The Matrix: Disentangling Anti-Psychiatry

T.N. Tampiyappa, FRANZCP
129
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“It’s a fair cop. But society is to blame.” — Monty Python

For the last forty years, psychiatry has been comprehensively critiqued from a myriad of disciplines including sociology, psychology, and the user movement.

But how do these criticisms hold up from the perspective of a psychiatrist working in the public system? Is there anything that can be salvaged from the psychiatry project? Indeed, would it be better, as many have argued, if psychiatrists were voted off the island altogether so other practitioners can more effectively help those with broken minds?

I propose that critiquing biological psychiatry is a straw man — albeit reinforced with concrete — as it is but one player in the crowded mental health industrial complex that involves culture, economics, government bureaucracy, the pharmaceutical industry and patients.

But first it is necessary to understand the niche psychiatry occupies in the medical establishment, which is underwhelming to say the least. Other medical specialists tend to see psychiatry as wooly, unscientific, “not proper medicine” and, most perniciously, an easy way out from the more arduous and exacting training of other specialties.

This leads to at least two reactions in psychiatrists. The first is to go on the front foot, proclaim the speciality as a subfield of neurology and be preoccupied by genetics, neurotransmitters and medication. The second group embrace this stigmatised role as an echo of the outsider status of psychiatric patients and take a more psycho-social stance around treatment.

It is important to note that both approaches accept, prima facie, the reality of ‘mental illness’.

Pulling back further, we can see that diagnoses, far from being “objective” or “carved at the joints of nature,” in fact follow socio-cultural changes. How else can we explain the ballooning of the American DSM classification of mental illnesses from 24 in 1978 to 265 currently? Alas, this increase is not the result of new discoveries of candidate genes or biomarkers. More likely it is the marketplace haggling between key opinion leaders, patient advocate groups, pharmaceutical and insurance companies and the cultural tides of the day. We are all now familiar with chronic pain, fibromyalgia, gender dysphoria, and social anxiety, yet these entities did not exist in the early 1980s. If we go further back we notice the complete disappearance of common disorders in their time. One would be hard-pressed to find a case of hysteria now — the diagnosis de jour in the late 19th century — or perhaps neurasthenia, the condition of indolence and lethargy that afflicted the middle classes in the last century. Lest those examples seem too obscure, how about homosexuality which only exited as a psychiatric diagnosis in 1987?

Far from being universal and objective, psychiatric diagnoses are cultural products moulded by the societal forces at the time. To take one final example: unlike the DSM, the ICD is a committee with representatives from 55 countries. In the most recent version of their classification, they found no evidence for the inclusion of narcissistic personality disorder which by stark contrast is firmly accepted as a common clinical entity in the Western world.

So if cultural mores affect psychiatric diagnoses, what about macro-economics? Is it a coincidence that the neoliberal project which started flowering particularly in the US and UK in the 1980s also saw the spectacular rise of psychiatric diagnoses? One could see that this emphasis on the individual as a discrete self-interested actor in the marketplace could have caused an epistemological shift in people where the seismic shifts in unemployment, government spending and income inequality were transmuted into private concerns, and the agony of anomie recast as disorders of the brain. Systemic, group and family therapies were jettisoned in favour of individualised, time-limited, data-driven (insurance approved!) manualised psychological treatments like CBT, solution-focussed therapy and positive psychology. Medications were matched to individual diagnoses, marketing slogans developed (“chemical balance”) and unscientific “screening” questionnaires distributed to general practitioners.

Voila — the mental health epidemic!

Does this mean mental illnesses don’t exist? Surely this isn’t a tired rehash of iconoclasts from the 60s like Szasz, Laing, Foucault, et al? Are you saying that people aren’t suffering?

Now we are on treacherous territory and I have to tread carefully. When I trained in the 1990s, schizophrenia, manic depression (reclassified as bipolar affective disorder) and severe depression were rare conditions that needed extended hospitalisation. But now the incidence of these diagnoses are rising exponentially in only a couple of decades, which rules out biological causes as genetic change moves at a far more glacial pace. By having de-contextualised checklist diagnoses, the boundaries have loosened appreciably.

Lethargic and feeling hopeless after you were retrenched when your company relocated? That’s major depression! Feeling inexplicably angry and at other times anxious because of your zero hours contract? Don’t worry, it’s bipolar disorder! Feeling like you need to stay at home and avoid people as the government subjects you to humiliating disability assessments and sends private investigators to check if you are not faking? Not a problem — a clear case of social anxiety disorder!

But not everyone gets a prize in the Psychiatric Kingdom. Those unfortunate enough to have addictions or personality disorders are chucked outside the castle gates, the stigmatised of the stigmatised; unwilling scapegoats of a system that needs to have some boundaries lest everyone have a disorder.

But surely the government can ensure there is no skullduggery as it is not, in theory, beholden to vested interests. The state is, however, preoccupied by risk and it delegates the management of this to the criminal justice system and, increasingly, psychiatry. That is why, should you have the misfortune to attend a psychiatric emergency department, you will be subjected to a lengthy risk assessment. Never mind that violent and suicidal acts are rare (incidence rate of suicide is 0.01%) and the predictive power of a psychiatrist’s risk assessment is the same as a member of the public. But, and this is a big but, should a patient harm someone or kill themselves after assessment, the psychiatrist will face serious professional and personal jeopardy; he will have to write a report, be subject to a chastening internal investigation and if relatives are aggrieved be cross-examined in a Coroners’ Court. To avoid this terrible fate, many psychiatrists will section a patient who says they are suicidal. In this scenario the patient is subject to a traumatic incarceration, all in the service of this bureaucratic shadow play.

The mental illness landscape, to a large extent, has had a hostile takeover from Big Pharma. They own the peer-reviewed academic journals, they own the key opinion leaders, they sponsor conferences and sweeten GPs and psychiatrists with sandwiches and gaudy ballpoint pens. They manage to get their drugs through regulatory bodies despite trials lasting often no more than four weeks and no long-term data on adverse effects. Read any of the established psychiatric journals now and you will notice a plethora of brain imaging and neurochemical research which reinforces the dominant on-brand message about treating mental illness with medication. Shamefully, for a psychiatrist to truly know how a drug is affecting his patient he needs to consult patient websites like Inner Compass or Surviving Antidepressants. It is the bottom-up advocacy groups that have alerted doctors and public alike to the manifold dangers of psychotropics.

And finally, on to the patient, user, survivor, client. Surprisingly, perhaps, the caricature of the disempowered patient kowtowing to a prescription-pad-wielding authoritarian expert psychiatrist is only a partial picture. Far away from the eloquent critiques of Mad in America, one is as likely to have a patient requesting to be diagnosed or to start a new medication. The matrix has done its job. Often a patient feels bitterly disappointed if he has left the psychiatrist’s office without a diagnosis or prescription. Solitary misery is painful, and wouldn’t you want your pain assuaged by society’s legal drug dealer?

So how would a psychiatrist practice ethically in such a nefarious environment?

Firstly, I believe she should realise that the psychiatric gods have feet of clay and the mental health industry serves the mores of the current socio-cultural-economic structures rather than the individual. Fundamentally, the abiding principle should be to do no harm. This is manifestly complex and involves many judgments about best interests, patient autonomy and the right of a person to make both wise and unwise decisions. For example, is it right to withhold a numbing addictive medication for someone who is in deep despair and wanting something to be done? Should the psychiatrist write the supporting letter for a disability pension acknowledging that the patient is not fit to take part in the circus to find ever more vanishing jobs, but at the same time risking that the patient sees himself as defective and existing outside of mainstream society?

And so, in the final analysis, a solution of sorts is to keep questioning in the spirit of not-knowing — crucially, in collaboration with the patient and his family.

It may be true that the house always wins, but that only applies if you choose to cross the threshold and enter the casino.

129 COMMENTS

  1. Neurosis was not removed from diagnosis. It has been renamed as personality disorder.
    Being “passive aggressive” was removed, “narcissism” removed, “homosexuality” removed.
    Behaviours of men tend to be removed as pathology, behaviours of women pathology. Although they realized the obvious continuation of sexism, they started assigning a few men with “disorders”, so women could not make their case valid.

    What disorders do you believe in and assign to patients?

  2. Not saying anything we don’t know and we know more. If I had a group/website what ever, I wouldn’t allow psychiatrists, psych nurses or anyone that severed any of that hate (antipsychotics) that they push into their victims around me. Why is it that you think it is ok that we read the words of people who are responsible for putting neuotoxins into peoples bodies and have – no doubt by doing so – caused tremendous harm. Sorry but you know… it’s not OK. We want rid of them and any other ‘MH professional’ who make a living/lot of money by neurotoxic harming. In the context of that, everything else… their words, actions, what ever else is just a falling away. If you disagree with me fine, but then I suggest you take a dose of an antipsychotic just once and then think about the people who have that forced into them every day or injected, then see if you want to listen/read the words of people who do this to other people.

    RIP Julie Green a great antipsych warrior

  3. This article is better than most articles published on MiA that are written by psychiatrists, but I found a few problem areas.

    Indeed, would it be better, as many have argued, if psychiatrists were voted off the island altogether so other practitioners can more effectively help those with broken minds?

    While I do advocate ending psychiatry, since most psychiatric drugs are prescribed by doctors who are not psychiatrists, that won’t solve all of the problems.

