programs and legislation influence their suicide rates? An ecological study of 100 countries,1 the authors concluded: “It is of concern that most mental health initiatives are associated with an increase in suicide rates.”
It’s not clear why they were so concerned as this was first shown in the mid-1960s. After mental health services were introduced to the Baltic island of Bornholm, everything got worse. In 2014, an exhaustive Danish study showed what an editorial by two Australian psychiatrists called “the disturbing possibility that psychiatric care might, at least in part, cause suicide.”2 It emerged that contact with mental health services didn’t cure suicidal urges but seemed to make them worse.
The editors, Matthew Large and Christopher Ryan, appeared shocked by the thought that the trauma and stigma of being hospitalised may push people over the edge, that a visit to the local emergency department was “suicidogenic,” as they put it. They shouldn’t have been shocked. You only have to talk to patients to find out what they thought of their “hospital experience,” and it isn’t nice. The more we spend on mental health, the more prescribed drugs people take, the more ECT we give, the worse the outcomes.
An earlier 2004 paper, whose authors included Prof. Whiteford (i.e. a member of the panel of enquiry), asked whether “there may be acceptable reasons for the observed findings.” This tends to be the response of the great majority of psychiatrists who only want to hear answers acceptable to themselves. As the late Carl Sagan noted:
ā…at the heart of science is an essential balance between two seemingly contradictory attitudes ā an openness to new ideas, no matter how bizarre or counterintuitive, and the most ruthlessly sceptical scrutiny of all ideas, old and new. This is how deep truths are winnowed from deep nonsense.ā
I submit that the reason massive expansions of the bureaucratic, regulatory and research machinery don’t achieve what they are supposed to is because the entire model on which it is based is not just broken but, in fact, doesn’t exist. All the recommendations listed in the overview won’t change this because psychiatry is riven by deep nonsense.
Take the recommendation that children should be screened for signs of mental disturbance. Will the psychologist tell the parents: “Your little Johnny is playing up at [kindergarten] Ā because of all the arguing at home, he’s just copying what he sees.” Or “Your little Emma is seriously anxious because her father yells and punches walls while her mother is out doctor-shopping for drugs.” That won’t happen. What will happen is that the parents will be told “Johnny has ADHD and needs to be on drugs for life,” or “Emma has ASD and Social Phobia and needs to be on drugs for life.” And they won’t get better.
Let’s look at my bete noire, ECT. I provided all the figures in my critical review of ECT, published last year, which was appended to my submission.3 From 2005-2015, private ECT in Australia increased by 87%, including an implausible 191% in West Australia. In the UK from 1985-2015, ECT usage went down by 90%. In my 42 years as a psychiatrist, including 25 years in the far north, I have personally assessed and managed somewhere from 12,000-15,000 unselected public patients.
Today, I run a bulk-billing practice in a working-class suburb, with about 300 new referrals per year, patients who would otherwise go to MHS, if they got any treatment at all.4 In 42 years, not one of my patients has ever received ECT. Not one. If I can practice public psychiatry in Perth, in the Kimberley, in Darwin and in Brisbane without using ECT, so can every other psychiatrist in the country.
According to the [Royal Australian & New Zealand College of Psychiatrists], ECT is an essential (their word) treatment for severe, life-threatening depression. If that is the case, can they explain why the overwhelming bulk of ECT in this country is given to distressed, middleaged, middle class, white women in private hospitals? The answer, of course, is money. The psychiatrist gets about $200 for pressing an electrode against an anaesthetised patient’s head, about two minutes “work” at most. Yesterday, I saw a 47-year-old veteran with a wrecked back whose wife had just left him. He hates psychiatrists, so we had an interesting hour. I did my report last night, another half hour. $225 for an hour and a half of difficult and potentially dangerous work; naturally, psychiatrists like ECT. An admission to hospital for twelve ECT costs something of the order of $57,000, so private hospitals profit handsomely. ECT in Australia is a $500-million-a-year industry, yet none of it is medically necessary.
As it happens, I get the same results as they do in the same or less time for under $1,000, about 98% saving. I am utterly unconvinced that ECT is essential, safe, necessary, or effective. Over many years, psychiatrists have shown themselves unable to self-supervise, and it should therefore be banned. There is not a shred of evidence to suggest that mentally troubled Australians would be worse off, but the Commission will not hear this from mainstream psychiatry.
Same goes for the suggestion that the “emergency department experience” should somehow be made less awful. That is completely wrong. The only way to prevent the “suicidogenic stigma and trauma” of going to hospital is to provide accessible local services. Of my 300 new cases this year, practically none will be admitted to hospital. If service is locally available in a pleasant setting, if people are seen on time and don’t have to wait, if they see the same person each time, if they are not brutally forced to take unpleasant and/or dangerous drugs, if they’re not treated as cattle, then people will happily stay away from hospitals. Nobody wants to go to hospitals; they’re dreadful.
The problem is that mainstream psychiatry controls the narrative of mental health, and I use that word in its very worst, post-modernist sense. Results like mine threaten mainstream psychiatry’s narrative: that they know all about mental disorder and it only needs a few tweaks and a flood of money to make it all come together. This is false. Mainstream psychiatry does not have a model of mental disorder;5 therefore, their treatment is a hotch-potch of serendipity, ideology, and blind poking. However, they routinely mislead the general public. For example, the claim last year by the RANZCP that “The prescription of medications is something that a psychiatrist only ever does in partnership with the patient and after due consideration of the risks and benefits.”6 Or that ECT is āessential.ā No, itās not.
