Awais Aftab is a psychiatrist in Cleveland, Ohio, and Clinical Assistant Professor of Psychiatry at Case Western Reserve University.

He is a member of the executive council of the Association for the Advancement of Philosophy and Psychiatry. He has been actively involved in initiatives to educate psychiatrists and trainees on the intersection of philosophy and psychiatry.

He leads the interview series Conversations in Critical Psychiatry for Psychiatric Times, which explores critical and philosophical perspectives in psychiatry and engages with prominent commentators within and outside the profession who have made meaningful criticisms of the status quo. He is also a member of the Psychiatric Times Advisory Board.

In this interview, he explores his journey into both philosophy and psychiatry and how he understands the relationship between these two disciplines. Aftab goes on to discuss how he began the critical psychiatry interview series and what he has learned from this experience and the pushback he has received. He then elaborates on how studying the philosophical issues in psychiatry, through a “conceptual competence” curriculum, could transform the doctor-patient relationship and improve mental health care.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

Justin Karter: Can you tell us about your background and what led you to a career in medicine and psychiatry?

Awais Aftab: I think a lot of people might not know that I’m from Pakistan, and that’s where I was born and grew up and went to medical school. Before I went into medical school, I was really interested in philosophy, and I was seriously considering whether I could pursue that on a professional basis. But philosophy as an academic discipline, especially as a way of making money, was pretty much nonexistent in Pakistan.

I do have physicians in my family. My older sister is a physician herself, so there was all this passive exposure that I was getting through family members who are physicians in Pakistan. It seemed like a natural choice for me to go into medicine as well.

I was interested in philosophy and psychology before medical school, and it became pretty clear to me early on that the only medical specialty that attracted me was psychiatry. It was not an easy decision, though, because there is a lot of stigma in Pakistan surrounding mental health, and this stigma also applies to people in the mental health profession.

There was a general perception at that time that good doctors don’t go into psychiatry and, if you’re intelligent, then you’re going to be drawn to specialties like surgery. I had to explain to family and to teachers that I’m passionate about this field and about changing this field.

 

Karter: You spoke about the stigma in Pakistan around utilizing psychiatric services and also the stigma toward professionals in the field. What was psychiatry training like in Pakistan? How do cultural differences impact training and practice in the field? Did any differences jump out to you when you began practicing in the US?

Aftab: There are tremendous differences in how medicine, in general, is practiced and in Pakistan versus the US, and those differences are present in psychiatry as well. Most of the medical training loosely follows the British model.

I think psychiatry in Pakistan struggles with being under-resourced, and the ratio of psychiatrists to patients is very low. The availability of medications, especially newer drugs, was a big problem. In general, there were a lot of challenges within the system.

When I started my psychiatric training in the US, one thing that was different was the legal apparatus that exists here with regards to mental health care. There is a system of rules that exist that set boundaries and also establish some accountability.

In Pakistan, there are very few legal regulations that apply to mental health care. It can create a sense of chaos when you’re treating someone who is experiencing symptoms of psychosis or mania, and the family is concerned. This can lead to deception on the part of the families, which sometimes can cross ethical boundaries.

It is pretty common there that family members would obtain psychiatric medications and mix it into the food of a person without that person knowing. That’s not ethically defensible, but I think you can see it as a consequence of a society that has failed to develop other ways of addressing these situations.

In the US, to obtain the majority of psychiatric prescriptions, you have to go to a doctor, and they have to prescribe the medication to you. In Pakistan, things are changing now, but when I was there, essentially, you could go to any pharmacy and get any medications you wanted. The psychiatrists were not the gatekeepers of psychiatric drugs, and anyone could go to any pharmacy and get a benzodiazepine or an antidepressant. So even though the number of psychiatrists was limited, the use of psychiatric medication was still widespread.

Another interesting difference between psychiatry in Pakistan and the US that I noticed was in terms of patient presentations. When it comes to depression and anxiety, a lot of people in Pakistan presented with what would be considered a neurasthenia presentation, where they’re focusing much more on somatic symptoms, such as headache, physical fatigue, weakness, or digestion issues.

There was this emphasis, privileging body problems, and physical problems over mental health problems. So people tended to present when they were depressed or anxious in that classic neurasthenia manner.

We used to see a lot of conversion disorder cases—far more than I’ve seen in the US. I think this is partially due to the fact that conversion disorder is seen much more often in women who are highly oppressed in many ways within the larger social system. I think that the higher rates of conversion disorder were sort of a barometer of social oppression.

Before I started my psychiatric training in the US, I had spent almost one year of psychiatric training in Doha, Qatar, where things are very different from the US and Pakistan in the way their society is organized. There is almost what you could call a ‘slave class.’ You have these laborers that come from various South Asian countries, like Nepal, Bangladesh, India. They come to Qatar seeking work, and then they get trapped there for various reasons, and they’re working in really horrible conditions.

While I was working there, we saw extremely high rates of what is called a ‘brief and reactive psychosis’ that refers to episodes of brief psychosis that seem to arise in situations of really high stress. That was a very common presentation among those laborers in Qatar. In contrast, it’s relatively rare to see a ‘brief reactive psychosis’ when the society’s not as oppressive for as many people.

 

Karter: It sounds like your experiences were really rich for thinking about these philosophical questions that come up in psychiatry and psychology about the role of culture in the experience of mental distress, and about ethical issues around coercion and deception in psychiatry. How did your philosophical training continue to develop during your medical training?  You produced a blog on the “History of Modern Philosophy” while you were in medical school. How did you see its relevance to medicine and psychiatry?

Aftab: My real love was always philosophy. Even though I was in medical school, I still was devoting a lot of time to my personal reading of philosophy. At that time, I was doing a lot of reading in the history of philosophy, especially the history of modern philosophy from Descartes onward.

As I was doing that reading, I was keeping notes, but once I had accumulated a relatively large volume of notes, I realized that with some more effort, I could give them a little bit more form and shape as a sort of book in a blog form. It ended up being this blog on the history of modern philosophy from an amateur perspective. I think that personal study gave me a solid foundation for further philosophical inquiries that I was interested in later on.

Initially, I didn’t see it as being that relevant to medicine. There was a bit of a disconnect in my mind. As I progressed, I began to appreciate how philosophical thinking can inform medicine. There are all of these hidden conceptual dynamics present in the way people make sense of distress, talk about disease categories, and approach them. I began to see this hidden philosophical structure beneath the practice of medicine, and this became much more apparent to me when it came to psychiatry.

Psychiatry is one area where things are relatively more subjective, and there’s a much stronger influence of values. It’s easier to see the influence of some of those philosophical assumptions on how things are practiced. But I don’t think that the nature of the underlying philosophical assumptions is that different in the rest of medicine.

Another big influence in this area happened during my final year of medical school when I became familiar with the work of the famous existential psychotherapist Irvin Yalom. At that time I was, I was personally really interested in the existentialist philosophers. I was exploring the views of Nietzche, Heidegger, Sartre, Camus, and when I discovered Yalom and started reading him, that made a huge impression on me as a medical student.

I love the way Yalom integrates existential thinking into his practice of psychotherapy and psychiatry and the way he makes sense of people’s distress and their anxieties. It gave me a much richer appreciation of what psychiatric practice could be like if done in the right fashion.

Later on, before starting my residency, I also read “The Divided Self” by R.D. Laing, who many people would recognize as being one of the so-called antipsychiatry philosophers. It’s a fascinating book because Laing is trying to understand psychosis from the perspective of existentialism. He’s trying to make sense of delusions, the disorganization, and the paranoia from an existential perspective, and he’s desperately trying to see meaning in those experiences. I don’t think I was fully convinced by what I read, but the sheer force and beauty of that intellectual effort left a deep mark on me.

 

Karter: You mentioned that you started reading works that applied philosophy to clinical practice in different ways. Yalom applies existentialism to psychotherapy, and Laing’s work takes existentialism and phenomenology and applies it to the lived experience of psychosis. How did this lead you to explore more of the critical psychiatry literature, and how did that shape your thinking?

Aftab: When it comes to the relationship between the field of philosophy of psychiatry versus what we now loosely call critical psychiatry, there is a big overlap, but they are also relatively distinct and somewhat insulated from each other. For much of my psychiatric training, I was reading literature in philosophy of psychiatry, and I was familiar with the intellectual work of the classic antipsychiatrists, such as Thomas Szasz and Michel Foucault.

Despite having this familiarity with the classic antipsychiatry thinking, the philosophy of psychiatry literature that I was engaging with wasn’t explicitly dealing with critical psychiatry issues. The critical psychiatry movement has very strong roots in the UK, particularly in the Critical Psychiatry Network. Until recently, there was not as much of a critical psychiatry influence in the US and the American journals and academic literature that American trainees are exposed to.

Even though there were articles related to critical psychiatry that were showing up in British journals and international journals, I wasn’t getting a lot of exposure to that in my training in the US. I think a lot of these critical psychiatry debates were happening in a much more prominent fashion online, especially on Twitter and on some of the blogs.