    Also, the mind is an abstraction – it cannot be broken or diseased.

    Other medical specialists tend to see psychiatry as wooly, unscientific, “not proper medicine” and, most perniciously, an easy way out from the more arduous and exacting training of other specialties.

    Again, most psychiatric drugs are prescribed by doctors who are not psychiatrists. If these other medical specialists are such skeptics, how did they so easily buy into the chemical imbalance hoax and why, instead, did they not warn their patients of this hoax?

    Aren’t doctors supposed to be healers?

    One would be hard-pressed to find a case of hysteria now — the diagnosis de jour in the late 19th century . . .

    “Hysteria” is now “borderline personality.” It never went away – psychiatry has always found ways of psychiatrizing women. For more on this, see “Chapter 6: Reproducing Patriarchal Relations” in Dr. Bruce Cohen’s book Psychiatric Hegemony: A Marxist Theory of Mental Illness.

    The mental illness landscape, to a large extent, has had a hostile takeover from Big Pharma.

    It has? It seems less of a hostile takeover and more of an open invitation by psychiatry.

    If you look back at Dr. Loren Mosher’s writings on The Soteria Project, psychiatry knowingly and willingly opened the door to big pharma. Here is just one example of Dr. Mosher’s writings on this. He referred to the American Psychiatric Association as the American Psychopharmacological Association – https://www.moshersoteria.com/articles/resignation-from-apa/

    Does this mean mental illnesses don’t exist? Surely this isn’t a tired rehash of iconoclasts from the 60s like Szasz, Laing, Foucault, et al? Are you saying that people aren’t suffering?

    I know the author is being facetious here, but one of the main themes that Dr. Thomas Szasz wrote about is the concept of psychiatry’s sacred symbol. This is about psychiatry’s power, not people’s level of suffering.

    The ability of psychiatry to remove people from their home, incarcerate them indefinitely, and to subject them to forced treatment is why psychiatry guards its sacred symbol.

    The author does explore this aspect by writing: To avoid this terrible fate, many psychiatrists will section a patient who says they are suicidal. In this scenario the patient is subject to a traumatic incarceration, all in the service of this bureaucratic shadow play.

    But the use of the phrase “bureaucratic shadow play” sends the message that it’s an accident of the system, rather than the purpose of the system.

    And so, in the final analysis, a solution of sorts is to keep questioning in the spirit of not-knowing — crucially, in collaboration with the patient and his family.

    Psychiatry would like nothing better than to keep this an insular conversation between the patient and his family. The solution is NOT to keep questioning, but to rise up and fight back in non-violent action with the growing numbers of people interested in psychiatric abolition. It will take a people’s movement, not sitting around talking to psychiatrists, no matter how “woke” they are.

    It may be true that the house always wins, but that only applies if you choose to cross the threshold and enter the casino.

    As far as those who “choose to cross the threshold and enter the casino,” many of us didn’t have a choice.

    I do agree that the casino is rigged. But make no mistake who and what rigged it. As Dr. Phil Hickey wrote, “Psychiatry is utterly and totally irredeemable. It simply needs to go away.”

    • Hi anomie,

      I believe that “broken minds” was phrased in a question, which might not point to Mr Tampiyappa himself believing in “broken minds”. Yet I agree with you, I very much dislike that wording.
      I am really not sure what to make of the article? Although I won’t give myself a headache over it.
      It seems he is a in the geriatric area of strokes and rehabilitation.
      What transpired in the years he worked as a psychiatrist?

    • Your point about the “hostile takeover” is very well taken. There appeared to be little in the way of hostility – it was more of a merger made in the interests of monopolizing the market. Both sides agreed from the start, and both sides benefited massively from the collaboration. The only hostility was toward any whistle-blower who tried to point out what was really going on.

      • Steve McCrea wrote:

        Your point about the “hostile takeover” is very well taken. There appeared to be little in the way of hostility – it was more of a merger made in the interests of monopolizing the market. Both sides agreed from the start, and both sides benefited massively from the collaboration. The only hostility was toward any whistle-blower who tried to point out what was really going on.

        Exactly, Steve. Thank you for bringing up the whistleblowers because that’s a very important point.

        Dr. Peter Gøtzsche is a perfect example of a whistleblower targeted for his research into how deadly psychiatric drugs are. When Robert Whitaker wrote about Dr. Gøtzsche, he uncovered the fact that it was E. Fuller Torrey who lodged the complaint:

        https://www.madinamerica.com/2018/10/the-cochrane-collaboration-has-failed-us-all/

        Psychiatrists, if indeed they are real doctors in the “healer” sense of the word, should be the ones who protect people from being poisoned by the corporate greed that fuels the psychiatric drug epidemic.

        But it’s the biggest names in psychiatry, the so-called “thought leaders,” whose own bogus research studies are turned into corporate marketing campaigns for big pharma. And then psychiatry has the nerve to blame the pharmaceutical industry for the outcome.

        But big pharma didn’t lock me in a psych ward and drug me for months at a time and then throw me out on the streets with a drug dependency problem that THEY created.

        That’s on psychiatry, especially since various psychiatrists spent years after that gaslighting me about my “psychosis” being the result of a chemical imbalance and withholding information on dopamine supersensitivity and benzodiazepine-induced depersonalization / derealization, or what I like to call psychiatry’s acid trip.

        These “doctors” are, after all, legalized drug dealers.

        And it’s not like psychiatrists don’t know the harms of these drugs – I found out about it researching while struggling with neuroleptic-induced cognitive impairment. Surely a psychiatrist with a medical degree and no brain damage could figure out why their “patients” are dying 30 years early.

        That’s if they really wanted to know. Cognitive dissonance can only explain so much.

        The psychiatric system isn’t broken. It’s working exactly as it’s designed – to silence the individual in distress as a way of silencing the societal problems he or she represents.

        I’m very grateful to the whistleblowers who risk their reputations and careers to bring us the truth.

    • Good points, anomie. But it is good that some psychiatrists are starting to wake up, and starting to acknowledge the “potential” iatrogenic harm being done with the psychiatric diagnoses and treatments. Only it’s not really just “potential” iatrogenic harm. We are actually living through another, on going, all of Western civilization, psychiatric holocaust of our elderly.

      https://www.naturalnews.com/049860_psych_drugs_medical_holocaust_Big_Pharma.html

      Not to mention the completely iatrogenic “childhood bipolar epidemic,” that Whitaker addressed in ‘Anatomy of an Epidemic.” And the torturous harm being done to your fellow human beings with the antipsychotics / neuroleptics. Given the reality that the antipsychotics can create the positive symptoms of “schizophrenia,” via anticholinergic toxidrome. And the antipsychotics / neuroleptics can create the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome.

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

      But we can say, so much for the theorized “genetic” etiology of even “the sacred symbol of psychiatry.” Psychiatry is committing a ton of real, medically provable, iatrogenic harm.

      And I will say, some of us were still misdiagnosed as “histrionic,” because I was a “slim white female” who is “pleasant” and “laughs inappropriately” (when questioned over and over and over again about the common adverse, odd, and withdrawal effects of the “happy, horny, skinny,” non-“safe smoking cessation drug,” Wellbutrin).

      It’s a shame so few of the psychiatrists know anything about the common adverse effects of their drugs. And thus cannot even follow the instructions that used to be in their “invalid” and “bullshit” DSM-IV-TR “bible,” but were intentionally, disingenuously taken out of their DSM5.

      “Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.”

      https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml
      https://www.wired.com/2010/12/ff_dsmv/

      Please try to assist your fellow psychiatrists in waking up, and overcoming their pharmaceutical industry and DSM based delusions, Dr. T.N. (Shaun) Tampiyappa.

      • Good points, anomie. But it is good that some psychiatrists are starting to wake up, and starting to acknowledge the “potential” iatrogenic harm being done with the psychiatric diagnoses and treatments.

        Someone Else, you raise some great points, but I think you’re giving psychiatry too much credit. They aren’t waking up so much as realizing the villagers may be coming for them with pitchforks.

        As reported last year in Psychiatric Times:

        https://www.psychiatrictimes.com/addiction/online-communities-drug-withdrawal-what-can-we-learn

        The traffic moving through these sites is mostly from within the US and is substantial: http://www.benzobuddies.org receives on average 250,000 hits a month and http://www.survivingantidepressants.org receives approximately 150,000 hits each month.

        Not to mention the coverage in the New York Times last year:

        https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html

        I think psychiatry will be looking for some ways to profit from the mess they created, while keeping their status as well-respected and legitimate doctors (not that it’s in any way warranted), so I’m looking at the reformist agenda and the psychiatric apologists with great skepticism.

        It was the grassroots movement of online withdrawal forums that collectively figured out the best practice methods of a slow and gradual taper, starting from information from the Ashton Manual and moving into the numerous interactive peer-run web forums.

        Psychiatrists have been learning from us from the start. But they want to keep their power and their paychecks, so I’m concerned about giving them too much credit and not enough credit to the people with lived history who have been at the withdraw game since the dawn of the internet.

  4. I find your fourth paragraph interesting Dr. T. As a layperson i wouldn’t guess other specialists feel that way about psychiatry. They certainly hide it well from the public. Why is that?

    i applaud your honesty in telling those who come to you for help that your pills restore nothing, but sometimes kill emotional pain.