ECT is part of the deeply entrenched, institutionally-sanctioned soft corruption of over-servicing. I note somebody else has commented on this at Submission No. 513. I urge the Commission to study that in detail, and impartially. But it is not just in the private sector. I remind you that it costs Queensland Mental Health Services four times as much for their junior staff to see their outpatients as Medicare pays me, a senior psychiatrist, and we are seeing exactly the same patients.7 The only figure I have seen for their in-patients came from Brisbane’s Princess Alexandra Hospital, $2,237.65 per day. Every day I keep a person out of hospital is a massive saving, but it can’t be done under the standard model of treatment.
More of the same, as suggested in this enquiry’s draft report, will not achieve anything except create lots of jobs for bureaucrats, lawyers, and epidemiologists. All too often, more means worse. Down at ground level, where I practice, nothing will change. At $65 million a year, you can believe me when I tell you Beyond Blue has had zero effect in Redbank Plains. At $11 million a year, [Queensland]’s Mental Health Review Tribunal has not led to any improvement in practice. More likely, it has made it worse because medical staff spend more time writing reports than they do talking to patients. Headspace? Forget it, a non-event, and $350 million of new money isn’t going to change that. Digital files? If this8 is what will be stored, why bother? GIGO. Garbage in, garbage out. All this money would be better spent on public housing just because the real problem in psychiatry lies much deeper than the proposed solutions can reach.
It has reached the point where psychiatrists routinely attack anybody who has the temerity to criticise their entrenched view. For example, the UN [Human Rights Council] Ā Special Rapporteur on Mental Health has issued two reports critical of mainstream psychiatryās reliance on drugs and regulatory systems. For this, he has been subject to a barrage of ill-mannered and factually wrong criticism. When psychiatrists are so insecure that they need to assail the UN HRC, we know there is something seriously wrong.9
There is indeed something rotten in the state of modern psychiatry, and it is the artfully concealed absence of a formal, articulated model of mental disorder. When medical students vote with their feet in not choosing psychiatry as a career, they are showing that they are at least intuitively aware of this. All the money in the world, all the committees and research projects arenāt going to do more than rearrange the deck chairs just because deep nonsense has now taken control.
No doubt for daring to expose this, I will be subject to the usual barrage of secret complaints by anonymous authors, which will be investigated in camera by an unnamed committee considering evidence I am not allowed to see, who will reach a decision that favours the status quo, and for which there will be no effective appeal. Because that’s how psychiatrists operate. The one thing they will never do is have a fair, open, transparent and, above all, honest debate about the realities of being mentally disturbed in Australia.
Niall,
Way to go!
I know some people lose hope that psychiatry will end with it’s falsehoods.
It has no choice but to fail. They are failing now.
The government does not need more mouths to feed, and since psychiatry is a great part of contributing to keeping populations “sicker” than they need be, at least it is becoming quite visible that the trending narrative is about as far from truth as we can get.
They are exposing themselves not only to yourself, but to other systems within society and to each other.
And this awareness is happening in the here and now. It is simply a matter of time.
There is no point in arguing with those who keep clinging to delusions. In time, they succumb.
Thank you for your brevity and your resolve. We are in this together.
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Niall,
I am quite aware that I cannot impart any new eye openers, we all know the corruption of “mental health” industry.
One of my greatest concerns at the moment are the outright attack on children. It is not possible that psychiatry is itself so deluded to think it is somehow okay to isolate millions of children into their hands. Sure it looks like they are living in their homes, but in reality they are prisoners of an idealistic view or pretense of views.
It is cult like. No really it IS a cult.
From my own experience of myself and others is that psychiatry breeds helplessness and hopelessness, through defining people as broken, and through drugs.
THAT is where suicide wins, is through the hopelessness and drugs. For our politicians to not get radical about this horrible slaughter is inexcusable.
Much luck to you, we are here for you, however we can help.
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Sam,
Psychiatry is more gravy train than cult.
The system of chief psychiatrist for each state also establishes a power structure that ensures that psychiatry as a whole is doing what its political masters (and therefore the media behind them) want.
There are some great practitioners out there, but it is a mixed bag, especially if you have to deal with any psychiatrist in the state system.
The issues with psychiatry are largely issues of bureaucratised medicine- and find an analogy in the bureaucratic delusion (strictly enforced) that Lyme disease doses not exist in Australia.
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“From 2005-2015, private ECT in Australia increased by 87%, including an implausible 191% in West Australia”
And here’s me thinking that the reason for the recent power cuts was a heat wave.
“According to the [Royal Australian & New Zealand College of Psychiatrists], ECT is an essential (their word) treatment for severe, life-threatening depression. If that is the case, can they explain why the overwhelming bulk of ECT in this country is given to distressed, middleaged, middle class, white women in private hospitals?” Is it a coincidence that these are the same demographic targeted by domestic abusers? Is the ‘treatment’ originally used to get soldiers to return to the battlefield being used in much the same manner these days? Sending these middle class women back into war zones?
Perhaps Police might do well to raid a few of these ‘clinics’ as part of their operations against domestic violence. Never know what might turn up when examining the records. š
Jock, i’m in Perth and if your ever here and would like me to shout you a cup of coffee and a piece of cake let me know. I’d be interested in talking to you about some matters that may interest you. Under no circumstances would I ever enter into a doctor – patient relationship with a psychiatrist but happy to chat as citizens of this country that is regressing into institutional corruption on a daily basis.
The anonymous article to the Commission sounds a little too much like an unsuccessful ‘tenderer’, so I can’t see any action coming about as a result but …… we live in hope.