The result is that my exposure to what we would call critical psychiatry happened pretty late, near the end of my psychiatric draining. It was only shortly before the edited book on critical psychiatry by Sandra Steingard came out.

About a year before that, I did end up reading “Anatomy of an Epidemic” by Robert Whitaker. Reading “Anatomy of an Epidemic” and engaging with those ideas was quite an experience for me. Most of the people that I had spoken to or who I had mentioned that book to before had been pretty superficial and dismissive about it, calling it extreme or antipsychiatry. When I decided to read the book, I was expecting that it would be something I could quickly go through and thought it wouldn’t be something I had to spend a lot of time and energy on.

Reading “Anatomy of an Epidemic” ended up being a really jarring experience because I quickly realized that a lot of the arguments and a lot of the data presented in the book were not easily dismissed. And the nature of what was being discussed—the possibility that psychotropic medications can worsen outcomes, at least in a subset of patients—was one that was particularly unsettling to me.

I think back to my relatively naive days, and I wasn’t exposed to this larger body of work. Whereas now, two years later, after reading the book, I’m still thinking about trying to address those issues.

I think that book left a pretty deep impression on me. It wasn’t just because I accepted all of the arguments in the book, or was immediately convinced that everything that was being said was correct. I could see that a lot of the arguments, at the very least, are deserving of serious engagement.

As I started talking to other psychiatrists in the community, I realized that a lot of other people had actually read the book too. A lot of them were struggling to make sense of these issues in the same way that I was.

This was a relative surprise to me because most of the people who read this book, within the psychiatric community, have a tendency not to talk about these issues. But when you speak to them on a personal level, where they might feel free to talk more openly, I think a lot of them would say that this book unsettled them, that it is not something that they can immediately dismiss, and that this is something that they are actively trying to make sense of.

That book launched me into a whole new, different area of inquiry. Then later on, when I started becoming more active on Twitter, that’s when I started getting more exposure to the critical psychiatry folks and in the UK and started reading their work.

 

Karter: You’ve produced a series of interviews titled, “Conversations in Critical Psychiatry” for Psychiatric Times with several of the leading voices in critical psychiatry. Can you tell us how this series came about and what’s been your biggest takeaway from these interviews?

Aftab: When I started this interview series, I didn’t quite understand critical psychiatry in the same way as someone from the UK or someone who was active on Twitter might. I had a more neutral idea about the term “critical psychiatry” as being representative of the very diverse ways in which critical thinking and criticisms can be directed at psychiatry.

I was actively reading this critical literature that seemed very serious and worth engaging with, and then I felt a weird disconnect because almost nobody in mainstream psychiatry was talking directly about these issues. There was a tendency to either ignore them, be indifferent to them, or talk about them in informal settings.

That was a little frustrating for me because I thought that these critical perspectives had something valuable to offer psychiatry and that psychiatry would, in fact, benefit by engaging with them. I wanted to start an avenue for meaningful engagement with these critical ideas, where I could highlight some of the issues that I think are important to our field.

I think I was lucky that I had a good working relationship with Psychiatric Times editorial team at that time. When I pitched the idea to them, initially, there was some hesitation, pretty understandably, because no one had done anything like this in mainstream psychiatry, and no one knew what exact shape this would take and how it would be received. But they decided to take a chance on me, and I’m really glad that they did. Overall, the series has done pretty well.

Going back to the reasons why: one reason was that I wanted to highlight the critical perspectives that I think we as a field needed to hear. Even though I may not personally agree with all of the views expressed in the series, I still think it’s very important that we hear these things and engage with these ideas.

Secondly, I was still in the process of learning more and making sense of this body of work. I thought this series would present an excellent opportunity for me to learn more about these critical ideas and perspectives.

Very importantly, I wanted these engagements to happen in a relatively non-threatening, productive manner. I think there’s this tendency toward an unhelpful dynamic that develops where criticisms tend to be aggressively presented, and then the other side reacts in a state of being totally defensive.

That doesn’t help lead to meaningful engagement. It is fine if you want to refute something or if you want to dismiss something, but it’s not conducive to learning. It was really important to me that these interviews happen in a non-confrontational manner so that the readers would think about these issues without being threatened.

 

Karter: So you ended up in the middle of two worlds that you felt weren’t always speaking to each other in a very productive way. I’m curious about two things: First, what has the response been on both sides—How has the mainstream psychiatric community responded to hearing these critical voices and how has the critical psychiatry movement responded? Second, what have you learned by existing in that intersection? What have you noticed about the dialogue between critical psychology and the field at large?

Aftab: I have to say, and I was a little taken aback by this as well, that overall, the reception has been very positive. I was surprised by how well these interviews were received, at least by the people who were reading them, and even by even by psychiatrists that you would think of as being thoroughly mainstream, and as operating within with the current mindset.

A lot of them found the interviews to be thought-provoking. I think a lot of people may simply have ignored these interviews, at least in the beginning. I think, initially, a large chunk of readers probably didn’t really care for these interviews that much, and then a smaller chunk found these interviews to be worthwhile and positive.

Then there was a smaller group that responded to it in a little bit more critical manner, saying, “I don’t really think focusing on critical ideas is such a good thing. That’s not what we need. That’s not what the field needs right now.”

So there was a small amount of backlash, but it was fairly small within the psychiatric community. I have to say that the criticisms have not been to the extent that I might have feared when I started the series. I have to emphasize that overall the reaction from the psychiatric community has been very positive.

To some extent, that may be due to the way these ideas and arguments were presented. For example, the very first interview was with Allen Frances. I think that said something about the intention of the series because Allen is someone who was essentially part of the psychiatric establishment until, during the DSM-5 debates, he started writing much more about the philosophy of psychiatry. He started writing about the limitations of DSM and the harmful effects that it has had on society at large.

Because Allen has that background, being one of the architects of modern DSM, no one can come out and say, “Oh, Allen, he’s just antipsychiatry.” That’s just not an argument that anyone can make in good faith. I think starting off with someone like Allen was symbolic because it showed the series was aiming to be rooted within the psychiatric tradition, but also honest in genuinely exploring these criticisms.

Another example: when Anne Harrington’s book came out last year, a lot of the initial reaction to that book, within psychiatric circles, tended to be relatively negative because people hadn’t read the book itself, but were mostly relying on the various book reviews.

When I decided to interview Anne Harrington, I was anticipating that there would probably be more backlash for that interview. But when the interview came out, Anne Harrington presented her work in a very balanced, scholarly, thoughtful manner, without any sort of inflammatory comments. And, similarly, the interview was very well received, even though the same people who liked the interview might have reacted negatively to the general perception of the book.

I think that gave me a very valuable lesson about the importance of context—that it’s not just about the content of the argument, but the context of the argument also matters, and the perceived intentions of those arguments also matter. I think that if we want psychiatry to engage with these critical views, we have to present them in a context where the mainstream psychiatric community will be able to engage with them.

There have been some interviews that have generated more controversy. I can think of two interviews in particular. The interview with Joanna Moncrieff generated a lot of discussion on both sides. Some people felt strongly that what Moncrieff was saying was wrong or expressed that they did not like the overarching trajectory of her comments. But, at the same time, Moncrieff has a large fan following, and I think there were a lot of people who liked that interview.

The interview with Giovanni Fava was more controversial because we touched upon some of the more sensitive issues surrounding psychopharmacology, especially these concerns related to the possibility of worsening long-term outcomes in a subset of patients, issues over withdrawal, and some of the other critical problems in psychopharmacology. I did notice that the Fava interview generated more critical comments and some more backlash, at least online and on Twitter.

Talking about how these conversations happen on Twitter, I’m seeing a similar polarization between people defending mainstream psychiatry and people criticizing mainstream psychiatry. You see this exchange, this back and forth, between relatively extreme positions. People get emotionally engaged in these debates, and sometimes these debates turn pretty ugly.

I think a philosophical perspective can offer you a little bit more nuance, and a little bit of stability in the debate.  Having a little bit of that philosophical sensibility can help you be grounded in the polarized debates that we are currently seeing on social media.

 

Karter: Does the success of the interview series and the way it has been received indicate that things are beginning to change in psychiatry?

Aftab: I would like to think so. My generation of psychiatrists (who is just entering the psychiatric workforce) is much more mindful of the ways in which the profession has been unable to deliver on the promises of the last three decades.

Around the time I started my residency, NIMH’s Research Domain Criteria (RDoC) was all the rage, and Thomas Insel had famously described the DSM as lacking validity and had said that patients with mental disorders deserve better. Allen Frances, on the other hand, while no fan of RDoC, was on a crusade against DSM-5 of his own and campaigning against widespread medicalization.

So my generation of psychiatrists trained in the shadow of these debates. Very few of us see our current diagnostic system with rose-tinted glasses; we are acutely aware of the limitations. At the same time, the literature on the long-term efficacy of psychiatric medications has accumulated, and studies such as STAR*D don’t paint a very pretty picture.

There is increasing awareness of bias in research, particularly misconduct by pharmaceutical companies, so I see a lot of caution among my colleagues with regards to research studies funded by pharma. My generation is also much more mindful of social justice issues and takes them very seriously. So I think there is a strong sentiment in my colleagues to question received wisdom and to look for alternative answers, and my series reflects that to some extent.