    As far as needing the drugs to kill the pain, how much of the pain was caused by social rejection/isolation and enforced idleness and poverty from getting the diagnosis and drugs to begin with? My SMI label nearly drove me to suicide since everyone turned on me.

    Fled to where no one knows about it and I tapered off the soul killing drugs. Still on disability because of my Inflammatory Bowel Disease. Official diagnosis. I believe this is from long term SSRI use.

    But I’m able to make friends, since I can understand social cues for the first time in my adult life. I am finally able to lose weight, shower regularly, and keep a clean house. People don’t shun me, or patronize me for a physical disability. For the first time in decades i feel like a human being again. 🙂

    And i hope to start a tutoring business preparing high schoolers for SAT and ACT tests. The pay could help me earn a living working part time since my habits are frugal.

    I never wanted to be unemployed forever. Many people in the system hate the enforced idleness, social isolation, and poverty. Do you think they knew what they were signing up for when they begged for a diagnosis and pills?

    And yes–many do beg for these. You are perfectly right. Few of the fellow “consumers” could conceive that the drugs and labels played a role in the unemployment and alienation they often lamented.

  5. So how would a psychiatrist practice ethically in such a nefarious environment?

    Maybe by changing fields?

    No disrespect intended, as you seem well motivated. Please realize the anti-psychiatry survivors’ movement is reeling this week in the wake of the devastating loss of two of our cherished comrades in the space of less than a month. I will attempt to be somewhat more erudite if & when I’m able to return to this discussion.

  6. Thank you for articulating your perspective and for permitting comments.

    “I propose that critiquing biological psychiatry is a straw man… as it is but one player in the crowded mental health industrial complex.” I believe that you underestimate the supreme power that psychiatry has in the “mental health industrial complex” based on its purported foundation on biology and physiology. Consistently, I consider “biological psychiatry” to be misleadingly redundant: all medical sciences are considered biological sciences by the community whether psychiatry is based on Freudian theory or is without an underlying theory. Psychiatry may be mocked by other medical science specialties but the community considers it a medical science and considers medical science to be the “holy grail” for addressing health problems. Medical schools are ultimately responsible for the calamity that psychiatry causes the community by accrediting a philosophy of “mind” as a medical (biological) science.

    “Does this mean mental illnesses don’t exist?… Are you saying that people aren’t suffering?” People are suffering extreme pain from social, economic and/or spiritual distress (natural, painful emotional suffering) but their suffering is natural rather than a disease. Psychiatry advocates Pollyanna and a fairy tale world of kindness and goodness.

    • Consistently, I consider “biological psychiatry” to be misleadingly redundant

      Hear, hear — thank you muchly.

      “Mental illnesses” do not exist, period. Moreover they CANNOT exist unless the rules of language are changed. Nor is “mental illness” simply a mischaracterization of something which does exist. “It” is a non-category as well as a non-entity.

      As per one of our recent conversations, when someone shows me a mind in a plastic bag I’ll reconsider my position. I presume that Szasz would also at that point. But this will never happen.

  7. Psychiatrists alone are responsible for the state of their own affairs, a complete catastrophic mess. The same is true for all those in relation to psychiatry, following its lead. They alone are responsible for what they do.

    I get tired of hearing about how complicated things are for psychiatry. They are the ones practicing medicine with no substantiated theory. How crazy is that?

    Not many people enter a helping profession with bad intent, but they sure as heck will do that with bad judgement.

  8. This piece certainly has some length but doesn’t really say much of anything. Most of us would be hard pressed to disagree with any of it but the straw man is the author’s twisted misrepresentation of criticisms of biological psychiatry – a fake argument.

    Mad in America purports to be critical of psychiatry but call me crazy essays like these that contradict themselves don’t really empower folks unless they believe being indoctrinated by professionals is the cure. Reading enough of this stuff will drug anyone into believing the status quo is irreversible because it’s simply overwhelming and complicated – especially for the broken minded. Maybe if we had the cell phone numbers of our congressmen we could make some changes.

    • Gene, sometimes I read articles and want to really express what I think of them, or the author.
      Yet I don’t fully disclose, how I really feel.
      I read the whole article, twice and tried to find a hint of the author understanding what field he was in, what position patients were in, yet I could not.
      I felt it to be just another article that excused psychiatry, and in fact I felt paternalized….(a lolly for the moment)
      I find it easier to read a pro-psychiatry piece than one that is supposed to seem as if it recognizes psychiatry.

      The ending about “the house wins, but only applies before entering the casino” basically told me exactly where I stood even with those who pen these kind of articles.
      And it might be easier to pen articles, that half heartedly support what we see and experience, when no longer ‘overseeing’ the crazy people.
      I might be taking a black/white stance on certain pieces, which I do when I can’t find anything helpful towards trying to get rid of a completely twisted authority.
      I really dislike using the word “authority”, I am not using it as an honorary or fearful word. It is much more a regime, a dictatorship.
      Any practice that becomes parts of our governments is a regime.
      It is there to try and force a society into an ideal, yet within that plan, it becomes sicker.

      • sam plover wrote:

        I read the whole article, twice and tried to find a hint of the author understanding what field he was in, what position patients were in, yet I could not. I felt it to be just another article that excused psychiatry, and in fact I felt paternalized….(a lolly for the moment) I find it easier to read a pro-psychiatry piece than one that is supposed to seem as if it recognizes psychiatry.

        sam, what you’re writing about here I think is true of most psychiatric apologists. In your first comment to this article, you asked, “What disorders do you believe in and assign to patients?”

        It’s true that this is not something conveyed in the article. Psychiatric apologists write as if they are spectators to the atrocities of their own profession, but by the very nature of identifying as “psychiatrist” and asserting the powers and privileges that arise from that identification, they are still participating in the atrocities.

        Perhaps there are examples when this isn’t the case. Dr. Loren Mosher comes to mind, as he never committed anyone or forced drugs on anyone in the 40 years in which he was a psychiatrist (page 75 – http://psychrights.org/Research/Legal/25AkLRev51Gottstein2008.pdf).

        But Mosher used a technique called being with, which speaks in the language of Paulo Freire’s Pedagogy of the Oppressed:

        A real humanist can be identified more by his trust in the people, which engages him in their struggle, than by a thousand actions in their favor without that trust.

        I don’t get the vibe that this psychiatrist, no matter how well intentioned, actually trusts the “patients.” The article’s glib humor is a way of distancing the author from the atrocities, but this distances him from the people most harmed.

        I’ve known far too many people who are dead, disabled, or disappeared by psychiatry to find much humor in any of the clever word play.

        The academic version of anti-psychiatry has always been a distraction. Perhaps this is a reason Dr. Thomas Szasz refused to play their game.

        Antipsychiatry belongs to the survivors.

  9. Thank you for this article and for your honesty. It is nice to see that more psychiatrists are intelligently revaluating the field. Yes, Big Pharma wants to present everything through bio-bio-bio explanations and they have also taken over the peer-reviewed academic journals. It is also sad to see that currently a large amount of money is spent on studying biological factors in isolation, and also that top journals like Nature and Science only seem to publish studies that focus on biological factors. I truly hope things will begin to change in a positive direction for the field of psychiatry soon.

      • Not necessarily extinction, because for the person who is suffering, it is a BIG issue. The psychiatric method of treatment can eliminate profit driven pharma drugs and replace it with interventions that provide hope and support for patients. Treatment can also specifically include practices like yoga and mindfulness (that are known bring about healthy structural and functional changes in the brain).

        • In Anatomy of an Epidemic, RW implies that psychiatry faced extinction back in the 60’s. We have counselors to help adults make better life choices as well as neurologists to treat real brain disorders and other specialties for medical problems that get labeled “SMI” by psychiatrists.

          Why do we need psychiatrists when we already have yoga and meditation classes at the local YMCA and fitness trainers? There are also a few counselors who belong to the Choice Theory/Reality Therapy school of thought founded by William Glasser or the kind founded by Peter Breggin.

          I’m not anti-therapy or counseling or whatever you choose to call it. Szasz himself practiced counseling “between consenting adults” if my fellow APs care to remember.

          The APA has chosen to put not just profit but personal egos above the health and lives of those who trusted them. Proving they were honest-to-gosh doctors practicing a legitimate medical specialty, required real medicines, diagnoses, and surgeries.

          Never mind that the “medicines” were addictive mind altering drugs similar to the street kind. Never mind their “diagnoses” had only the “expert’s” say so with no objective tests and consisted of insulting laundry lists of character traits which shrinks wrongly claim are lifelong. Never mind the psycho surgeries (SOME of the surgeons do resemble Norman Bates come to think of it) are only random acts of brain damage any semi-literate thug could perform with an icepick or wooden baseball bat. They proved they are Real Doctors. Which is all that counts.

          The only thing I admire the APA for is their clever marketing techniques mixed with ingeniously packaged propaganda that would make Big Brother green with envy. Master Illusionists.

        • “Anxiety” is a natural survival mechanism, not a “mental disease”. Any wall of abstract “suffering” you are facing can completely collapse when you understand that basic fact. Should your “suffering” be caused by toxic chemicals though you will have to withdraw from such chemical abuse to cease “suffering” so much. Drugs, in this instance, are the problem, not the solution. The solution is to trust your instincts and your senses, to be wary of the false promises of pill pushers, and to stay safe by staying healthy.