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Boans. This made me chuckle.
“And hereās me thinking that the reason for the recent power cuts was a heat wave.”
And yes I read the anonymous article, but stopped midway. I was waiting for something while reading, some surprise turnabout but doubt it was coming.
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Always good to get a smile š
Seriously though Sam, when they were discussing our new Mental Health Act one of the issues was the age at which psychiatrists could begin ECTs on children. There were concerns in the field that someone might bring legal action against a psychiatrist for their ‘treatment’ of a child in this manner. Without going into too much detail the clause allowing the forced sterilization of children without parental consent was removed, but they did set an age limit on ECTs of 14 years old I believe.
And I think the data above shows it’s been full steam ahead ever since. I guess we will have to wait and see if the ‘epidemic’ of teenage suicides falls as a result. Though I think that our politicians were merely attempting to look like they were doing something about the problem with knowledge that by the time the damage has been identified, they will be living in a Mansion in the South of France claiming unintended negative outcomes.
Re the article, the whistleblow is there, but one would need a good understanding of how the fraud works to see it. Can’t imagine it would make a lot of sense to someone who doesn’t have our system where the trough is being filled only to be syphoned off by unscrupulous operators.
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Psychiatry should be careful.
“invasion of the zombies”
I cannot imagine how treatments of a harmful nature are permitted by government. And how they are permitted to be used AGAINST children.
These are human rights issues.
Insanity is evident by a system, not an individual. One single man was able to convince a whole nation that they were superior.
I suppose in general, humans are just not bright enough to see underlying falsities,
They do not examine statements made to them and psychiatry caters to our prevailing hostility towards differences.
Psychiatry is a hostile practice unaware that it is attempting to cleanse the globe. In all cleansing attempts, a path of destruction occurs and that destruction bites not only the victims, but the supporters of the cleansing.
I wonder if south America is big enough to hold all the psychiatrists? Perhaps they have bunkers.
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The recent passing of a Euthanasia Law, the enabling act presented by our new Mental Health Act and we have a Prime Minister passing laws with zero (and I mean not one word of) debate, the raiding of journalists homes to identify whistleblowers, and now we are being told by our PM that we should separate ourselves from the UN (and by proxy the Conventions)? We need to stand up as a Nation independent of such bodies (so lets make it illegal for anyone other than the government to report human rights abuses to the UN. How many reports of rape would there be if only rapists could report them I ask?) we are being told via our propaganda machine. But this has all been seen before. They don’t like providing human and civil rights to folk, they don’t deserve them according to our elite. So lets do the Nationalist talk and have them think we are going to behave fairly with these new powers we are affording the authorities. Detention without charge, torture, targeting peoples families who are a threat to the status quo ………
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Sam Plover:
re the following:
“I suppose in general, humans are just not bright enough to see underlying falsities,”
I don’t think this is quite right. I think the issues stems from our inbuilt intuitive empathy and need to coexist in a tribal setting- at the peril of being banished, or having a bone pointed at us.
We evolved as tribal creatures in an interdependent society- and our core instincts are to fit i and be agreeable. In fact one of the big five personality traits that our psychologists talk about is “agreeableness”.
That’s all very well, but it leaves most of us following the line of being agreeable and fitting in even when the agenda is being set by a disreputable bully. That’s not stupidity, it is ore down to the psychopaths who rise to the top– especially in the higher levels of the public service.
I do not know how we re-balance this see saw of agreeableness vs dynamic but greedy individuals though.
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I loved this whole piece! Honestly! And this part especially:
“Take the recommendation that children should be screened for signs of mental disturbance. Will the psychologist tell the parents: āYour little Johnny is playing up at [kindergarten] because of all the arguing at home, heās just copying what he sees.ā Or āYour little Emma is seriously anxious because her father yells and punches walls while her mother is out doctor-shopping for drugs.ā That wonāt happen. What will happen is that the parents will be told āJohnny has ADHD and needs to be on drugs for life,ā or āEmma has ASD and Social Phobia and needs to be on drugs for life.ā And they wonāt get better.”
But, that ending… Could you maybe not refer to people experiencing extreme states as “mentally disturbed”. Language really does matter. Thank you!
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Hi kindred,
Yes I noticed. I was hoping that it was reflective of learned language.
I prefer “distressed”
And thanks MIA for the article and I especially like the illustration with the dangling carrot.
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“The Australian Productivity Commission (APC), which is a division of the Federal Treasury, is holding an enquiry into mental health.” Sounds promising, except the “mental health” workers are the “omnipotent moral busy bodies” for the globalist banksters.
But perhaps now that it’s largely known, at least by the “awakened,” that both the globalist banksters and their child rape profiteering “mental health” workers are amongst the evil on this planet. Well, one can maintain hope that the good will win in the end.
Thanks for doing your part, Niall. And absolutely I agree with you, the right for psychiatry to force their treatments onto others, including ETC, needs to be taken away. The “formerly” Christian nations need to get rid of psychiatry, since the psychiatric theology is largely the opposite of the Christian theology. What a sick shame the DSM “bible” is actually being taught in the seminary schools today.
Largely because the mainstream Christian religions bought into the psychiatric and psychological industries’, historic and continuing, primarily child abuse and rape covering up, system – by design.
https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
https://www.madinamerica.com/2016/04/heal-for-life/
https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1
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What I do not understand is why you would wish to continue to work in psychiatry. Forgive me if I’m wrong, but I presume you prescribe the drugs, yet know full well the lies behind it all and the harms. Why would you do that and not go into some other field as a doctor and expose it from the outside?