 

Karter: You’ve proposed this idea of conceptual competence as a framework for improving mental health training in psychiatry, and the goal is to bring some philosophy training to psychiatrists and other mental health professionals. I’m wondering what you think philosophy training would add. How would conceptual competence help trainees in the field to be part of these conversations between critical perspectives and mainstream views? What do you think some of the major theoretical issues are that trainees should be exposed to? How would this training change everyday practice?

Aftab: I’ve been very engaged in efforts to promote the philosophy of psychiatry among psychiatric trainees. While I was chief resident in my psychiatry residency program, I developed this preliminary curriculum for teaching philosophy of psychiatry to psychiatry trainees, which I implemented at my program for two consecutive years, and it was received very well by the residents. We ended up publishing a report on that in Academic Psychiatry.

Recently, Scott Waterman and I got together, and we wrote this piece arguing for this notion of conceptual competence in psychiatry. We are definitely not the first ones to talk about this idea of conceptual competence. You, yourself, have written about conceptual competence when it comes to psychiatric diagnosis.

But when it comes to mainstream psychiatry, we were probably one of the more prominent voices talking about this. Our basic notion is that it’s pretty well established now how all these implicit conceptual assumptions are guiding psychiatric research and practice. Including assumptions, for example, related to what mental disorders mean and what constitutes the border between “normal” and “disordered.”

If it is recognized that all these conceptual assumptions are influencing a psychiatric perspective, then why don’t we talk about these assumptions and examine them and engage with them more explicitly and rigorously?

The main idea is that we train psychiatrists to recognize the conceptual ideas that are influencing their approach and the conceptual ideas that are dictating and guiding their practice. I think it is precisely our neglect of these conceptual ideas that lead to some of the more widespread problems, such as the reification of psychiatric constructs.

When we think that these DSM constructs represent some sort of discrete diseases, and we attribute more reality to these constructs than is warranted, it raises issues of widespread medicalization.

How do we draw the boundary between what should fall within the domain of medicine and what should not? Right now, the process of medicalization is operating through its own logic, and we’re seeing this steady expansion in the proportion of the population that falls under these various psychiatric constructs.

My main goal in promoting conceptual competence is that trainees start asking these questions and that they become more explicit about these hidden philosophical ideas. Once that happens, then we can begin to ask more meaningful questions about what to do next and how to change things?

If you have more awareness, if you have more understanding, then then I think we can engage with these philosophical issues in a more productive manner, and we can start making the changes in our practice that need to happen.

 

Karter: There have been other movements in the field of psychiatry. The movement for multicultural competence and humility helps to train mental health professionals to think about the role of culture in experiences and expressions of distress. Structural competence is a movement to think about how institutional discrimination and systemic racism impact clients and patients. How do you see conceptual competence complimenting these other movements, and what does it add to those existing movements in the field?

Aftab: I think that the development of cultural competence and structural competence are some of the most promising developments that have happened in medicine and psychiatry at large over the last 10 to 15 years.

I think that these movements are forcing us to engage with issues of cultural diversity. These movements have challenged to consider the way culture affects medical presentations, including psychiatric presentations, and, very importantly, to get away from taking the Western perspective to be the default natural perspective. We can be more mindful, we can be more respectful, and we can be more understanding of the way culture interacts with medical and psychiatric problems.

Structural competence is doing an excellent job of highlighting how various social systems and forces of oppression—whether this is gender discrimination, racial discrimination, economic inequality, extreme poverty—influence medical conditions, prognosis, and access to treatment.

There is a pretty good body of literature to show that psychiatrists need to be more mindful of the ways social forces operate if we are to provide good care.

 

Karter: To take this a little bit further, if a psychiatric trainee or a psychiatrist were to make a study of a conceptual competence curriculum and utilize the framework, how do you imagine that would change daily practice? If you were a service-user showing up to a psychiatric visit, how might you experience that visit differently if this training were available?

Aftab: It’s difficult to say precisely how a conceptual competence would change psychiatric practice, primarily because the emphasis is first on recognizing what the hidden assumptions are and what the questions are that need answering.

The approach of conceptual competence doesn’t necessarily provide the answers themselves, because when it comes to philosophical questions—whether these are questions in philosophy medicine, philosophy of psychiatry, or philosophy of science—they rarely have clear cut and settled answers. It’s more of a process of dialogue where you have to engage with a question, think about it, and reflect on it.

One thing it does do, though, is it helps weed out some of the bad answers. There are some approaches to psychiatry that, if you are conceptually competent, you can see that they are mistaken. Take, for example, this reified view of the DSM as representing discrete disease entities. I think that someone who is conceptually competent is better able to understand the pragmatic nature of these constructs and the functions that these constructs serve.

I think conceptual competence can help psychiatrists become immune to some of the misguided tendencies that we see in current practice. By being more thoughtful, I hope that they would be able to engage with patients, and with the society at large, in a much more healthy fashion.

Right now, if you look at the public education that is being done with regards to psychiatry, the public is getting a very biomedical understanding of psychiatric disorders. There was all this talk of chemical imbalances, and there still is to some extent. There’s even talk of disorders being brain diseases.

The public is getting a certain version of how these things should be understood, but someone who has a better conceptual and philosophical understanding of these issues can easily see that these claims that are being made about brain diseases are somewhat simplistic and that they might not be helpful and that more conceptually healthy understandings of these categories are going to look very different.

If they have an openness and this conceptual understanding in their mind, I think that it will influence how they’re informing patients about a diagnosis, and how they’re educating and listening to their concerns. We might then be able to think more outside the box, and we might be able to listen in a more healthy and sincere manner to some of the longstanding concerns raised by the consumer, survivor, ex-patient community.

 

Karter: It sounds like conceptual competence may lead to a change in the relationship between service-users and providers as well, in that there might be more humility and maybe more openness; less an expert who is identifying something and more of a dialogue between parties.

Aftab: Exactly. I think the emphasis on humility is something that is very important. In fact, one of the elements of conceptual competence that is outlined in our paper is conceptual humility.

It is the idea that these are challenging questions, there are often competing answers, and reasonable people can disagree. The best approach we can take is to be open-minded and be humble about the possibility that what we are thinking may not turn out to be the case, and that we can wrong.

I think that a sense of humility can enable us to have a dialogue in a more open and sincere manner and to also listen to other perspectives, even if you may not agree with them immediately. At the very least, we can begin to engage with them, listen to them, and give them the respect and the attention they deserve.

I think we would see a very different sort of psychiatry if that happens.

 

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MIA Reports are supported, in part, by a grant from the Open Society Foundations

57 COMMENTS

  1. “It is pretty common there that family members would obtain psychiatric medications and mix it into the food of a person without that person knowing. That’s not ethically defensible, but I think you can see it as a consequence of a society that has failed to develop other ways of addressing these situations.

    In the US, to obtain the majority of psychiatric prescriptions, you have to go to a doctor, and they have to prescribe the medication to you.”

    So Australia has failed to develop ways of addressing these situations?

    In Australia you go to a doctor, have them prescribe you benzodiazepines, put them in other peoples food or drink, and then when they collapse you plant a knife on them and call mental health services. Then, once the police have thrown them into the back of a police van and delivered them to a locked ward, a doctor can then prescribe the drugs that were administered without their knowledge 12 hours before they even knew of the existence of the person, and after they were administered to conceal the criminal offence (an offence in and of itself, compound or conceal evidence of a criminal offence). They can even use the effects of the ‘spiking’ as being symptoms of an illness the person doesn’t have to justify further drugging without consent.

    We do of course have laws that make this unethical behaviour illegal. Intoxication by deception, and stupefying to commit an indictable offence, but because police are so under resourced here in Australia, they can’t find their copy of the Criminal Code and will therefore arrest you for having the proof that you were ‘spiked’. The dilemma being that they like being able to have citizens ‘spiked’ with stupefying/intoxicating drugs without their knowledge before interrogations, can then acquiesce their duty, and have an effective method of torturing citizens not available to the personnel at Guantanamo Bay.

    I did however see a documentary regarding the use of this method in England called “Kidnapped and Drugged for Family Honor”. In that situtation the person who was ‘spiked’ in the same manner as I was, and was then kidnapped had a team of 16 detectives working on the case, and people went to prison. It was bizarre when I saw that and looked at the letter I have from a Police Superintendent saying they sent me an email, and I didn’t respond in 14 days (because I never received it) so they have closed the matter without even looking at the documented proof I have of the crimes. And here was me thinking that as a result of being a Commonwealth country our laws were very similar.

    Same drugs, administered without knowledge or by deception to enable items to be planted on me and have me transported against my will to the locked ward of a psychiatric institution where they were going to make me very sick. Of course the people doing the kidnapping were under a false impression, that what they were doing was medicine, and not aware of the fact that it was being arranged by organised criminals in our system but ….. and so they do cover ups by ‘fuking destroying’ the person who complains about their conduct. I really would like a framed copy of their “Code of Conduct and Ethics” on my wall. I get more laughs reading that than I do from watching Marx Brothers movies.