        • Rachel, oldhead and Frank: I agree that we do not need psychiatrists to provide hope and to teach yoga and meditation – other specialists can do that. However, I think this whole problem started long long ago, with the start of the field of psychiatry – those pioneers of psychiatry mislead many generations. But I don’t think they did this intentionally (with evil intentions) – they seem to have genuinely believed that the brain had to be somehow ‘fixed’ using chemicals. We are faced with a situation now, where many psychiatrists blindly follow the ‘donkey path’ of those pioneers. But there are a few intelligent psychiatrists too, who question the status quo and are willing to talk about these things openly. So, if we are honest, compassionate and want genuine change, we should encourage those psychiatrists, especially if we truly want to help patients who complain of mental issues. This is why I like to encourage people like the author of this article.
          I also agree with oldhead and Frank regarding anxiety being natural and that it is not an illness, but we still have suicides happening, and there need to be some system in place to help those individuals, especially if they seek help from others.

          • You have the right to take your own life. Alright. Suicide issue, dealt with, settled, out of the way. Now when you try to prevent a person from committing suicide you are violating that person’s human rights.

            I think the problem started long before there was a medical specialty called psychiatry. In other words, the root of all evil is not psychiatry, nor did evil doing begin with psychiatrists. I think the problem first began with locking people up and forcing treatment on them for being disobedient or unruly, and second, when an expanding profitable enterprise grew out of this imprisoning and torturing of such dissidents (i.e. the violation of their human rights). There was a point in time at which the profit motive, coupled with job stability and careerism, made such an exploitative racket take off. How do you derail a run away freight train? How do you end it? Well, certainly not by making more and more investments in it.

          • Whoever is not against us is for us.

            I am grateful for anyone trying to help, including the writer of this piece. At least he tells those who come to him the truth about the drugs he prescribes and it sounds as though he only supports consenting consumers.

          • I agree that people have the right to end their lives – however, many people do seek help when they are feeling very low and feeling suicidal – I think such people definitely need to be taken care of.

  10. Basically if you get 25 % of the world, if I’m not being too conservative (today’s estimates have risen to 50 % and beyond), to buy your crap, you have job security. I find that there is a limit though to the amount of crap I personally can take. Necessity, it would seem, is a lot less necessary than it should be.

    I’d like to see a campaign directed against mental health treatment addiction. If we could wipe mental health treatment addiction off the map, we might be getting somewhere.

  11. Wish to draw peoples attention to this:

    https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/evolutionary-biology-an-essential-basic-science-for-the-training-of-the-next-generation-of-psychiatrists/1F62CEEB904F90C3C045872C108C53ED/core-reader

    “This encourages clinicians to consider the possible consequences of treating potentially adaptive states of defence activation in individual patients.”

    ‘defense activation’ that means you provoke by some form of abuse/violence

    This goes on right now in psyh wards where ‘care assistants’ and other patients are allowed to abuse patients.

    “In addition, evolutionary thinking can illuminate and inform public health strategies for reducing epidemics such as depression, suicide and drug misuse. ”

    So does that means we would irradicate doctors who precribe drugs that cause suicide…. 😉

    Ofcourse the eugenicists used evolution to justify abuse and ultimately killing psych patients.

    So they seek to intellectually ligitimise this. Me thinks we need to keep an eye on Dr Derek Tracy.

    • streetphotobeing,
      They actually have the evolution stuff partly correct, but since no one can really guess (theorize) why I get anxious, they aim to do same as always. “your suffering is an illness, you should be non responsive, productive, and half azzed happy”
      When I first started reading I thought, yay, they are normalizing people through evolutionary theory. But nope, just trying to fortify that old “maladaptive” crap….”well my dear, used to be when we were hunter and gatherers, we fought huge beasts and had reason to have anxiety……”

      They are forever the academics, hoping to speak in a language that non academics don’t understand. Trying to attach itself to anything possible.
      Really it sounds like an attempt at “abnormalcy cleansing”
      “phenotypes”

      • The special interest group of evolutionary psychiarty (in the UK ) is a very serious development. Evolutionary psychiatry has an appalling history in German psychiatry and it has to be taken seriously, watched and challenged. Please note in the recent news letter… the Lavin Assad student essay they are highlighting:

        https://www.rcpsych.ac.uk/docs/default-source/members/sigs/evolutionary-psychiatry-epsig/17th-epsig-newsletter.pdf?sfvrsn=89b44870_2

        In case you do not know

        The “Euthanasia “ Program in Nazi-Psychiatry.

        http://www.youtube.com/watch?v=4YU6CHaTWb0

        In 1920 Karl Binding (lawyer) and Alfred Hoche (psychiatrist) wrote a book: Die Freigabe der Vernichtung lebensunwerten Lebens (“Allowing the Destruction of Life Unworthy of Living”) used by the Nazi’s to justify their Aktion T4 mass murder program. Six ‘hospitals’ were used to mass murder psychiatric patients at: Brandenberg, Grefeneck, Hartheim, Sonnenstein, Bernburg and Hadamar. ‘These centers served as training for the Schutzstaffel (SS) who used the experience to construct larger killing centers (Auschwitz, Treblinka, etc.) The psychiatrist Imfried Eberl (look him up) was Treblinka’s first commandant.’ The important thing to note is that according to Prof Michael Von Cranach, the German psychiatrists were not under the boot of Hitler… they were not forced to kill their patients, but willingly did so… and almost all of them.

  12. Dr. T.N., This appears to be your first blog on MIA and it’s encouraging to me when any “mental health” professional, especially a psychiatrist, is willing to acknowledge the iatrogenic harm of psych labels and “treatments”.

    You stated ““By having de-contextualised checklist diagnoses, the boundaries have loosened appreciably”.

    Yes, it’s absurd there is no scientific basis for any DSM disorder and too bizarre to believe that no causation, nor context is considered before sticking harmful, life-long labels on someone. (likely someone experiencing difficult life circumstances beyond their control and/or facing a temporary state of distress)

    Many people do not choose to cross the threshold to enter the casino, often it is involuntarily. If someone does voluntarily cross the threshold it is unfortunately due to misplaced trust and total unawareness of the harm that awaits them. I appreciate the issues you have validated in this blog however I agree with Anomie there are still a few problems with what is presented. I am hopeful your viewpoints will continue to evolve.

  13. The US for example is governed by relentlessly plundering corporations having converging interests acting with the power and force of a most oppressive monarchy . Psychiatry with all it’s torture via toxic substances , electro shock “treatments” , forced injections of toxins , rendering people unconcious against their will, coercion at every level, stigmatization , alienating human beings from their loved ones ,taking away people’s children(we could go on and on) will never be stopped by presenting reasoned , honest explanations to those responsible for the torture . To keep countless people working at low paying, boring, unfulfilling ,dead end jobs ,even jobs torturing others , the threat of psychiatric torture and police violence is by design held over the heads of the people . At Harvard Medical School this last october classes for an “exciting and rapidly growing field” was announced , Neuropsychiatry : A Comprehensive Update
    One of the best replies to psychiatry was made in Switzerland by the Collective of Zurich Lawyers who defended victims of coercive psychiatry . It was started by Edmond Schonenberger
    Barrister at law and 2 other lawyers. I found the info about this group searching Fundamental criticism of coercive psychiatry.

  14. One of the things I glean from these comments is an undervaluing of the kind of psychotherapy I and many other therapists practice. I am trying to help people realize that whatever they are experiencing, no matter how painful, debilitating, bizarre is understandable in view of their histories and how they are reacting to their life situations and to concerns they have about their lives and themselves. So I am helping people use their “symptoms” to learn about themselves and to get to know themselves in an accepting and loving way. I am helping people become aware of limiting beliefs about themselves and the world, disowned parts of themselves, habitual, fixated responses that get in the way of them loving the way they want to love and expressing themselves the way they want to express themselves. I am helping them learn to manage their thoughts, emotions, intentions, perceptions and behavior to live more they way they want to live.

    I believe this kind of psychotherapy is way undervalued and underused in our society. Also, when we use the word psychotherapy I think we should include all of the ways in which people can be helped to love and express themselves in satisfying ways – yoga, support groups, all kinds of group and family therapy, exercise, sports, dance, help with relationships and work, meditation, spiritual practices, etc.

  15. James Hillman on the folly of reducing mind to brain.
    ———————————————————————–
    The upshot of genetic studies leads in two (!) directions: a narrow path and a broad one. The narrow road heads toward simplistic, monogenic causes. It wants to pinpoint bits of tissue and correlate them with the vast complexity of psychic meanings. The folly of reducing mind to brain never seems to leave the Western scene. We can never give it up because it is so basic to our Western rationalist and positivist mind-set. The rationalist in the psyche wants to locate causes you can put your hands on and fix.

    Machines provide the best models for meeting this desire. Take them apart, find their inner mechanisms, and then adjust their functioning by modifying their ratchets, enriching their fuel, greasing their connections. Henry Ford as father of American mental health. Result: Ritalin, Prozac, Zoloft, and dozens of other effective products for internal adjustments that we consume in abundance, millions of us, daily or twice daily. The simplistics of monogenic causes eventually leads to the control of behavior by drugs–that is, to drugged behavior.