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The answer to nialls question posed in the title is NO and that is all any of us need to know. His submission to the “inquiry”will be ignored at best at worst will lead to further vilification and impuning of his reputation but at least he gets in there and gives it a go and for that we are grateful.
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Calling Jan Carol and Boans.
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“….When psychiatrists are so insecure that they need to assail the UN HRC, we know there is something seriously wrong.9..” Psychiatrists are doctors that are not employable doing anything other than what they do (prescribing “medications”) – I think this is what’s wrong.
[In the long run, as far as I can see, psychiatric treatments make people more, not less distressed].
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“[In the long run, as far as I can see, psychiatric treatments make people more, not less distressed].”
A by product of the Alchemical process? The production of ‘gold’ resulting in much human misery? Which of course will need to be dealt with by the State, and NOT the Alchemists.
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Fiachra,
I have wondered what a psychiatrist would do for employment if not psychiatry? Their “jobs” are closely related to interests, or lack thereof, money from parents, push from parents, and an ability to study, retain and regurgitate.
I believe some might have a curiosity about their own minds and a judgmental side to them.
Just my musings and what I have seen from students that enter “med school”. Also
bits n bites I have heard from doctors.
I am always curious how one could sit within a position that ends up hurting so many and not have the courage to stand up.
If someone questions their profession, they never fail to use “extreme states” (which most people have witnessed) as their concrete proof that they are helping. Never will they admit to what reasons they DO have. And by the time they are practicing, I think it is akin to an army, where you might have gone into it with a few questions about ideology, but those they learn to silence.
Eventually it’s just another day in the trenches, all thinking is aside, and by now, it’s also a lifestyle, while they combat the enemy, which now of course includes millions of children.
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Dear Sam,
What other medical speciality would employ people that are trained to operate at the standard of Psychiatry. I think for the most part they’d be unemployable!
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“…that theirs is the only conceivable approach to mental disorder and that all criticism is malicious…”
The 47 year old veteran (you mentioned) might be better off attending a 12 step group mixing with people who understood exactly where he was coming from.
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I was lucky enough to arrive at the productivity commission to hear Dr Mc Claren speak.
He was so honest for a psychiatrist about all the abuse of patients and public purse so obvious to us facing this system.
I got to speak after him, and gave my experience as a victim of system, exposing how despite my UQ Medical Degree I didn’t know I was taking a cousin of valium with temazepam or how my real issues or use of depressant was ignored before I was sent manic on SSRI.
I also mentioned how my education as GP by industry cosy psychiatrist led to my zoloft panic induced hospitalization and later Effexor induced suicidal psychosis.
Later I spoke to commissioner re difference between prescribing information and patient information esp re psychiatric side effects.
Glad this is getting international attention.
Hope Dr Niall gets a bigger platform, he’s a thinker with a big heart and real clinical skills. I wish I could consult him vs garbage I get from RBH docs.
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In the UK a 2nd generation Caribeann Man is 10 times more likely to be diagnosed “schizophrenic” than an indigenous UK man, but is not many times more likely to completely recover. Its the Psychiatric treatments that cause the “long term conditions”.
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Is there something about Australian psychiatry that would make the answer to the title question less of a no-brainer than it would be for any other brand of psychiatry? And should the obvious answer require a whole blog to explain?
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I think it might be a bit like the Eugenics movement in the world during the 1930s oldhead. Most coutries were dabbling in the idea, one took it to it’s logical conclusion. Australia is heading down the rabbit hole of National Socialism and will quite possibly be the model other countries will adopt, much like our version of aparthied was adopted by South Africa all those years ago. Or a more recent example of our police methods being adopted in Guantanamo Bay (see the Kennedy Royal Commission into Police Conduct). Cattleprods, bags (or buckets) over the head before beatings, waterboarding…. we were 20 years ahead of the times.
We’re trendsetters š
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Wow, Doc. You are in my neck of the woods! I thought you were up in NT somewhere, or I would’ve referred folks to you when they want to come off their drugs. Unfortunately, the only ones I have in this neighborhood are docs who go too quickly, and throw people into crisis, and then indicate that their “coping skills aren’t handling the consequences of the withdrawal from chemical assault. . .
So – that cuppa and cake which Boans offered, goes for me, too – I’d happily shout you to compare notes about tapering. And I’m “in the ‘hood” so to speak.
Good to know that someone on the inside see psychiatry’s crock of yhit for what it is. (I notice your “Rate a Doctor” ratings include what a grumpy bugger you can be – likely you didn’t give out the scripts they wanted!)
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Well Jancarol,
Doctors in general can be grumpy and I know what lies in their discontent.
It is not the meds. It is the disillusionment and that condition prevails across the board within professions that entered the “helping or fixing people, or systems”
Problem being, the consumer is left to feel the discontent. The discontent is rarely admitted or talked about. I mean, a doctor cannot use the patient as confidant, nor can he use the profession as a confidant.
Shame that the client bears the brunt of his own discontent plus the public servant.
There is much to be grumpy about when machines break down, and you realize the machine never worked as you imagined it.
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Thanks Dr. McLaren speaking out with such honesty and candor! The faƧade of psychiatry is desperately trying to conceal their rotten and crumbling core. Much gratitude for your work and your voice. Your submission is very thorough. This is some of what stood out for me:
āMy experience over nearly half a century is that reminding psychiatrists of their error provokes the most bitter hostility. They go to quite extreme lengths to prevent any criticism becoming public.ā
ā¦ā¦And this deletion is VERY telling (would have loved to read it!)