    So you lost me fairly early in your interview Aftab.

    So what was the “situation’ that my society has failed to find ways of dealing with? My ‘illness’? No, nothing of the sort. I disagreed with my wife, and she sought ‘help’ from a psychologist who had a distinct dislike for me for not wishing to be ‘sidetracked’ from a private clinic into the wallet extraction service of her husband (a psychiatrist ‘shock doc’). Do you know what happens to someone who if you have them taken away by police in front of their family and neighbours to be locked in a mental institution to save them from having potential for damage to reputation and meaningful relationships? You just literally destroyed their very being, effectively killed them. In fact I have been pushing for police to be allowed to simply execute people in this situation at their homes as it seems a waste of resources transporting them for ‘treatment’. Execute them in their homes and save the time and effort of trying to heal them from the damage you have incurred to find out if they need your ‘help’. And it seems that recently police have been given that power where I live, the right to shoot those deemed mental patients.

    Consider the person who cracks all the eggs in the carton to ensure they all have yokes. That’s pretty much what our mental health services do where I live. They break people to find out if they will break and call it medicine.

    And how did I become “mental patient”? Someone called the hospital, said they had drugged me with benzos and that I had spoken to a psychologist. I was then listed as “Outpatient” before the Community Nurse and police were dispatched to kidnap and torture me. All fairly clever and with zero accountability due to the negligence of the Chief Psychiatrist and Minister who both claim to not understand that their is a burden (suspect on reasonable grounds = police saw man collapsed from ‘spiking’ = mental health referral = kidnapping service for doctors = corruption runs rampant and torture and convenience killings now available) placed on the Community Nurse before detaining citizens ….. I have a letter that I will share if your interested. Though the fraudulent documents used to cover up what was done seem to be the preferred narrative by people who have the power to intimidate and threaten witnesses (they certainly did my family). Though they did fail to retrieve the documented proof I have, and now simply ignore me because imagine kicking the victim of torture and kidnapping while he was down (Operations Manager says “we’ll fuking destroy you” for complaining about this conduct) to ensure your criminal conduct was concealed? difficult to maintain your ‘good’ reputation with that sort of behaviour.

    I doubt you will read my response to your comments though I write them to inform you that you speak of Pakistan as being somehow less of a place than ‘first world’ practice. We simply conceal our misconduct with ‘unintended negative outcomes’ in the Emergency Dept a bit better, and point fingers at others for the very things we are doing ourselves.

    I will read the rest of your interview and wish you well. As Salaamu Alaykum

    “My generation is also much more mindful of social justice issues and takes them very seriously.”

    woops, I stop there i’m afraid. You all turned your backs on me, while one of your colleagues tried to murder me in the ED. Take them seriously? If it wasn’t for a cardiologist noticing what was to be done about their little problem i’d be a dead man. Because he hasn’t got the stomach for it he tells me.

    Kidnapped and Drugged for Family Honor
    “Documentary telling the shocking story of how a 23-year-old British girl was drugged and kidnapped by members of her family after refusing to go through with a .”

    Funny but thats where the quote on youtube ends…… should it read “mental health assessment” at the end? lol Of course not, they would have been given assistance by police to retrieve the proof if it did. And they would have ‘fuking destroyed’ her for complaining.

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    • “Consider the person who cracks all the eggs in the carton to ensure they all have yokes. That’s pretty much what our mental health services do where I live. They break people to find out if they will break and call it medicine.” ~Boans

      Like dunking persons labelled “witches”. Does the DSM have a “witches NOS” category?

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      • I do think psychology and psychiatry replaced the witch hunters of old. They perform the same societal functions, at least. Defaming and destroying strong women, and covering up child abuse and rape. And the psychological and psychiatric fields did seem to materialize within about 50 years of when witch hunting went out of vogue, I think.

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  2. Thank you for this interview!

    Finding different questions begins in not knowing. Asking oneself, asking the other, and reflecting. The worldviews and frameworks, the language where we begin reflects what we’ve been taught, experienced, received and absorbed from dominant culture. It’s hard to open ourselves to the language and meaning of other without assuming that our starting place is superior/valid/real.

    Experience and knowing are not contradictory; they contain tension and conflict. Moving towards what appears contradictory requires courage. Those with access to structural power attempt to define the answers without seeing or hearing real embodied experience and knowledge, without inquiry. They guard what’s familiar to their hierarchy. In order to achieve in the US educational system, students are taught to not think, to not question. Mechanical, binary, linear, measurable, predictable answers that maintain hierarchy reward compliance, stabilization, and assimilation.

    What are the presuppositions underlying this education? By the time students reach “higher education,” they’ve been trained to overcome their natural curiosity and openness to “not knowing.” They will produce, consume, maintain until an existential crisis rocks them. Natural and built environments and social systems rooted in superiority, violence, and oppression can’t be managed by what western capitalist education has taught.

    Before we can ask questions that don’t assume an answer or outcome, we must recognize the toxic dominance that has shaped our learning. Survival depends on learning to think, to question, to find language and frame meanings that are not based on familiar hierarchies. This interview is a brave beginning in a context that is fraught. Holding our knowledge tightly makes it harder to breathe, see, feel, think, and grow. I’m grateful for your mutually respectful tone. You’ve opened space for ongoing questions and learning.

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  3. “Very importantly, I wanted these engagements to happen in a relatively non-threatening, productive manner. I think there’s this tendency toward an unhelpful dynamic that develops where criticisms tend to be aggressively presented, and then the other side reacts in a state of being totally defensive.

    That doesn’t help lead to meaningful engagement. It is fine if you want to refute something or if you want to dismiss something, but it’s not conducive to learning. It was really important to me that these interviews happen in a non-confrontational manner so that the readers would think about these issues without being threatened.”

    I appreciate that you, as a psychiatrist do not want to attack your peers, but as for other critics and victims of psychiatry, this is an unreasonable demand. Psychiatrists can literally torture people, but victims and critics must be nice? What else is this other than a huge power imbalance? It’s as if a rapist has the right to demand that his victim be nice, in order to better engage with him, and hope to change his mind about whether or not to rape people.

    If you can recognize that aggressive attacks can make people defensive, and fail to engage people in learning, why can’t psychiatry recognize that attacking people, known as the mentally ill, might result in bad responses?

    Now, excuse me while I go write some highly critical attacks and condemnations of the behaviors that the mental health industry in the US have engaged in with me, as well as others, including torture.

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    • I agree. It is the psychiatrist who should make certain that any such interactions happen in a non-threatening manner for the PATIENT! Te psychiatrist has all the power, and expecting the client to protect the psychiatrist’s ego is very much like expecting the victim of an assault not to upset his assailant too much for fear of “provoking” further attacks. The person with the most power is the most responsible for creating a safe atmosphere for discussion. If the psychiatrist’s ego is so weak that s/he can’t accept feedback, s/he should not be in the business of “helping” people at all.

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      • “If the psychiatrist’s ego is so weak that s/he can’t accept feedback, s/he should not be in the business of “helping” people at all.”~Steve M. (To protect your identity.)

        How many “MH” and/or “Alternative” “helpers” have you met that can accept feedback? lol. The worst stonewalling, victim blaming, labeling as defective, when confronted with a painful truth that I’ve known have been self-proclaimed “radical” therapists. 🙂 Funny how many “helpers” get insulted when you try to “help” them.

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        • I fully acknowledge that the overwhelming majority of people in the “mental health” field should be doing something like flower arranging that doesn’t involve pretending to “help” people. The humility to accept feedback is a very rare commodity, and seems to be becoming rarer as the years go by.

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        • “If the psychiatrist’s ego is so weak that s/he can’t accept feedback, s/he should not be in the business of “helping” people at all.”

          But this is the case with most of the so called “mental health” workers, given the reality that none of them know that the ADHD drugs and antidepressants can create the symptoms of “bipolar.”

          And none of the mainstream “mental health” workers claim to know that the antipsychotics can create both the negative and positive symptoms of “schizophrenia,” via both neuroleptic induced deficit syndrome, or antidepressant and/or antipsychotic induced anticholinergic toxidrome.

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      • ‘Te psychiatrist has all the power’

        mmmm not really. I’m sure that the Vietnamese could have said the Americans have all the power and left it at that but …… it’s matter of how you fight the powers that be.

        “We are not going to fight in the American way, we are going to fight in the Vietnamese way” Col. Giap to the people who armed the Viet Cong. The small can destroy the big, it’s a matter of picking your time, and being sure that those who have done you harm do not wish to bring about peace by making good on their wrong.