    Robert Plomin, on whose passionate, prolific, and perceptive writings this chapter has frequently relied, urgently warns against using genetics in a simplistic manner. He states: “Genetic effects on behavior are polygenic and probabilistic, not single gene and deterministic.” I gather from him a warning to psychiatry: Do not capsize your noble vessel under the weight of pharmaceutical, insurance company, and government gold, and do not set your compass toward Fantasy Island, where genetics will define “disease entities in psychiatry.” “We have learned little about the genetics of development [how genes act and interact over time] except to appreciate its complexity.” Therefore we can never arrive at that equation where one defective gene equals one clinical picture (except for true anomalies like Huntington’s chorea).

    These warnings have little effect; simplistic thinking fulfills too many wishes. The heads of Henry Ford and Thomas Edison are carved into the Mount Rushmore of the mind. The monster of mechanism appears in every century of modern Western history and must be watched for by each generation–especially ours, when to hold out for “something else” besides nature or nurture means believing in ghosts or magic.

    Ever since French rationalism of the seventeenth (Marin Mersenne, Nicolas de Malebranche) and eighteenth (Etienne de Condillac, Julien Offroy de La Mettrie) centuries and right through to the positivism of the nineteenth (Antoine Destutt de Tracy, Auguste Comte) in which all mental events were reduced to biology, a piece of the collective Western mind had been yolked like a dumb ox to the heavy tumbrel of French mechanistic materialism. It is astounding how people with such subtle taste as the French and with such erotic sensibility can go on and on contributing so much rationalist rigor mortis to psychology. Every import that arrives from France must be inspected for this French disease, even though it carries the fashionable label of Lacanism, Structuralism, Deconstruction, or whatever.

    Today rationalism is global, computer-compatible every-where. It is the international style of the mind’s architecture. We cannot pin it to a particular flag, unless to the banners of the multinational corporation that can spend big bucks turning psychiatry, and eventually psychological thinking, and therefore soul control, toward monogenetic monotheism. One gene for one disorder: Splice the gene, teach it tricks, combine it, and the disorder is gone, or at least you don’t know you have it. The narrow path leads back to the thirties and forties of psychiatric history, though in a more refined manner and with better press releases. From 1930 into the 1950s, correlating specific brain areas with large emotional and functional concepts provided the rationale for the violence of psychosurgery and the lobotomizing of many a troubled soul at odds with circumstance.

    The narrow path is yet more retro, going back to the skill analysis of Franz Josef Gall (M.D., Vienna, 1795), who settled in Paris and was much appreciated by the French. From him came the “evidence” that skull bumps and declivities could be correlated with psychological faculties (a system later called phrenology). Much as they are today, the faculties were given big names, such as memory, judgment, emotionalism, musical and mathematical talent, criminality, and so on. Refinement in methods over the years does not necessarily lead to progress in theorizing: 1795 or 1995–material location, and then reduction of psyche to location, prompts the enterprise….
    ——————————————————————————————————————–

  16. Nobody has commented much on the risk factor that the article mentions. The governments are keeping psychiatry alive and in power due to their claim that they can assess risk to society. Indeed in the middle of the nineteenth century, when arguments were being held whether you needed medical specialists in the new built asylums, let alone running them, the medics argued strongly that only they could detect dangerousness, at 50 paces if you like, even when it wasn’t apparent to others. This gave them key to the asylum, and they have held them ever since. No other profession or body, other than the courts, have made this claim. Until this is addressed psychiatry will rule the casino.

  17. There are a bunch of things I’d like to comment on, but – for now – there is one that I think is a crucial point. You finish: “It may be true that the house always wins, but that only applies if you choose to cross the threshold and enter the casino.”

    But that’s precisely the contrary of how psychiatry works. I’m sure we could dig up some numbers, and I don’t know them offhand, but I’d wager to guess that some substantial portion of psychiatric victims never **chose** to cross the threshold and enter the casino. Psychiatry came and got them – and, once it got them, it sunk in its possessive claws and didn’t let go. Some people got tangled in its bureaucratic weaponry (i.e., mental health laws), some people got “treated” in ways that destroyed their lives, and some people either died from the abuse or decided that they couldn’t live with the hellish memories of what psychiatry had done to them.

    I know I didn’t search out any psychiatric casino, and I surely didn’t choose to enter it. When (real) doctors accidentally killed me and needed an “alibi,” so to speak, who do you think they called? It wasn’t the ghostbusters … Psychiatry came, saw, conquered, and destroyed. There was no voluntad here.

  18. Dr. Tampiyappa, While I certainly appreciate your enlightened musings on the state of your chosen profession, I find similar essays pop up on MIA…with no ‘real-world’ solutions.

    As a former ‘client’ and part of the “ballooning” of diagnoses (2004), gifted with a financially compromised (ProPublica “Dollars for Docs”) bipolar diagnosis…AND as a result of the DSM IV… the 11 years of loss (everything) and resultant damage (brain lesions and seizures, +more) I experienced, comprehensively informs me that talk is cheap…especially from someone who could make a bigger noise in your position. I finally won a ‘new’ diagnosis, (F41.9-Unspecified Anxiety-no shit) with a “Good bye, good luck, keep quiet”.

    If you join the ‘party-in-power’, learning of and/or knowing it is characterized by a plethora of systemic fatal (literally) ‘flaws’, I would have hoped you could offer more than “…keep questioning…” as a push-back.

    Full Moral Status is the goal of any legitimate and ethical medical “niche”. Reform will happen within your ranks when this essay is followed by a ‘How-To’ addendum published in industry publications and ostensibly ‘neutral’ journals…and given space on the agenda’s of major association conferences…relentlessly.

    Psychiatry/Pharma’s goal has never been shrouded in mystery: cost and liability containment and a ‘lifelong’ revenue stream. Their absolute support by the U.S. Judiciary is the iron-clad cultural and legal firewall that protects, reinforces, and ensures sustainable power….unique and apart from the “…medical establishment…”. There might be ‘side-eyes’ from other medical professionals, but they know that speaking against psychiatry is fraught with professional liabilities, a nest of legal vipers. I experienced it as a client, in an ER suffering from yet another ADR, with the angry, sympathetic doctor following up the next day with a quiet, surreptitious referral for safer care…that came to nothing. But he ACTED.

    U.S. Psychiatry is a Harvard Business School wet dream…. define your target market unchallenged, label it a ‘lifetime’ condition to be feared by ‘others’, and provide the only ‘treatment’.
    The largest obstacle has been keeping the ‘host’ alive long-term, extracting maximum profits.

    The industry has been adjusting their marketing to accommodate the louder, inescapable accumulation of data (Science!) that is nibbling at their toes with more millennial-friendly language as they see the rise of algorithms, apps, and a chemical/corporate-suspicious population eroding their growth. It’s a tactic that has worked well in the past.

    Safety for clients already drowning in chemicals and GED-level care in public clinics is the cesspool that needs addressing. It’s unpleasant, contentious, and messy, completely unsupported by legislation and the public. And it’s the first step for real reform.
    I found your comment regarding doctors learning about ‘real’ drug effects from Inner Compass, naïve. Most lower income clients get prescriptions from PA’s, MA’s, and NP’s. Bluntly put, they don’t spend their free time researching the harm they may be causing. Most of us know that they will be characterized as ‘symptoms’, not side effects.

    A journey starts with one step. I hope you become more active in the part of the movement that addresses safety. Conquer the battles that will win the war; tactics and strategy…fighting a massive cultural cancer.

    Your heart sounds true. It needs to be louder…. with verbs.
    By definition, former clients have little to no credibility with the industry or the public.
    We’re often left preaching to the converted…or bickering about semantics among ourselves.

    Challenging psychiatry effectively is waaaay past “Keep questioning”. And, respectfully, according to psychiatry ‘..everyone DOES have a disorder’. It’s measured by economics of the client, situationally, and subjectively…what could go wrong? And there is no true collaboration with clinic clients without full disclosure…something that evaded me in 11 years. private and public ‘care’.

    As ‘psychiatry abhors a diagnostic vacuem’, removing the financial rewards for those diagnoses is fundamental.

    It’s huge, messy, contradictory, and ‘pushing back’ against hundreds of top-shelf attorneys and world-class marketing for pharma…not to mention manufactured cultural mores that are regarded as truth.

    Having been a croupier in the cruise industry, I don’t think your ‘the house always wins’ is an apt metaphor.
    It trivializes the consequences of trusting a medical professional to behave ethically, compassionately, with Primum non nocere as their driving principle, not chance and the spin of a wheel or the fall of a card.

    Considering the recent extinguishing of important voices noted in this issue of MIA,,,,lives are at stake.