ā (e) Corruption in psychiatry. ā
āDeleted on legal advice, specifically “risk of action for defamation”.
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“Mental disorder is a reality. I don’t have any time for those who say psychiatrists have invented it to keep themselves in business.”
https://www.youtube.com/watch?v=bjABUhyu6dw&feature=youtu.be&list=PL19122100290F5A86&t=69
Given what we now know about the DSM via James Davis… that the conditions were voted into existance and the DSM caused epidemics – by the admission of Allen Frances – do you still hold to that view ?
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Yes, mental disorder is real, and sometimes medication is of great value.
Im 58, and on treatment for Bipolar 1 and ADHD- but with a sensible doctor who is keen on lower doses.
Now, in my case, the mental disorder creates trouble and hurts people I care about.
I worked as a doctor until 12 months ago- having to stop because of symptoms from an old whiplash injury.
I have spent lot of time thinking about this, and seeing other people in similar situations.
Most of them have a range of closely related issues with eye coordination, balance and fine motor coordination, and irregular stress responses.
I can meditate well- despite having ADHD and have been a Buddhist for about a decade.
My conclusion is that all these extra symptoms that I mentioned are part of the ADHD, and each one impairs attention.
The trouble is that we in the West do not have an adequate definition of “Mind” let alone mental disorder. Most of our mind is subconscious/unconscious and is more involved in background tasks- like getting your eyeballs to point at the same target quickly enough to be useful.
The opthalmologists call this “binocular vision dysfunction” and it has the same symptoms as ADHD!
However the ADHD symptoms are exhausting and demoralising (a second level of dysfunction) and do need attention of some sort, or your “patient” will struggle in almost all activities for the rest of his life.
Now here is what bugs me
1) ADHD is recognised as a neurodevelopmental disordeer.
2) It has all these co-morbidities (dyspraxia dyslexia, binocular vision disorder, dysautonomia) which are guarantee to produce a poor outcome on any academically based attention task but for some strange reason are classified as a separate problem.
3) The Swedes have come up with an umbrella term “Deficits of Attention, Motor Control and Perception”
So, in Australia, some kids get an occupational therapy review, but the majority do not. They do not get a comprehensive and careful neurological examination needed to find these issues.
No adults get that or any sort of neurological assessment.
I should know, I’ve been seeing psychiatrists for 30 years.
Psychiatry is like the curate’s egg: good in parts, but in all that time i have never had a psychiatrist do any more than examine my blood pressure.
My breakthrough was being approached by a chiropractor who specialises in neuro- rehabilitation/ functional neurology because he was concerned about my bloody gait and neck posture ( we met at a conference focussing on meditation in psychotherapy- and sitting up right with a straight neck is highly relevant to good results in meditation). His initial assessment was frankly scary- he believed I might have Lewy Body Dementia (not good at age 46). His work has been immensely valuable to me and he has had me read a good deal of the neurology work that underpins his practice. Things are improving in terms of my attention and alertness, despite the orthopedic issues with my neck.
Trust me- it is a humbling experience for a medical practitioner to meet a chiropractor who surpasses him in virtually all areas of practice.
So here it is:
We do not have a proper definition of mind.
Therefore we do not understand the relevance of the symptom clusters I mentioned above (even though some radicals in Sweden know better).
Therefore we classify them as “not ADHD, but comorbid”.
Therefore we do not do examinations. Who the hell thought that an assessment of a person with a supposed neurodevelopmental disorder could possibly be complete without doing a bl@@dy neurological examination?
It beggars belief.
The neurological signs of ADHD are very clear if you know what you are looking for.
What is wrong with people?
It comes down to this– if you do not operate from a solid and sound definition of mind, you should stay out of the field.
The bad results we are seeing are a result of woolly thinking.
However, there is an antithesis to this– if you don’t have a definition of mind that makes it possible to understand these conditions— how can you hope to criticise current medications or treatments?
Any comments gratefully accepted- I want to sharpen this one up. The task of making the most of this line of thought has been troubling me for a good while.
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“However, there is an antithesis to thisā if you donāt have a definition of mind that makes it possible to understand these conditionsā how can you hope to criticise current medications or treatments?”
If I do not have definition of mind, I don’t pretend to. I as a shrink explain my almost laughable knowledge, and as an educated person would be embarrassed to promote it.
I especially would be embarrassed to present it as “illness” and I sure would not participate in a practice that gives labels that affect people in every single area of society. I would not participate in using drugs like Haldol, etc, and then try to poopoo the effects. Or misrepresent effects as part of illness.
NO good care is ever involved in practices that violate people.
And all this goes on WITHOUT knowing mind.
The alternative is for psychiatry to come clean. Admit it all, take away harmful labels, offer people the drugs along with ALL information along with user information, along with the true fact of not knowing.
I’m with you on the eye thing. Because of me searching my own brain, to the extreme of watching others, I came to the conclusion that even though I do not possess medical knowledge, if scientists started to listen to consumers, of what the consumer thinks the problem is, they might actually find something.
I’m not using grandiose thinking, it’s desperation and realization that science holes up in labs without opinions.
It’s amazing what knowledge lies in someone that has studied themselves for years.
Eye problems could theoretically result in many so called MI issues, from avoiding to psychosis and everything in between.
It could also result in “trauma” from parents that don’t understand the baby’s eye or other neurological issue and respond to it in frustration.
So in this way, I believe there is no MI. And neurology is in such EXTREME infancy, almost not worth mentioning. I went to a neurologist 25 years ago, who was wise enough to say that even though he was giving me tests, he felt as if he was using equipment from the 1800’s. The only doc I ever met that said something profound.