        I think about my situation where I understand the State concealing their use of known torture methods. What is not acceptable to me is that they are doing that for people who were NOT public officers, and are assisting people who have committed serious criminal offences to conceal their involvement in those offences. My wife and the psychologist were not public officers and therefore should not receive the protection of the State for their crimes (conspire to stupefy and commit an indictable offence, namely kidnapping 40 years prison, lets start there). And just because they managed to procure the services of corrupt public officers to do their bidding (torture and kidnap me) should not exempt them from punishment. And further, a doctor signing prescriptions post hoc for police to conceal ‘spikings’? And my community isn’t concerned about that? Is he doing it for rapists too? Because I have some concerns about a Catholic priest who is also a doctor engaging in that type of conduct for some fairly obvious reasons. Didn’t know of my existence and is signing a prescription for drugs administered without my knowledge 12 hours after it was done? Surely a duty of care would have required a toxicology report and to inform the victim of the offence? No, lets put him in the locked ward for the first time in his life and see what happens to his mental state if we don’t tell him, and fuking destroy him (and his family) if he complains.

        But as stated they are working closely to ensure the torture program (and subsequent killing of victims) is concealed from the public in the interest of the State. They are thus in breach of the agreement they signed with the UN in regards the Convention against the use of Torture. And have no respect for the rights of citizens, and are only interested in maintaining their positions of power and privilege.

        If it is a matter of public officers getting citizens to commit offences which they then refuse to prosecute then we are in big trouble in little China. I understand the method of offering drugs or alcohol to persons they wish to interrogate whilst under the influence of intoxicating substances. Caveat emptor if your chose to leave yourself vulnerable. Police often time their arrests to coincide with hangovers. But the ‘spiking’ of persons by citizens who are then assisted in concealment of that offence because of the benefit to public officers in being able to torture (via the acquiescence of duty) is a clear breach of the Convention.

        However, as I have stated my State finds it fairly easy to drop people off at the Emergency Dept (you did after all fall asleep and the “reasonable grounds” for police referral are met), and with “No National Standards as to what constitutes a chemical restraint” a person may be easily injected with enough chemicals to result in an “unintended negative outcome” and the problems associated with them being capable of bearing witness to the offences disappears. Like a magic show, and police simply arrest anyone who turn up in the police station with proof (or threaten their family as has been shown to occur).

        “It’s as if a rapist has the right to demand that his victim be nice, in order to better engage with him, and hope to change his mind about whether or not to rape people.”

        This is precisely the model used where I live. Once you set the wheels in motion with the procurement by planting evidence on an individual, they will simply keep ‘raping’ until the victim accepts their ‘illness’ and complies. Stop complaining or they will ‘fuking destroy’ you. And they have police resources available to do that, even when it is known that they are committing serious acts of misconduct (ie enabling acts of torture and kidnapping). And they will continue to slander you even when the proof has been presented to them. Further acts if uttering by public officers not concerned at all about their further misconduct.

        Orwell said it all in 1984, that real power was the ability of the State to take something and make it that “it never happened”. I have the documented proof, but they have the right to commit acts of fraud and slander to conceal the truth and manufacture a narrative that suits their purpose.

        What is really sickening is the perverted way police actually enjoy exercising their power over victims and ensuring the obstruct the path to justice. I guess the sickness comes from time in the job, and the false belief that they are unaccountable. Which if they can use the services of organised criminals in our hospitals to conceal their misconduct, I guess they are.

        Oft quoted but worth remembering

        All it takes for evil to succeed is for good people to do nothing.

        And I have watched for 9 years as evil has reigned supreme, and our politicians (and authorities) refuse to even inform me of where I can make a complaint about the use of known torture methods by police and mental health services. I would like to have my property returned and leave this vile country. 2 generations of my family and these corrupt public officers come here and within 2 years are bringing their vileness with them and destroying the work of good people. Whats even sadder is that they are being enabled in that behaviour.

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        • “The psychiatrist has all the power.”

          I’m not saying that psychiatric survivors cannot eventually become activists or writers–to warn and educate the public, connect with others, and put pressure on the industry to either radically change or disappear, as I hope to do, but in the immediate sense of the doctor/patient relationship. The psychiatrist has all the power either by legal force or total breach of trust. If you fight back against them directly in even the slightest way, they hold the power of institutionalization and forced drugging over you.

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          • “Deterrence is the art of producing in the mind of the enemy… the FEAR to attack.” Dr Strangelove.

            When I was physically assaulted by the doctor in the hospital, I had a choice. He had no right to touch me, I had pointed out that he had no right, and he decided that I was at a disadvantage and he would ignore my right to physical integrity. He was close enough for me to snap his neck quite easily, though I chose not to. I let him believe that because he had a nurse about 10 feet away that he had all the power, I knew different.

            How was he to exercise his power of legal force or breach of trust in the morgue? (His funeral, my trial) Let him run, lets see where he goes with this. If God so chooses, they have no power at all. There is nothing they can do without Him allowing it to be.

            God has all the power. Whilst it can be painful to be subjected to torture, as was shown in the case of Bilal ibn Rabah, there are those who will not allow this to be done to others for their beliefs. Unfortunately they are not the people who are in government in my State at present. Despite their ‘big talk’ regarding their ‘Parties’ rejection of the use of torture before they were elected. It is they who are now the Masters of the ‘cover up’. Oh how power corrupts.

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          • Hi boans,

            I do not feel that killing people is a legitimate power, though as you indicate, it is a kind of power. There may be very rare cases where killing someone is the only possible way to defend your own life or the life of the innocent, but usually, less lethal means can be used. How many times has “self-defense” or defense of the innocent been unjustly used by people with a little bit more social, legal, or political power against someone with less power? I feel that any claim to human rights generally, depends on a fundamental recognition of the sanctity of everyone’s life. Otherwise, you’re just left with arguments in favor of some people having human rights, while people with less power having few to no human rights. These are the very tactics that psychiatric abusers and torturers use to justify what they do, because they have no fundamental respect for people’s lives. They only understand power and money.

            If you actually had killed your abusive psychiatrist, the consequences would have been much more far reaching than you going to jail. The headlines wouldn’t have been, “Boans Defended Himself Against an Unjust Person,” but, “Schizophrenic Violently Murders Kind Psychiatrist Who was Helping Him.” I have no idea what mental illness labels they actually gave you, but murder is usually blamed on “schizophrenia.” Acts like that, when they’re blamed on “mental illness” usually further enshrine the public’s and politician’s views about the “mentally ill.” Mental illness is commonly used by politicians on both sides as the root cause of violence. This allows them to shirk their duties to take meaningful action that would genuinely benefit everyone.

            As far as appealing to politicians to take action for justice on the behalf of us who are truly marginalized, I think that’s a wasted effort. I once reached out to my state politicians to change the laws regarding the statute of limitations for civil suits for people who had been harmed by psychiatry–like when antidepressant use makes you psychotic, or when you’re physically and sexually assaulted in the “hospital” where you’re committed. One of them never got back to me. The other sent me some BS about how she would fight for the rights of the mentally ill.

            As you have stated elsewhere, “The pen is mightier than the sword.” Politicians won’t do anything for us until popular opinions about the “mentally ill,” what psychiatry actually does to people, what psychiatric drugs actually do to people, etc. changes. There’s a lot of material to cover. I do believe change is possible. I hope I can play some small role in getting people to reconsider what they believe is true about mental health care. I want to expose the lies and heinous injustices. I want to appeal to people’s better nature in making a case for the fundamental dignity and human rights of the “mentally ill.” I feel if popular opinion changes, political change will follow. Politicians care a lot about getting re-elected. Money plays an huge role in politics in the US. At the same time, if voters feel strongly about an issue, politicians have to appeal to voters too.

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          • “The headlines wouldn’t have been, “Boans Defended Himself Against an Unjust Person,” but, “Schizophrenic Violently Murders Kind Psychiatrist Who was Helping Him.” I have no idea what mental illness labels they actually gave you, but murder is usually blamed on “schizophrenia.” Acts like that, when they’re blamed on “mental illness” usually further enshrine the public’s and politician’s views about the “mentally ill.” Mental illness is commonly used by politicians on both sides as the root cause of violence. This allows them to shirk their duties to take meaningful action that would genuinely benefit everyone.”

            And what would the headlines be if they actually allowed the abuses occurring in the hospitals be? Schizophrenic doctor assists patients in their journey to the other side? Or is that style of killing somehow different to the regular type of schizophrenic killings?

            And as far as labels go, that seems to change as often as required, today bi polar, tomorrow terrorist, then the next day your cured depending on how they would like the statistics to play out.

            So if mental illness is the root cause of violence, and the police are simply the most violent people in our community……

            Seriously though Caroline, I get what your saying. My point relates to the notion of people having the power to do violence to others, and have that violence sanctioned by the State. I’ve heard it called ‘silent violence’, and putting the type of spin on it that is done by politicians does not change the fact it is violence.

            They know this, they know what they are endorsing. It was the reason our State Treasurer needed to get out of the State in a hurry to receive ‘treatment’ for his bi polar disorder, knowing the consequences of falling into the hands (and falling outside the law) of a psychiatrist as a result of a police referral in THIS State. I think the ‘diagnosis’ he received might possibly have been the same (slanderous hate speech has trends, but tends to be the same words), but his ‘outcomes’ would have been very different as a result of making an enemy of the Minister for Mental Health. Not that it would ever be admitted. And of course these types of rifts (along with the exposure of people being tortured by police, not just me but some made public as a result of the opposition, who now do what they accused the government of doing, covering up that is) have decimated the Party.