  19. Thanks for this thoughtful and fun article. I always appreciate hearing about red pill observations from folks inside psychiatry. I’d like to suggest that the rise of psychiatric diagnosis does not have its beginnings in economic neoliberalism, but further back with the advent of bigger and shinier machines. It was industrialization that set off the whole circus; industrialization happened just after the European Enlightenment threw away souls in Nature and replaced the entire material world as composed of wound-up, mindless clocks. That’s where the idea of a body as a machine emerges. Psychoanalysis in the early 20th Century, like the Romantics the century before, were aghast at that conceptualization and offered interesting rebuttals in their theories of psyches. But after WWII, with the rise of nuclear proliferation and the Cold War and the obsession with machines making humans better and brighter, the whole body-as-machine ideology firmly took root. I can’t find hardly any scientific thinking that doesn’t start with the idea that biochemistry makes minds, and that biochemistry is run by the immutable laws of physics. That’s the foundation we need to attack: the body, and the mind, are not machines, and neither is the way the Universe is run…

  20. This is right on the mark and well said. Mainstream psychiatry is struggling and faltering under the yolk of scientism (“an exaggerated trust in the efficacy of the methods of natural science to explain social and psychological phenomena, solve pressing human problems and provide a comprehensive unified understanding of the meaning of the cosmos” [Webster’s collegiate Dictionary]). It ‘s like the man who was looking for his keys under a streetlight. A passerby asked him what he was doing. “Looking for my keys”. “Well, did you lose them there?” “No” “Then, why are you looking there?” “Because it’s the only place I can see”.

  21. Look at the DSM, which is in fact a CATALOG of BILLING CODES. After only short “treatment” with psych drugs, every so-called “diagnosis” in it can be reduced to 2 words: “Iatrogenic neurolepsis”….
    The dramatic expansion of the DSM has ONE primary driver. More bogus “diagnoses” =equals= that many more excuses to $ELL DRUG$…. Follow the MONEY, and Power, and Control. Psychiatry is 100% FRAUD!

  22. “Does this mean mental illnesses don’t exist? Surely this isn’t a tired rehash of iconoclasts from the 60s like Szasz, Laing, Foucault, et al? Are you saying that people aren’t suffering?”

    Here is the rub. This is the main problem with Mr. Tampiyappa’s article.

    He poses the rhetorical question as if it weren’t an important question, but it is the central question. The answer to the question is “Yes. This means that mental illnesses don’t exist.” The truth is always fresh, not a tired rehash. Furthermore, lumping Szasz in with Laing and Foucault misses the mark by a long shot. Szasz wasn’t simply an iconoclast, and he was as different from Laing and Foucault as day differs from night. Szasz understood and articulated the truth about psychiatry. For that crime, he has suffered the fate of most truth-tellers, namely, to be ignored, ridiculed, downplayed, or misinterpreted.

    The truth, as Szasz well knew, is that mental illness is a myth. Nothing could be more necessary than to “rehash” the truths that make psychiatrists uncomfortable, which discomfort leads them to dismiss Szasz as an iconoclast or to group him with people with whom he vehemently disagreed. Szasz wrote an entire book on the foolishness of Laing, and he Szasz occupied the opposite end of the political spectrum of both Laing and Foucault.

    So, let me answer the questions one by one, because they shouldn’t be rhetorical questions:

    “Does this mean mental illnesses don’t exist?” Yes. Exactly. There is no such thing as “mental illness.” So-called “mental illness” is a fabrication of the most nefarious kind, and an illusion of the psychiatric imagination that has caused and continues to cause unspeakable harm to untold numbers of innocent people.

    “Surely this isn’t a tired rehash of iconoclasts from the 60s like Szasz, Laing, Foucault, et al?” Again, there is nothing tired about the truths that Szasz set forth in his voluminous works. The truly nauseating and tiresome ideologies are those propounded by psychiatry itself. Nothing could be more necessary than to reiterate the truths that Szasz articulated so clearly, because truth is always new and fresh, whereas psychiatric propaganda is insidious.

    “Are you saying that people aren’t suffering?” People are suffering, and many of them are suffering as a direct result of the continued existence and expansion of psychiatry. Psychiatry is the very cause of the suffering that it purports to assuage. Yes. People are suffering, and until psychiatry is abolished, people will continue to suffer from the abusive and coercive practices that are inherent in psychiatry.

    Enough is enough. Let me help everyone out of the Matrix. There is no need to disentangle antipsychiatry. There is an urgent need, however, to abolish psychiatry. The time has come to slay the dragon of psychiatry.

      • I don’t know about cannonizing Thomas S. Szasz, nor demonizing R.D. Laing and Michel Foucault, however, labeling all three iconoclasts is rather like demonizing the lot of them. (Rather them than the lot of us conformist pro-shrinkery shrinks perhaps, huh?)

        I don’t think the critical arguments against standard practice have grown any stronger since the exit of the three above mentioned “iconoclasts”. If anything, the matter has degenerated, in the boring department, to the extent that it could put almost anybody to sleep. Maybe they can use them to cool the tempers of people labeled as “suffering” from bi-polar disorder, a disorder that grows more popular with every sales pitch.

        If you’re going to demonize all three, please, I beg you. Let me join the ranks of the condemned.

  23. With all due respect Dr. T, I don’t have the power to vote anyone off the Island since I lost all citizenship rights after getting labeled. (The label itself made me suicidal while i believed it.)

    You might say I have fled the island no longer feeling safe there.

    I have no doubt the pills help some by numbing their emotional pain.

    i sought out psychiatry willingly but had no idea i would be labeled ‘bipolar’ because the SSRI would keep me awake for 3 weeks straight. On a cocktail for 22 years and kicked out of college. No career or family or friends in my late forties thanks to being labeled and drugged so heavily I slept 10-12 hours a day. (And too numb to pick up on social cues and nuances I ordinarily could.)

    You could argue I came willingly but so could the victims of Farid Fata who willingly took lengthy chemo treatments because he told them they had leukemia. And they didn’t.

    Unlike you Dr. T., my psychiatrists told me I had a chemical imbalance in my brain their drugs would rectify and I would probably harm myself or others without the cocktail i must take. Most denied what i experienced–my tonic seizures (minor side effect)–and blamed my weight gain on nutritional ignorance and gluttony. Then marveled at my depression and low self esteem. Fancy that. *Eye roll.*

    When I read William Glasser i was so relieved to know i was not a monster and it was not my fault the drugs made me feel awful instead of helping me live independently and get along with others outside the MI ghetto.

    Nowhere but MIA to share stories like mine it seems. And there are plenty.

    Thank you for acknowledging people like us exist and shouldn’t be locked up for what others have put us through.

  24. I wonder if the person wants a medication and the patient is warned about side-effects and withdrawal and that it will be for a trial period doesn’t medication still have a valuable role in the mental health field?

    You can become dependent on a benzo in as little as two weeks and you can become dependent on antidepressants and neuroleptics in about a month.

    Are patients warned about that aspect? That doesn’t give you much time to “trial” a drug before ending up having to stay on it for months or even years in order to do a safe taper.

    Regarding your comments about seeing some people’s lives transformed and other’s destroyed by the drugs, have you heard of the “more harm than good” conference? A write up is here from CEPUK:

    http://cepuk.org/moreharmthangood/

    And the videos are here:

    https://www.youtube.com/channel/UC8eIK8kuf7tht1gV1HApH0g

    When the harms outweigh the good, then your answer is no, there is no valuable role for these drugs. That’s not just my opinion but basic math.

    Also, you may want to read Dr. Irving Kirsch’s writings on the placebo effect.

    https://www.madinamerica.com/2017/09/irving-kirsch-placebo-effect-tells-us-efficacy-antidepressant-drugs/

    They want a diagnosis and treatment preferably a pill.

    Of course they do – psychiatry has been preaching the chemical imbalance for decades, meanwhile diverting much-needed resources away from other things that could be helpful that don’t involve destroying our health.

    For the vast majority symptom checklists give little indication whether medication may make a difference or not.

    By “symptom checklists,” do you mean the DSM? The manual of checklists that psychiatry wrote?

    So if psychiatry doesn’t know if the “medication” (drug) will make a difference, why did psychiatry form its practice around the bio-medical model? Psychiatrists were the ones who wrote the checklists.

    So in conclusion, rather than voting psychiatrists off the island shouldn’t we together honour our different experiences and commit to continuing respectful, mutual learning from each other?

    I’m going to quote Dr. Phil Hickey to answer this question. From his blog “In Defense of Anti-Psychiatry”:

    Psychiatry is not something good that needs minor adjustments. Rather, it is something fundamentally flawed and rotten. Based on spurious premises, and devoid of even a semblance of critical self-scrutiny, it is utterly and totally irremediable. It has locked itself into the falsehood that every-problem-is-an-illness-and-for-every-illness-there’s-a-drug from which it cannot extricate itself. It is nothing more than legalized drug-pushing, endlessly attempting to mask its guilt by proclaiming its innocence, vilifying its critics, and calling for more “treatment.” It has built into itself the seeds of its own destruction, and will eventually fade away as its credibility dwindles, and more and more potential recruits recognize the sordid reality and seek careers in genuine, ethically-driven medicine.

    https://www.madinamerica.com/2019/04/in-defense-of-anti-psychiatry/

    • Thank you anomie for the comment, and great quote from Dr Hickey.
      I have gone to ER quite a number of times in the last 5 years, though I have not used much healthcare in my 60 years.
      At ER, they do love to use the MI. Argue with them and they look at you coldly and say humorous things like “there is science behind it” “scientific studies”.
      Well wth am I supposed to do with that? He has no bloodtest, nothing, just a set of “symptoms” or “behaviours”. which of course are all inherently flawed. So no matter what, I am flawed because the “checklist”. The checklist proves I have something and it also has a label under that checklist.
      So in reality, one never has to step into the casino, psychiatry ensured that in every facet of society, their casino exists, so it is NEVER voluntary, and is the biggest reason to get rid of them.
      What is SO very mind boggling is that they themselves grumble about how the checklist does not deal with the many “maladies” we “suffer” from, so their answer to this, voila, make more items on that checklist.
      It is in theory, like something out of a Monty Python movie. But in practice like something out of a Frankenstein movie.
      It really is an embarrassment to psychiatry and they have no clue how to get themselves out, because they are trying to do so, saving face.
      I think it’s most likely best to just own up to the complete failure than to keep twisting it, since twisting and adding to stories only makes one look less credible.
      Sometimes one has to step down or go down the hard way.