Well I did know one doc who had a chinwag with me about the dreadful way we extend people’s lives and drew me graphs lol. And then there was my GP friend who told me that shrinks are nuts.
Each one contributed to shaping, or validating my questions.
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Well said! It is the responsibility of those claiming to “treat the mind” to come up with a coherent definition of the “mind” they are supposedly treating. Those criticizing the approach don’t need to define “mind,” they just need to point out that those claiming to be “treating” it can’t define their terms.
You can’t treat a metaphor!
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These people seem to struggle with burdens of proof. For example it has been claimed that it is my burden to prove that I was no ones “patient” before the authorities will act on the fact that I was kidnapped and tortured. This requires me to contact every doctor in the country so that they can confirm that i’m not their patient.
I would have thought it was their burden to prove I was a “patient” before having police snatch me from my bed and lock me in a cage and force drugs and other objects down my throat without express consent. Apparently not, and believe me don’t dare complain about it if they do it to you or yours. And well, when they find out your not a “patient” they just put together a set of fraudulent documents that make it look like you were a “patient” for ten years, send them to lawyers and call it “editing”. My preferred term is fraud but police can’t find there copy of the Criminal Code so I assume their negligence is appreciated by these organised criminals operating in our hospitals. Having a little trouble defining what are and are not crimes. Seems to be related to the colour of ones skin and who you know not what.
Similarly our Chief Psychiatrist tells us that the legal burden of proof to lock someone up and force drug them has been changed from “suspect on reasonable grounds that the person be made an involuntary patient” to “suspect on grounds they believe that the person requires examination by a psychiatrist”. Two very different scenarios and well, I had no idea he had the power to rewrite the law without approval of parliament.
Looks like if he says he can treat a metaphor Steve you better agree, coz otherwise they move in on you family, and as I’ve been told will “fuking destroy you”.
That’s real power.
P.S. I agree with Barliman regarding the Chief Psychiatrists being the lackys for their political Masters. It seems on the evidence I have at hand that the ‘poison pen’ letter signed by the Chief Psychiatrist making him appear to be an incompetent defective might not have been written by him at all, but by a lawyer at the Mental Health Law Centre who was committing a number of serious criminal offences (pervert, fraud etc) at the instructions of the Minister. They just happened to make the C.P. look like an absolute idiot in the process by assuming they had retrieved the real set of documents before distributing the fraudulent ones. Not that anything will be done to assist those who have been the targets of these criminals, bit too much work and they still haven’t figured how to raise the dead let alone figure out a definition of what is mind.
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It is the responsibility of those claiming to ātreat the mindā to come up with a coherent definition of the āmindā they are supposedly treating.
Along with photos and diagrams!
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Sam Plover,
re neurology, the problem is that Medical Neurology is more slanted towards diagnosis of tumours and diagnosis and management of very recalcitrant degenerative diseases.
There is a newer area called functional neurology which works more with TBI, balance and coordination problems, neurodevelopmental disorders anxiety, improving symptomatic control of Parkinsons.
These sorts of problems are usually accompanied by a host of physical signs that us conventional doctors never really knew what to do with.
It is getting much better results than we have been used to seeing, without drugs or need to resort to deprivation of liberty.
That is somewhat beside the main point- which is that the majority of ADHD and anxiety patients can be shown to have these minor functional deficits that clearly generate most of the symptoms are amenable to a rehab approach.
I dont know whether I made this point but conventional psychiatrists do not even do physical examinations– despite claiming that all psych diseases are brain diseases. This is clearly an area where they could do much better.
That points to these problems having a subcortical brain origin -even though there will always be an overlay of reaction formation whch will need counselling and support.
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Barliman,
I’m 61, a bit too late to delve into further examinations. I could not stand being looked at anymore š
But I do believe that much can be resolved without meds if only we had not become conditioned to view all unexplainable things as “mental illness”.
My fear of looking at it as physical, is that it will still be about “behaviour”. And even if looking it from a functional view, do we really want to keep differentiating normal from abnormal?
IF we could actually come up with a thought process within society where these distinctions don’t affect the observer or the observed, that would solve the problem.
We have a huge problem on our hands where we not only hate psychiatry, but ourselves, if we buy into the construct of something being ‘wrong’ with ourselves.
It has ruined many people’s lives. It has always been that way but only seems to get worse.
I do believe that behind every human lies a secret, but not for fluffy diagnosis and harsh pills.
It is so simplistic that it boggles my mind. If they really wanted to get ahead, they would be wise to drop their idea of norms, listen to people’s ideas about themselves and the world. Not as disorders, but as glimpses into what could be.
WE ALL want to hold some importance, not as someone disordered or ill.
If we can’t come up with ‘care’ that is not dehumanizing, we should throw in the towel.
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I have a few issues with the title of this piece. Rather than Is Australia’s Psychiatric System Redeemable, like a sales coupon, or a lottery ticket, or a government bond, how about Is Australia’s Psychiatric System Salvageable, like a scuttled vessel, a scrap of antiquity that we’ve grown too sentimental about to thoroughly trash, or, say, a relic from the Third Reich.
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But psychiatry actually likely is redeemable though…you can turn it in to the UN for reparations!
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psychiatry is a mess but nothing short of a revolution will fix it
WT…? So many assumptions here. The first is about the purpose of psychiatry, which is to enforce the norms of the established social order, which involves first and foremost preventing revolution at all costs, or even its active contemplation by the people. The effect of a true revolution would be to neutralize or eliminate psychiatry, not to “fix” it.