            I did actually sit next to one of our Politicians in a psychiatrists office as he was being dealt with for Misconduct by the Corruption and Crime Commission. I wonder how he went, given the way I was dealt with as a result of needing a report written for my employer. Snatched from his bed, tortured, kidnapped and unintentionally negatively outcomed perhaps lol.

            So if we were to look for a root cause for the conduct of this doctor doing a few snuffs in the ED for organised criminals, the answer lies in labeling him a schizophrenic? I mean I saw the craziness in his eyes, seen that before when men (mostly) have killing on their minds. But I get the feeling that despite him being promoted, all he deserves is the label murderer, which is after all not an illness, but an act (or in his case acts) that is deserving of punishment, not profit. Though I guess once again it’s a matter of who is being killed and who benefits from that killing. In my instance, a few people, including the State authorities who did not want anyone to notice they had kidnapped and tortured me. Seems fair. Saving the public a heap of money in the end, and we might even get to a point where our courts are simply not even needed anymore. Like the Police no longer even knowing where their copy of the Criminal Code is, why, when you can make it up as you go along based on …. oh I don’t know, the color of someones hair?

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          • I totally agree with you, boans, that the State and psychiatry have no such right. I guess what I was trying to say is that because the State and psychiatry are so powerful, and they have done such a good job of demonizing their “mentally ill” patients, they spin any effort to defend yourself as an act of predatory violence by the less than human “mentally ill.” Whereas, when they commit genuinely horrific acts, they face no consequences whatsoever. On top of that, they spin stories that a psychiatry naive public buys into, as they are the experts, and the patients have been dehumanized. This is one of the reasons why they’re able to get away with all they do. The “mentally ill” really need an effective PR campaign that sets the record straight in the eyes of the public.

            I actually just wrote an article on this theme, but its publication date hasn’t been scheduled yet. I hope that if you read it, you will find something useful in it.

            PS Moderator, I am subscribed to this post, but haven’t been receiving the emails for the comments.

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          • “I was trying to say is that because the State and psychiatry are so powerful, and they have done such a good job of demonizing their “mentally ill” patients, they spin any effort to defend yourself as an act of predatory violence by the less than human “mentally ill.” Whereas, when they commit genuinely horrific acts, they face no consequences whatsoever. ”

            I’ve heard this called Alinsky (after Saul Alinsky) tactics, where you make your victim play by the rules and exclude yourself from them. Which fits with exactly what is being done in my State. And consider when you look at the situation, it is like the State is at war with the people who vote for them. Have they gone totally insane?

            I note our Attorney General who spoke up for a man tortured by our police noted the “disgraceful conduct” of police in releasing the mans criminal history to the media in order to slander him for complaining. Funny but he doesn’t seem to have a problem with medical records being released unlawfully for the very same reasons. Documents not requested provided to slander, and documents critical (and showing State sanctioned torture and arbitrary detention) removed, and then handed over to lawyers who had been told not to act in the interest of their client by the State.

            Bizarre really. But things have changed now it is the “Party of the downtrodden” with their boots on the neck of the downtrodden. They’re worse than the people they replaced.

            Fix the game and there are no problems. And you think a P.R. campaign might help? Not in my State which has the media completely under their control, and publication of stories not approved by the State, your going to receive a visit from the Federal Police and find yourself on charges. And in a place where the planting of evidence, the torture and unintended negative outcoming of witnesses is all accepted practice, I don’t think i’d risk it.

            But these are all old stories (see your Book), and the outcome is known. They seem to look at the National Socialists and think they know why they failed, and that they can do it better this time. Totalitarianism is always doomed to failure.

            I laugh about the War of the Worlds remake showing on tv at present. My government (like aliens) on the verge of total control of the population, only to be foiled by a virus lol

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          • Hi boans,

            I am so sorry about the situation in Australia. I had always presumed that Australia had a free press. America has a free press, but at the same time, mainstream publications want to publish whatever is sensational to bring readers/viewers in and/or whatever will please their corporate sponsors. Sometimes journalists are punished/persecuted for what they write. So, there are some problems in America too regarding a truly free press. In a way, the desire to draw in readers/viewers kind of makes sense. If no one reads/watches your publication, what is the point of publishing? But I do feel that a good PR campaign could potentially have a positive effect, at least in the US.

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          • Yes, we’re fairly good at managing our public image internationally. You’d be appalled if you knew what is being done to the indigenous population of this country. Luckily the only person getting the word out is John Pilger, and not a lot listening to him.

            “Australia dropped two spots last year to rank 21st out of 177 nations in the World Press Freedom Index, which noted that the nation’s investigative journalism in recent years been reduced due to “draconian legislation”.

            “[Australia’s] laws on terrorism and national security make covering these issues almost impossible,” says the index.”

            And given the ability to do arbitrary detentions (called welfare checks) and force them to take brain damaging drugs and torture them (called ‘care’) it’s no wonder the world isn’t hearing about these things. National Security does not trump Convention against the use of Torture, but I can show you how to use it to conceal the fact it is being done. It’s actually fairly easy, call it medicine, and the victim “patient”. And that is achieved in my State by a doctor calling police to ask for a welfare check of someone he/she doesn’t even know.

            They are even discussing making any criticism of Australia a crime, and then pointing fingers at China for laws less restrictive.

            And we even have the cheek to point fingers at other countries while we know we are possibly one of the worst human rights abusers in the world at present.

            Black Lives Matter? They haven’t in this country since Captain James Cook parked his butt on the land of other people and said “terra nullius”. Black lives only became lives in 1968, and even then it appears it was only as a way of making us appear to be ‘progressive’ in the eyes of the world.

            The latest raids related to government whistle blowers who can be snuffed at the E.D. by some doctor who is looking to advance his career. I’m sure the reason that police couldn’t find their copy of the Criminal Code when I turned up in their station with documented proof of the torture and kidnapping was to provide the window of opportunity for a doctor to see that the matter was resolved in their favor. Without the documents proving the motive to murder, there was no crime. And the State ensured they distributed fraudulent documents to ensure no one was aware there was motive to have me killed so……. they’re pretty good at this. And I can prove what the authorities do when they found out. Take a look at the letter I have from the Chief Psychiatrist. Despite his claim that he doesn’t understand the law he is charged with enforcing, he looks the other way if anyone complains about human rights abuses. “You did a cover up Operations Manger? Good, I’ll run with that then. Lawyers have fraudulent set of documents and the victim is dea….. he’s what? Turning up with the documented proof of the torture in police stations, and a politicians office? It’s every man for himself” lol Like rattus rattus on a sinking sloop.

            I went to a friend who is a Community Nurse and suggested we did to the Premier what was done to me (I did after all have it in writing from the Chief Psychiatrist and Minister that it was lawful). ‘Spike’ his meal, when he collapsed he was in possession of a knife from the lunch, have police make referral to my Community Nurse friend and we could have him dribbling in a cell in an hour. Imagine if we gave him a haircut on the way to the locked ward and dressed him in his pajamas his claim to be the Premier might even be used as proof of his mental illness. (Yeah Yeah, and my granny used to be the President of the USA nutjob lol)

            Of course it might be that the authorities have figured out that what I was saying was the truth, but they couldn’t possibly admit to their wrongdoing now. And someone went to all the trouble of ‘fuking destroying’ my life, committing acts of fraud and pervert the course of justice etc. Why not just keep running with that and hey, who is going to step up and help Boans? And take on the vicious bastards that fuking destroyed me? They have families too, and so all these good people would prefer to stand and watch, despite knowing the truth.

            I make no claim to be anywhere near the person that Jesus was, but I can say that they will stand and watch while they nail up a good person rather than risk the comfort of their pathetic miserable crawling lives. On your knees to the gods you stand before, and a long time in Hell for breaching the first commandment.

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  4. Thanks Justin for this interview with Dr. Aftab.

    “Reading “Anatomy of an Epidemic” ended up being a really jarring experience because I quickly realized that a lot of the arguments and a lot of the data presented in the book were not easily dismissed.”

    First I commend Dr. Aftab for the acknowledgement of Robert Whitaker’s outstanding book. It’s good to know many psychiatrists have at least read this book.

    Psychiatry starts harming someone the minute they depersonalize someone by turning them into a subjective “label” rather than a person struggling to navigate difficult circumstances in life. Conceptual competence and humility may be possible for some psychiatrists to adopt but I fear most have far too much arrogance and hubris to ever accept they could be wrong or could learn from a service user. The young psychiatrist I saw for insomnia while in cancer treatment certainly had no conceptual competence. Furthermore she had no humility and no competence – period. How do you ever learn humility if you never allow yourself to be corrected?

    I appreciate Dr. Aftab for trying to make positive changes but a real turning point would be if Dr. Aftab was to interview a service user for Psychiatric Times. If psychiatrists were able to hear, process and acknowledge the harm a service user has endured now that might led to some progress in conceptual competence and humility.

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  5. Thanks Justin for all your hard work.