  25. Dr. T….Know when to stop.
    “…respectful, mutual learning from each other….”…Really?

    Your insistence on having it, not both ways…but ALL ways in this convo is insulting.

    “…shouldn’t we together honour our different experiences and commit to respectful, mutual learning from each other…?” is the equivalent of beseeching the victim of the Stanford Rapist, Brock Turner, to ”understand’ the motivating principles that compelled his attack on her…..AND (as the first judge did) “respect” the negative impact a criminal record would have on his otherwise bright future.

    No. It’s about the victim.

    He did it because he could… and expected to walk away sated and waiting for the next ‘opportunity’, undiminished in any way.
    It was a rare anomoly that he got caught…and ultimately paid a tiny uncomfortable price.

    Nobody talked about the victim’s price. She had to do that heavy lift herself.

    The topic of psychiatry’s exploitation of human suffering is decidedly NOT a “Can’t we all just get along….and respect each other?” moment for the massive number of victims.

    And for all the seemingly drug-supported, ‘happy’ customers…check back in 2, 5, 10 years as their ‘maintenance’ prescription problems permanently outstrip any initial ‘issues’ they once had.
    I defy you to cleanly isolate and address the initial ‘complaint’ at all…now metasticized into a larger, more ‘drug-resistant’, intertwined tumor.

    More to the point….why do you think psychiatry has to find answers to questions regarding the damage it creates and sustains by reading about it on websites or forums?

    Try LISTENING AND BELIEVING the clients sitting right in front of you. They are not algorithims and abstractions.

    Navel-gazing and theorizing (& ultimately excusing) your profession’s history of irrefutable carnage (well-earned hyperbole) souns like specious, self-absolving existential indulgence.

    My decade of assault by psychiatry trumps your “experience” with 25000 clients. I believe your remark “I don’t see myself as an expert…”. Is disengenuious.
    As a resident of the U.S. south, it’s like saying you’re a member of the Klan….. but one of the ‘good’ ones.

    I don’t “honour” predators…of ANY kind.

      • Exactly Rosalee,
        I was thinking about that this morning….how refreshing it would be to have a shrink upon first meeting say “I stay away from diagnosis or leaving notes that in any way can be construed and used in the diagnostic field”
        I have never even met a therapist who does that.
        It is not mentally healthy to see people in the “mental health” field. In fact is so convoluted that one can’t mention a diagnosis even to a therapist. It definitely influences people’s opinions.
        IF I share parts of me, it is because I could care less what the person does with that within their own heads, but I certainly know I could never change a perception and it is not even my job. I gave up on curing shrinks or even laypeople of their biases, narratives.

  26. One of the things I glean from these comments is an undervaluing of the kind of psychotherapy I and many other therapists practice. I am trying to help people realize that whatever they are experiencing, no matter how painful, debilitating, bizarre is understandable in view of their histories and how they are reacting to their life situations and to concerns they have about their lives and themselves. So I am helping people use their “symptoms” to learn about themselves and to get to know themselves in an accepting and loving way. I am helping people become aware of limiting beliefs about themselves and the world, disowned parts of themselves, habitual, fixated responses that get in the way of them loving the way they want to love and expressing themselves the way they want to express themselves. I am helping them learn to manage their thoughts, emotions, intentions, perceptions and behavior to live more they way they want to live.

    I believe this kind of psychotherapy is way undervalued and underused in our society. Also, when we use the word psychotherapy I think we should include all of the ways in which people can be helped to love and express themselves in satisfying ways – yoga, support groups, all kinds of group and family therapy, exercise, sports, dance, help with relationships and work, meditation, spiritual practices, etc.

    • I do not undervalue good real help. And I use the word “help” carefully.
      A lot of people look for guidance, and I believe that people get stuck in areas, often developmentally, but it has no need to be defined. Not just in psychiatry but in other therapies as well.
      People hate feeling as failures and don’t need to be reminded.

      But Al, if you get results, if you genuinely help to empower people without stripping them of rights by using labels, I applaud you.

    • I believe this kind of psychotherapy is way undervalued and underused in our society. Also, when we use the word psychotherapy I think we should include all of the ways in which people can be helped to love and express themselves in satisfying ways – yoga, support groups, all kinds of group and family therapy, exercise, sports, dance, help with relationships and work, meditation, spiritual practices, etc.

      Al, I don’t see what yoga, exercise, sports, dance, meditation, and spiritual practices have to do with psychotherapy.

      Something that’s good for you doesn’t need to be labeled as part of any “psy” category.

      This is a key part of the antipsychiatry message – in order to end one oppression (psychiatry) doesn’t mean offering alternatives. There are things that are good for you that aren’t any part of any of the “psy” professions.

      Since anti-psychiatry is in the title of this article, I think this is important to point this out because many psychiatric survivors who identify as anti-psychiatry are also anti-psychology and for good reasons – most psychologists “treating” people who are tapering off their drugs are uninformed psychologists who create even more trauma for their “patients” by not believing that their anxiety, depression, and voices are withdrawal symptoms.

      Until this profession gets an education in de-prescribing and stops attributing iatrogenic drug harm as their “patient’s” having a relapse of “mental illness” due to coming off psych drugs, psychologists need to be avoided.

      Again, you don’t need a “mental health” professional to do things that are good for you.

      • “Al, I don’t see what yoga, exercise, sports, dance, meditation, and spiritual practices have to do with psychotherapy.”

        I want to piggyback on this one and add both agreement and disagreement.

        I agree completely that these things should not be viewed in the context of alternatives to psychiatric care. These are things that are good for everyone and should be available to folks, but largely aren’t. And I am of the mindset that people who want to see these sorts of things available socially should work to create community spaces where these sorts of group activities can be offered. I am entirely against the idea that these things should become part of the medical paradigm.

        On the other hand, I also believe that alternatives to psychiatry – things like Soteria House and Open Dialogue and RLCs and peer run respites – are absolutely critical to providing safe places for folks who are in or recovering from extreme states. If “we”, the patients and former patients, don’t take these initiatives, “they” will continue to believe that “we” need “help” which “they” have deemed themselves to be the “experts” on providing.

      • Yes anomie.
        Do you realize how many hours I have spent scrolling through “psychologytoday” to read all the bios.
        “I know how hard it is to look for help. But you have taken the first and right step. I am here to help you identify where your problems are and how to help you achieve better mental health”

        As they say. “good help is hard to find”. Possibly this should be nailed to every shrinks and therapists door.

        • Again, why should we care “what they believe”? — do we get paid to educate shrinks about how to do their alleged “job” better? Just stay away from them.

          But also let’s not conflate psychiatrists (“shrinks”) with “psychotherapists”; the latter is not a clearly or consistently defined term.

          • Drug therapy versus talk therapy, basically, that’s a big difference in my book. Boring Neo-Freudian or Jungian revisionist talk shrinks aren’t Neo-Kraepelinian drug pushing bio-shrinks. Thing is, they discovered, just the other week, you don’t need a medical degree to administer talk. I guess the idea is…the more cooks the better the stew. A popular saying, of course, folk wisdom, has it the other way around. Most of these talk shrinks dish out a few drugs and most of these bio-shrinks offer you 15 minutes of fame during rounds. It’s the exceptions that are helpful, but the problem is, there are just too darned few of them to make much of a difference. Peer pressure, but not from those peers, I think, is one of the reasons that this is the case.

  27. TN,

    Here’s the problem with psychiatry.

    In order to be mentally healthy, human beings have to be able to love the way they want to love and express themselves the way they want to express themselves. They have to be connected to other human beings in satisfying ways – romantic love, sexual love, familial love, collegial love. And they have to be able to use their faculties, their abilities in satisfying ways. When they can’t do that they become agitated, upset, manic, obsessed, depressed, psychotic. Effective treatment consists of helping them learn to use their thoughts, emotions, intentions, perceptions and behavior to love the way they want to love and express themselves the way they want to express themselves.

    When psychiatry decided to become a laboratory science – paying attention only to things that could be quantified, measured, seen on brain scan, studied in a laboratory, it turned its back on human nature and became essentially useless to human beings.

    You can’t study human love and human expression in a laboratory and you can’t help people learn how to love and express themselves with a pill or psychosurgery. This is psychiatry’s dilemma. And, so far, it has been unwilling to acknowledge it and deal with it.

    • Of course, they don’t really even do laboratory science, either. They do experiments on heterogeneous groups, don’t identify proper outcomes half the time, if they do identify outcomes and they come out negative, they shop around for positive outcomes instead of reporting, and when their own research condemns their process, they ignore it or “explain” it away and keep on doing whatever they already decided they wanted to do. Not very scientific.