Psychiatry is a tool of social control, period. To make it otherwise would not “fix” it, but would eliminate its usefulness to the system, hence its existence, so don’t look for anyone’s “useful suggestions” to be heeded any time soon.
So I share Frank’s consternation as to why “redeeming” or saving psychiatry should even be a goal — at least our goal.
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As good as it gets Niall, the parents- no 2- and no 1 you missed- the law that the Government wont alter or emend- that stops or allows for all “first episode-rs” to refuse being poisoned- fix that- and “all the other problems begin to absolve and disappear”. Nothing else will change or stop what their doing, talk till the cows come home, way too invested and stupid for that, but it will stop all the CTO abuse and wasted expense, stop victims returning every 12 to 18mths cause they just cant live their lives drugged like that, that at any given time, make up 70% of the, in facility, revolving door population.
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Dear Dr Niall,
I like your straight talking style.
“….The one thing they will never do is have a fair, open, transparent and, above all, honest debate about the realities of being mentally disturbed in Australia…” It sounds like “they” are the ones that are disturbed!
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Thanks for your excellent article and all the great work you do, Niall. I moved to Perth about ten years ago from the UK and was, and still am, horrified by the quality of psychiatry I hear about. We need more people like you.
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“…..No doubt for daring to expose this, I will be subject to the usual barrage of secret complaints by anonymous authors, which will be investigated in camera by an unnamed committee considering evidence I am not allowed to see, who will reach a decision that favours the status quo, and for which there will be no effective appeal. Because thatās how psychiatrists operate…”
Don’t worry Dr Niall you’re already in “negative popularity territory”.
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Right Fiachra,
It’s an honor not to be favored.
I bet any shrink who does not label or give out a lot of drugs,
is probably looked at with suspicion.
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This attitude is exactly the same in all the branches of the College of Physicians, and some of Surgeons too.
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re sam plover January 5, 2020 at 3:25 pm
I couldn’t find a reply button for your last reply to me, so..
However as an introduction _ Im 58 in 2 weeks- so am close behind you.
“I do believe that much can be resolved without meds if only we had not become conditioned to view all unexplainable things as āmental illnessā.”
I think the problem her lies in the vague use of the word Mental.
It makes you think that there is something fundamentally wrong with you as a person.
– As you will see, I believe that a great deal can be resolved without medication.
Heres one way we go about illustrating that. Im using this as en example because it is the one that I know- not to be advertising one approach or another
Im a Buddhist and as such I provisionally accept that mind is “that which is luminous and knowing” – our Buddha nature- and no stain can adhere to it.
In face the have three levels: coarse, subtle and very subtle and these definitions are derived as the pooled experience of millons of adepts over 2,500 years.
The core nature is very subtle mind, or rigpa and it underpins everything else– so the term “mental illness” is something of a nonsense.
What ‘s worse is it is contaminated by Judeo-Christian ideas of original sin and mind body dualism.
“Coarse mind” (ordinary human consciousness) is a fusion of pure awareness (rigpa) and various unhelpful ideas that we have picked up throughout the course of our life (possibly – lives, if you wish to go that far.
My fear of looking at it as physical, is that it will still be about ābehaviourā. And even if looking it from a functional view, do we really want to keep differentiating normal from abnormal?
IF we could actually come up with a thought process within society where these distinctions donāt affect the observer or the observed, that would solve the problem.
Well, as someone who has ADHD (much better than it was due to the help of my chiropractors) still uses a small and variable dose of dexamphetamine, and also has Bipolar 1 with several admissions in my past:
For simplicity’s sake- lets go with ADHD
As a rule people come to see a doctor with these conditions (especially ADHD that has been missed until adulthood)- the behaviours are what matter. People seek help, as I did about 12 years ago because the behaviours are driving us nuts.
The behaviours cause people to lose jobs, to have car accidents, to lose everything all the time, break up marriages. We end up unable to have a full nights sleep because of the flood of memories of things we forgot to do that day. That is no fun at all
We have a huge problem on our hands where we not only hate psychiatry, but ourselves, if we buy into the construct of something being āwrongā with ourselves.
It has ruined many peopleās lives. It has always been that way but only seems to get worse.
It is also a problem if we allow an inanimate discipline turn into people eating monsters.
I know some excellent psychiatrists- none of them works in the state/involuntary system.
I would see the problem being more in the hierarchical arrangement– very much like the Medical Hospitals in the state system.
Those environments promote bullying and aggression, and the hierarchical structure stifles most innovation outside of the approved way of seeing things. Thats ok for a cut and dried area like thoracic surgery, but it is not appropriate in a highly theoretical area like psychitry
“I do believe that behind every human lies a secret, but not for fluffy diagnosis and harsh pills.
It is so simplistic that it boggles my mind. If they really wanted to get ahead, they would be wise to drop their idea of norms, listen to peopleās ideas about themselves and the world. Not as disorders, but as glimpses into what could be.”
The funny thing is that all of us ADHD adults have gone through the process you describe- but we find ourselves listening to people who have no idea of the nature of our problems.
The advice on attention of someone who has not a clue of what the problem is like, does not, unfortunately help.
Now in ADHD, we have this idea that there is something called attention that is miraculously fixed/ palliated by medications.
This delusion makes it hard to make any real progress.
However ADHD has a huge number of “comorbid problems”- such as binocular vision disorder, dyslexia, dyspraxia, dysgnosia, sensory processing disorder, dysautonomia.
In Sweden these are called Disorder of Attention, Motor Control and Perception.
In Australian public hospitals (RCH in Melbourne) the patients get ample occupational therapy work.