    “But philosophy as an academic discipline, especially as a way of making money, was pretty much nonexistent in Pakistan.

    I do have physicians in my family. My older sister is a physician herself, so there was all this passive exposure that I was getting through family members who are physicians in Pakistan. It seemed like a natural choice for me to go into medicine as well.”

    Sorry, you are not in “medicine”, nor in “philosophy”

    “I think that if we want psychiatry to engage with these critical views, we have to present them in a context where the mainstream psychiatric community will be able to engage with them.”
    Very importantly, I wanted these engagements to happen in a relatively non-threatening, productive manner. I think there’s this tendency toward an unhelpful dynamic that develops where criticisms tend to be aggressively presented, and then the other side reacts in a state of being totally defensive.”

    “I think back to my relatively naive days, and I wasn’t exposed to this larger body of work.”

    Several Times Awais, you mention that we need to have these wonderful non threatening discussions. And I assume you mean where a psychiatrist says something like “yes I know psychiatry is not perfect, and I do not see my field through rose colored glasses”.
    And then you say “gee, I’m glad to hear that” and go on to present your “philosophical” views? And then you all take your paycheque, because only through being part of psychiatry could you receive the money, since being a mere philosopher could not earn a living.

    You “used” to be “naive”?

    Awais, you are playing a game, and that is worse than being a shrink. And no, I would obviously not have that “nice conversation” with you or a shrink. And you could not pay me enough to engage in such pretentious dialogue. I’m glad you think you “used to be naive”…it’s almost as if you think you can’t be naive now, or in the future.
    What if in 10 more years you discover more about the people you had all these “non shutting down” “nice conversations”.
    But by that time, you have kids to send to university to become a “good psychiatrist”

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  6. “When we think that these DSM constructs represent some sort of discrete diseases, and we attribute more reality to these constructs than is warranted, it raises issues of widespread medicalization.”

    Yes, especially since the psychiatric industry knew nothing about the common adverse effects of the drugs you prescribed. Like for example, the psychiatric profession knows nothing about the common adverse effects of the antidepressants, as is arrogantly described in this 2005 article.

    https://www.cambridge.org/core/journals/psychiatric-bulletin/article/brain-shivers-from-chat-room-to-clinic/642FBBAE131EAB792E474F02A4B2CCC0/core-reader

    “Right now, the process of medicalization is operating through” money only talks, not “its own logic, and we’re seeing this steady expansion in the proportion of the population that falls under these various psychiatric constructs.” Is based only on the money talks theology.

    “There is a pretty good body of literature to show that psychiatrists need to be more mindful of the ways social forces operate if we are to provide good care.” Especially since the psychiatrists know nothing about the common adverse effects of the drugs they prescribe. Like for example, that the antidepressants and ADHD drugs can create the “bipolar” symptoms.

    https://www.alternet.org/2010/04/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america/

    Despite the fact it was clearly pointed out in the DSM-IV, not to misdiagnose millions of people as “bipolar,” due to the common adverse effects of the antidepressants.

    “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.”

    “It’s difficult to say precisely how a conceptual competence would change psychiatric practice, primarily because the emphasis is first on recognizing what the hidden assumptions are and what the questions are that need answering.”

    I’m not quite certain what a “conceptual competence” means. But I do know that the common adverse symptoms of the ADHD drugs and antidepressants are being regularly misdiagnosed as “bipolar” on a massive societal scale, by our “mental health” workers,” to this day. Especially since this DSM disclaimer was taken out of the DSM5.

    “if you are conceptually competent, you can see that they are mistaken. Take, for example, this reified view of the DSM as representing discrete disease entities.”

    And this includes the “schizophrenia” diagnosis. Given the reality that the antipsychotics/neuroleptics can create both the negative and positive symptoms of “schizophrenia.” The negative symptoms can be created via neuroleptic induced deficit syndrome. And the positive symptoms can be created via antipsychotic/neuroleptic induced anticholinergic toxidrome. Two medically known syndrome, which are both – conveniently for the psychiatrists – missing from the DSM “bible.”

    “We can be more mindful, we can be more respectful, and we can be more understanding of the way culture interacts with medical and psychiatric problems.”

    I agree.

    “There was all this talk of chemical imbalances, and there still is to some extent. There’s even talk of disorders being brain diseases.”

    Yes, despite the fact the “chemical imbalance” theory of “mental illnesses” was debunked decades ago. And all the DSM disorders being debunked, as invalid, seven years ago, by the head of the NIMH. And I will give you a link to a stanch pro-psychiatry worker, in regards to the fact that that the “chemical imbalance” theory is garbage.

    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml
    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

    “There was all this talk of chemical imbalances, and there still is to some extent. There’s even talk of disorders being brain diseases.”

    But it’s all “bullshit,” according to the DSM-Vi author, who is correct.

    https://www.wired.com/2010/12/ff_dsmv/

    Yes, the psychiatrists are wrong, but I do understand that this is difficult for them to understand, since “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”

    “At the very least, we can begin to engage with them, listen to them, and give them the respect and the attention they deserve.”

    Yes, continuing to defame and discredit, those of us who were misdiagnosed with your make believe “disorders,” is not the answer. And the psychiatrists have malpractice insurance for a reason. We mistakenly trusted doctors – because of the propaganda telling us to do so – and because you had malpractice insurance to pay for your mistakes. And the psychiatrists still owe us for your malpractice.

    But I do understand the entire “mental health” industry needs to rethink their “invalid” belief system. And you do owe a lot of us, a lot of money, for your systemic malpractice. But getting the psychiatric and psychological, and all the DSM “mental health” believers, to garner insight into the reality that your DSM “bible” is “bullshit” will take time.

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  7. “About a year before that, I did end up reading “Anatomy of an Epidemic” by Robert Whitaker. Reading “Anatomy of an Epidemic” and engaging with those ideas was quite an experience for me. Most of the people that I had spoken to or who I had mentioned that book to before had been pretty superficial and dismissive about it, calling it extreme or antipsychiatry. When I decided to read the book, I was expecting that it would be something I could quickly go through and thought it wouldn’t be something I had to spend a lot of time and energy on.”

    Awais, I would like to point out your reference to “extreme” and “anti-psychiatry”, realizing of course that you seem to no longer see the “book” in those terms. However, is “anti-psychiatry” or “extreme” a negative position?
    Why do you think Psychiatry is so damaged? Is it because they are “extreme”? Or because the very basis of psychiatry has a completely wrong basis.

    You seem to think there is something fixable. Like an old car that is being held up by a few new struts, and more and more repairs until finally one realizes that the money being sunk into this old beater is not productive. Into the scrapyard it goes. It could never be recognizable again, as the car it used to be. Someone might use a door to restore another car, but no one could identify it.

    And Sometimes we are by then old and wise enough to just bus it.

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  8. Hmm…There is a section in the written interview that should occur in the audio at about 39:00 but isn’t there.
    It was an informative interview, but I would have liked to find out where all this has taken Dr. Aftab in his own viewpoints or opinions on where psychiatry came from and where it should go.
    We still have the problem of who is going to take responsibility for this part of human life if we fire Psychiatry on the basis of incompetence. Obviously, Aftab thinks the profession can be reformed. But, boy, does he have a lot of work on his hands if he decides to take that goal seriously!

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  9. It must be realised that these people were conspiring to murder me to conceal their criminal conduct. And whilst they failed in that task, it has generally been accepted that it is just what one would expect given the circumstances. I mean, we give these doctors the power to snuff a few every once in a while, and well, the guy found himself in a position where his wife had conspired to have someone tortured and kidnapped, and there was a citizen walking around with the proof of that going into police stations.

    Quick, call the police and procure their assistance to ensure they don’t take the proof from the victim, and then arrange a killing in the Emergency Dept. I wish I could be honorable and say it’s not what I would do but ….. unfortunately if I had the power to call police and have them assist me with killing people I disagreed with, i’m afraid i’d be a little weak, and they would be a little busy. I don’t think I truly understand the insanity behind that reasoning by police (ie that its okay to kill because what choice did he really have?) but it’s what gets used by them to neglect their duty and allow these types of convenience killings. And the evidence is there, documented and well….. concealed from the public for their own good.

    I don’t have the power to murder people while police turn a blind eye, and these people do. And they were obviously taking advantage of that situation to enrich themselves.

    I wouldn’t worry though, because the people who have a duty to do something about it refuse to act, mainly because of their negligence in the first instance.

    And no one knows better than me how narratives are being manufactured by the State, via fraud and slander. In fact, there are people here who have made a lot of money from having people labelled ‘mentally ill’ commit offences for them after a little gaslighting. Almost the perfect crime having the nut do the deed for you, and then use the mechanism of the State to conceal your involvement. Mental patient batters mother to death [and sister gets the house].

    I really have no problem with the State killing people, I just find it offensive that they would do it for complaining about their criminal conduct. That sort of cancer needs to be dealt with and I apologize to the police for bringing them the message. Sure its so much easier if your planting the evidence and then dropping complaints off at the ED for slaughter. I mean we aren’t openly killing people in prisons, and yet its an open secret that the State is slaughtering any complainants regarding State misconduct.