    • “Effective treatment consists of helping them learn to use their thoughts, emotions, intentions, perceptions and behavior to love the way they want to love and express themselves the way they want to express themselves.”

      This is typical treatment provider speak, assuming that the problem is within the patient and not within their environment. One reason I greatly respect Robert Whitaker despite our differences in outlook on the potential redemption of psychiatry is because I believe this is one aspect of psychiatric harm that he truly understands.

      Psychiatry harms because it pathologizes the “patient” and attempts to correct the “patient” when the malfunction is in the space between people in social relationships. This is the crux of the medical model, no matter how many nice sounding psychology terms you couch it in.

      • “Psychiatry harms because it pathologizes the “patient” and attempts to correct the “patient” when the malfunction is in the space between people in social relationships.”

        Yes, exactly why I say that psychiatry is based on scapegoating, which is harmful for individuals, obviously, and socially divisive, to the point of creating easy targets for social abuse. I also agree about the problem being in “the space between people and social relationships,” that is perfectly stated.

        So my quesiton is: who or what would be the agent of change to correct that particular malfunction?

  28. Anomie, Ditto.
    Complaining about being “undervalued”…. how genteel.
    This is a bloody, bruising, often deadly street-fight.
    Psychologists should fight harder for their ‘market-share’ and position in treatment if they feel slighted and unappreciated. Form a better lobby and more aggressive marketing, buddy. Suck it up. THEY are who they are. Push back harder about what you can offer…not how bad they are. .beating a dead horse and preaching to the converted here.

    The ‘undervaluing’ is by in$urance companies and, of course, the APA/Pharma bloc…resulting in being ‘undervalued’ by politicians who hang on every directive from their donors (#3, behind ‘Energy’ and Wall Street). “Drugs are cheaper, better, faster…quality therapy is expensive, indulgent, and slow. The American Psychology Association does NOT ‘support’ your re-election campaign.”
    As the American Psychiatric Association (Pharma’s field reps) dictates, therapy is regulated to LCSW and case managers if you don’t have top-shelf insurance. Few options.
    It sucks….not for you Al….for us.

    And BTW, my top-shelf insurance (before forced Medicaid) provided me with a psychiatrist/psychologist-a ‘DD’-dual doc) in a beautiful high-rise in Fort Lauderdale, gorgeous office, big leather chair, and an impressive ceiling-to-floor library behind him.
    I had lost my house after a bipolar diagnoses (presenting with financial anxiety and insomnia!) from side effects, being unable to work. Homeless, drugged, couch-surfing, and filing bankruptcy at 54 years old…followed by someone running a stop sign and totaling my car. Perfect.
    In the ER on a gurney, my ‘couch-host’ dropped by to tell me to get out THAT DAY.
    I couldn’t even live in my car. I welcomed the quiet, cool room my brain immediately went to. I was thoroughly blunted by the drugs, knowing I should be shrieking in despair. It was REAL madness…and my Trileptal (+++) was telling me to kill myself. Called my doc.

    At my appointment, Dr.P listened with glasses perched on his forehead, rocked in his chair frowning, tented his fingers and asked me…”If you were Jello, what flavor would you be?”
    I. Am. Not. Kidding.

    Yoga, Tai Chi, ‘group’, exercise, dance…and Jello…..yeah, that’s the ticket.
    I needed a safe curb to sleep on that nite.

    I’m a little low on empathy regarding being “undervalued”, Al.
    This fight is not for the delicate. Your part of an established, white-collar profession. Make some bigger noises. Be aggressive.
    Change things.

    • “If you were Jello,” seriously??? That is majorly warped.

      I’m glad you brought this up, especially regarding the obvious financial advantages the “mental health professionals” display. It seems like quite the slap in the face. I mean, I get someone wanting to have a nice office that doesn’t have paint peeling or sticky spills on the floor or broken blinds, but these opulent offices just scream “I’m making a boatload of money off people like you, and when push comes to shove, that’s what really matters to me.” I think it’s inherently offensive. But I guess if the “professional” really believes their clients deserve less because they are that much less important or valuable, maybe they don’t notice how insensitive and greedy they’re being.

      • I spent time in a day facility where the man in charge, a psychologist, used to go sailing in the Virgin Isles on his vacations. You think any of the screw ups in his charge got to go sailing in the Caribbean, too? Heck no. Most of them had been robbed blind by the mental health system. Specifically, by people like him. Believe me, I wasn’t shedding any tears when eventually he lost his job.

        I generally don’t go in for such places anymore. I don’t see the benefit in setting people like him up at my own expense. I’ve got better things to be doing. Almost anything you can imagine has got to be a better thing, in the sense of goodness, than what he was doing. I think the unfairness of the world was in a way his expense account, and I’m happy not to be there to foot the bill.

        Am I crying foul as far as his case is concerned? Yeah, I think that’s exactly the way I’d put it.

    • Krista,
      The psychological questioning can be so minimizing. And I know it is, even to kids.
      If one asked a kid inside a therapeutic setting, “what flavour of jello would you like to be?”
      The kid would either think it to be a weird question, or he would realize that someone is
      attempting to get the “right answer”.
      A lot of or most of these settings are belittling.
      I went to a “psychological group”, housed inside a large old house, with massive banisters, wide stairs, in an affluent neighbourhood. The psychologist was “nice”, in that nice way, but as soon as I sat down she turned on her video cam, sat down with her note pad and never looked up.
      My fear of having a bunch of crap sitting around in offices, cd’s, paperwork is that what if someone gets hold of it. What if I get into some trouble and all this info is used against me?
      And it is never used for you. We give people some intimate details and I realize now, the only time
      there is a secret is if you tell no one.
      Society tells people that IF you feel suicidal, never tell anyone.
      It is why some articles recommend to go to a friend that has no degree.
      I did have to try and stuff the feeling about the grandiose offices I went to, and as Steve mentioned, I realized they can’t be in some ramshackle office, yet still, I realized the amount of money needed to upkeep this historic house. And that $150 per hour, four times per month is $600 out of pocket, IF you don’t want the whole world to know your biz.

  29. Kindred Spirit,
    I agree that our society is toxic, oppressive, inhumane and that a lot of fixing needs to be done. I also think there’s value in helping people to live more the way they want to live inside of it.

    Krista,

    Yeah, we’re not doing a very good job of fighting Biopsychiatry. I belong to an organization that is dedicated largely to doing that. We have only 146 members. Compare that to the thousands of members of the Society of Neuroscience and the billions of dollars that are going into studying the brain, an effort that is not likely to help human beings very much in the foreseeable future.

  30. Is it a coincidence that the neoliberal project which started flowering particularly in the US and UK in the 1980s also saw the spectacular rise of psychiatric diagnoses?

    This is an impressive and spot-on insight which makes me realize most of my comments so far have been tangential, or in response to other comments.

    My general response to the article is that the author is no dummy and has a very good understanding of a slew of psychiatry’s contradictions, but at the same time doesn’t seem to make some of the connections which might prompt the realization that psychiatry IS a police force, not a legitimate branch of medicine, and that these logical disconnects are not random or coincidental. So as an academic article this has its moments; the lingering question is what impact this somewhat disjointed analysis has, for better or worse, for Dr. T’s “patients” if he does indeed “practice.”

    • My general response to the article is that the author is no dummy and has a very good understanding of a slew of psychiatry’s contradictions, but at the same time doesn’t seem to make some of the connections which might prompt the realization that psychiatry IS a police force, not a legitimate branch of medicine, and that these logical disconnects are not random or coincidental.

      Oldhead, my take on this is that the article is INTENTIONALLY disconnected. Many of us made these connections while coming off psych drugs and dealing with profound cognitive issues.

      It’s not that hard to connect intellectually. But connections aren’t always made at the conscious, intellectual level. In order to reach this realization, psychiatrists – the “healers” of our tribe as they’ve been taught to believe – have to face what they really are and what their profession has done to millions of people left disabled, traumatized, and many, dead.

      So maybe I’m wrong and not all the disconnect is intentional, but perhaps, simply a human response. I don’t think any psychiatrist signed up for this any more than any “patient” did. Other than Dr. Thomas Szasz, I can’t find any other psychiatrist who figured it out prior to medical school.

      Please don’t think I’m excusing any crimes at the individual level because there are many, but I believe it’s about the system.

      And yes, it is a police force, not medicine. It never was meant to be anything other than that.

      • I didn’t say the disconnects are intentional and would have no way of knowing. In any case they’re there; I think why they’re there is secondary. Sometimes unless something jibes with one’s personal experience “obvious” connections aren’t so obvious. But it’s a positive sign that he sees the contradictions.

        • Sometimes unless something jibes with one’s personal experience “obvious” connections aren’t so obvious.

          This is very true, Oldhead. Yet another reason academic anti-psychiatry is problematic.

          But it’s a positive sign that he sees the contradictions.

          Yes, perhaps this doctor will eventually become an ally once the connections are made. Not many psychiatrists admit there are problems in the field and acknowledge the work of the online peer-led advocacy groups.

          It’s all a process, not an overnight event. It will be good to find more allies.

          • Yes I remain hopeful Dr. T. N. will be an ally.
            Btw, Anomie thanks for the link to the NY times article “The Largest Health Disparity” on how doctors dismiss physical health problems of those with psych labels and that this form of discrimination has actually been given the name of “diagnostic overshadowing”.

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