However I assert that these are all part of the one problem (See ADHD as a Disorder of Brain Behaviour Relationships or Subcortical Structures and Cognition- Koziol et al).
The trouble here is not with the core idea of “ADHD”, it is of the DSM process that has split off the learning disorders so that doctors looking at ADHD using only the behaviour questionnaire and not thinking further. Compliance to the mainstream system, one which is supported by enormous amounts of pharmaceutical company money — that is a problem.
In my own case, yes I see a psychiatrist every couple of months for ongoing prescriptions- and with time and observation I have seen that the medications help my tendency to low blood pressure when upright.( Dysautonomia) I would like to dispel the myth that these are harsh medications. Careful dosing by a competent prescriber will avoid side effects and they wear off fast as well.
However the bulk of what I have had done on myself has been chiropractic and chiropractic neurorehabiitation, along with meditation practice, training myself particularly Vipassana body scanning to identify the physiological signature of the key mental states.
“WE ALL want to hold some importance, not as someone disordered or ill.
If we canāt come up with ācareā that is not dehumanizing, we should throw in the towel.”
In terms of holding importance there are a great number of support groups that help us understand the great contributions that many ADHD people have made, and the same for Bipolar.
Equally, the mode of Mind that I propose to use here clearly separates out the disorder from the Self.
In terms of dehumanising care, Ive been far less than impressed with the approach of doctors when I was in inpatient care,but that is another story. Ive also sacked more than my fair share of psychiatrists.
ADHD is maybe the best example here because the symptom lists do define a clear patient group (to the extent that I prefer the company of ADHD individuals to non ADHD) and that defines a reasonably narrow number of functional neurological problems, which are highly treatable, or would be if we could get more practitioners here.
Re this functional neurorehabilitation that I was mentioning:
This short video on You Tube is a case history of neurorehabilitation in a teenage girl.
No medications at all.
However the history of her ADHD symptoms
14 year old with ADHD https://www.youtube.com/watch?v=J92vg3nrgSY&t=269s
In the end it is not necessary to throw the baby out with the bathwater.
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Barliman,
Everyone’s experience is unique, and I was one who sincerely did not want to throw out the baby with the bathwater.
It was not a choice. And I am no better for doing so…..that is how impossible the “system” is. Perhaps not for everyone, but for me it definitely was. But it was not only the psych system, yet that is one area, and usually the last one, sought out in desperation, that screws people over.
I am actually sad on reflecting, so I now have that to deal with. It is when hopes get dashed, when ‘free will’ was not strong enough to make choices.
But yet try not to fall into the feeling of “a life gone bad”. Stinkin thinkin, I am told.
I am perplexed on how I co-wrote my script, how it shaped my future writing. And I question how I continue to write it, knowing it has scrutiny from all sides, including myself.
58 and 61 are not old in years, depending on physiology.
The way authority views each individual is so very dependent on outcome, or our own views of ourselves, and of systems.
Psychiatry can never be impartial, it’s not humanly possible, and one of my biggest fears is “artificial intelligence”, because it, even more so, does not have the ability to remain impartial.
I wanted to rescue psychiatry from childhood on. From the time I was shown ink blots.
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Daniel Amen claims that these things which you call disorders (“bipolar” and “attention”) are neurological in origin and can be balanced with brain treatments, like neurofeedback (there are others, too). There is an excellent clinic in Melbourne doing this kind of work.
Orthomolecular doctors will correct a lot of these “disorders” with diet and supplements such as high dose niacin.
Will Hall frequently speaks of the need to modulate sleep cycles in order to keep from “flipping.”
Some might even claim that these “disorders” are rampant in our society due to epigenetic insults – re-engineered wheat (dwarf wheat which has high yields, also has more chromosomes than heritage wheat), pesticides, herbicides, even chlorine and fluoride, as well as food additives and processed food.
Then there’s the role of trauma, relationships, and what strategies you learned as a child that are less effective as an adult.
The truth is probably a combination of the above, and a “true” “bipolar 1” might still struggle, even after these things are corrected. Thing is – if you read Robert Whitaker’s “Anatomy of an Epidemic,” you will learn that “bipolar I” was never a chronic illness, it was episodic. If you could only treat your behaviour problems when they get out of line. But these drugs are not designed for going on and off, and this would be further destabilising.
Ex-Bipolar, here (yes, there is such a thing). What I’ve learned over the course of my life (57 yo) is that if *I* can’t manage my behaviours, then nothing else will. Lithium poisoned my kidneys, flattened my brain – it’s coming back, but I’m a lot less intelligent, flexible, and capable than I was before. Antidepressants (combined with surgeries that happen in the course of a life) ruined my gut, challenged my endocrine system in a way that looks like chronic fatigue and fibromyalgia.
I know how to be depressed, and I know how to prevent my “manias” (sleep is my key, as well as nutrition, and light cycles). And I found that the drugs actually ramped up my symptoms over time. So if I “get out of line,” it’s up to me to choose the things which help. Drugs are no longer among those things.
I’m not saying that nobody ever finds use for the drugs. I am saying that there are many roads up that mountain.
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Thanks Jan,
good read. Even within Anti-psychiatry one likes to find bits and pieces that are validating. validating in the sense of a much different view than psychiatry could ever allow themselves, because frankly I believe they are simply not capable (the attempt at converting an atheist into a believer and visa versa).
The beauty of people who are antipsychiatry or anti-simplistic theories and practices, is that it was born out of the very flexibility of thought that psychiatry used to pretend did not exist in clients.
Do they not see irony in accusations?
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