    And believe me, they really don’t care who knows. In fact, i get the impression they want the word put around to generate fear in the community. Live with the corruption because we have no intention of doing anything about it.

    Advocates? I think that may be an auto correct error and should read sycophants.

    I watched a video of our Attorney General speaking 9 years ago when I was being tortured, speaking about another man who had been subjected to some viscous torture captured on video by police. He spoke about our Premier being the Premier of cover ups, and how his party was for the ‘downtrodden’ and only they would stand up for this man. He also spoke about the Aust. Human Right Commission acting on his complaint regarding torture. And yet now in power, the story changes. He can’t even inform me of who I should forward my complaint regarding the 7 hours of torture I was subjected to, and refers people to an authority our Prime Minister has stated is a “kangaroo court” that is being used for State cover ups.

    They will use whatever comes to hand to advance their careers, and simply don’t give a damn about who gets hurt. In fact at that public rally concerning this man being tortured, and the demand for the full video to be released, was the now Minister for Health, who was in support of the victim. These days he simply slanders anyone complaining regarding torture as being mentally ill and considers that the end of the matter.

    And I wouldn’t worry so much about anyone in the community doing anything about it. These are the same people who pointed fingers at Jews in the 1940s and watched as they were also dragged from their homes and ‘treated’.

    How simple has it been for these ‘good’ people, who, when the truth doesn’t suit simply refuse to accept the documented proof and ignore the complaint. Though one does need to consider these organised criminals forming networks in our public service are new to the place and need to be given a bit of time to acclimatize and get the lay of the land before moving up the criminal ladder. And our politicians know this and are concealing their misconduct until they do, with such bizarre claims as ‘the law isn’t the law, and we are enabling arbitrary detentions’. Any complaints we will treat you.

    I care zero anymore. The people who haven’t been ‘fuking destroyed’ ask me why I am still upset about the effects of being tortured, and then go play in the park with their families. What I have found most bizarre is that there is a verse in Qur’an regarding people who ask ‘why should I help when with a click of His fingers God could feed these people?’. Even my own brothers may be able to recite the words, but they seem to fail to understand what they actually mean.

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    • “I care zero anymore. The people who haven’t been ‘fuking destroyed’ ask me why I am still upset about the effects of being tortured, and then go play in the park with their families.” I SO hear you, boans.

      So hear you.

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        • I have to share my new favorite song boans… (and Sam too.)
          https://www.youtube.com/watch?v=Mks4mvjbRDg It made me smile!

          I found it while licking my wounds after a recent blindside run in with a past therapist. It reminds me of myself and my inner self-blame psychoanalysis conditioned spiral.

          I was asking if I was needed. If my presence was a detriment to this movement. If I should just walk away. I was not in a good place.

          He never did answer my questions. He never said, “STAY! I need you.” Having my fear confirmed left me spiraling worse.

          He told me instead how I was too much and doing human 101 wrong, right before insisting that I accept him as he is. Hermit, mercurial, flitting. Just as he is.

          What if this is just how I am too?

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          • Actually I just thought of something… Who I am in “therapeutic” “patient” relationships is NOTHING like who I really am. It’s like I’m trying to live down to what the therapist imagines I am. Has already decided I am. When I have been me with a therapist i got hurt, really bad. So there are lots of memories that make “nice” “calm” “fun” a struggle with any “therapist”.

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          • Just as you know psychiatry is not close to knowing any “truths” about people, so should we look at many people’s opinions about us. Difficult to do and sometimes a lot harder than other times…

            Wow that guy singing has a major in english lit? Amazing vocabulary. I had to pause it to read lol.

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          • I really am laughing at present as a result of the debate about the passing of laws in China regarding Hong Kong.

            Arbitrary detention laws that have been passed and may be used by the Chinese government to arbitrarily detain people and have them transported to mainland China to face charges have been passed. And the good human rights violating Australian government has provided 10 000 visas for people to avoid these laws. Hey hang on a second……..

            Anybody wish to look at the Mental Health Laws in this country? Certainly not the Chief Psychiatrist who writes that a person can be detained by police and force drugged based on nothing more than a “suspicion” (he removed the “reasonable grounds” section and hey presto like magic we have arbitrary detention and torture available to mental health workers and police). How is it possible he can protect our human rights when he doesn’t know what the protections are?

            The ‘trick cycle’. Mental health worker says ‘patient’ to police, who then ‘suspect on reasonable grounds’ the person is suffering from a mental illness [s. 195 of MHA]. Police refer to mental health worker who authorities ‘spiking’ of ‘patient’ [neglect duty of care whilst person is in custody]. Hands back to police for interrogation whilst being ‘transported’. Police then torture, and hand back to mental health worker, who then hands on his ‘police referral’ to a psychiatrist for examination, with a ‘verballed up’ statutory declaration [not unlike providing the Courts with fabricated evidence, which will never under any circumstances be prosecuted]. Psychiatrist receives a citizen who has been subjected to torture, thinks its a mental illness and starts the wheels in motion. Left to the Judge to figure it out, and if your real lucky they may notice the evidence was planted.

            And I get it, that the Community Nurse may at times need to have police assist with a “patient”, much the same way if a prisoner escaped from prison. But that doesn’t mean police get to call anyone they want to torture an ‘escaped prisoner’ and lock them up and rape them until they tell them what they want to hear. Or does it? I might be speaking too soon on that one, i’ll get back to y’all lol

            Now if I, the ‘mental patient’ have enough grey matter to understand why one might need more than a “suspicion” to detain someone and force drugs into them against their will, in a place they have been transported to against their will, surely a lawyer (principle of the Mental Health Law Centre) or the cabinet Minister of the Upper House would understand why it makes arbitrary detentions available to public officers?

            And whilst the threat of it occurring may be real in Hong Kong, I can bear witness to the fact that it is being done here in Australia. And not a soul saying a word about it, mainly because they are being subjected to ‘treatments’ that make Chinese water torture look like an afternoon of watching Sesame Street.

            What a disgrace that we are offering a hand to people to enter a place that is DOING what they claim CAN AND MIGHT BE DONE in another.

            I’m sure the Chinese government is aware of the large scale human rights abuses that are occurring in Australia (i’ve certainly spoken to one, and am certain given the ease with which this can be done, there are others), and it may be a good move to stop their citizens from coming to this place. Of course this might also make it possible to empty the prisons in Hong Kong, and reduce the tax burden to their Nation.

            “Suspect on reasonable grounds” an objective test under law that provides the protection to citizens, and can be used to resolve issues of misconduct by public officers, becomes “suspect on grounds they [mental health workers and police] BELIEVE to be reasonable” (criteria of s. 26 literally removed, and without Parliamentary approval, imagine) The rewritten version by the Chief Psychiatrist, and approved by the Minister for Mental Health, that is subjective, no test, and provides zero protection from detention because the Community Nurse wants police to drag you from your bed, kidnap you, and force drugs into your system to deliberately damage your brain and call it medicine. And the people enabling this say China is a human rights violator?

            And given there is no avenue for complaint regarding acts of torture, (hence the reason we have such a good record, that and the refoulments) these people might want to consider the ‘treatment’ they are going to get if they DO seek refuge here. Because surely some of them would be spies right? And we can torture here, ask me, i’ve been training public officers for a few years now 🙂

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          • “I have to share my new favorite song boans… (and Sam too.)”

            Very clever O.O. I like it too.

            I sent the following clip to some of my friends to explain to them the complaints process in this State.

            https://www.youtube.com/watch?v=oudNoKfNUfs

            It’s a very effective means of ensuring the public are viciously humiliated for daring to question authority, and results in your god like status being maintained, despite the known wrongdoing. Hence the reason for a lack of remedy for acts of torture and kidnapping. No need, when you simply make life impossible for the victims.

            Luke did of course commit a crime, my only crime was that I dared to complain about being drugged without my knowledge and snatched from my bed by police for no reason (unless you consider the fraudulent statutory declaration as being “reasonable”) How dare I complain that my State is doing such things, when there are people in China who are being threatened with laws that allow this to happen? Funny but they simply can not see themselves as being human rights abusers, until of course they are committing acts of fraud and gaslighting people to suicide to conceal their criminal conduct. That’s the point you KNOW they know they are abusers.

            I do like the song “Ain’t no grave gunna hold me down”

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      • Funny but I found myself actually caring in a situation where I thought I wouldn’t.

        This psychologist who I have spoken about who ‘assisted’ my wife with her ‘referral’ and getting me to ‘talk’ when I felt I had said enough, …..

        She (and her psychiatrist shock doc husband) have as I have said elsewhere, been ‘hijacking’ patients for profit. Vulnerable people with money being mislead into a ‘treatment’ that has been advertised via our media, and the laws changed (added protections) to protect docs who wish to ‘treat’ 14 year old girls without parental consent.

        Now normally I would have said who cares what happens to rich people, they don’t seem too worried about me (and this continues to be true given the lack of action regarding my torture and kidnapping). And this psychologist obviously positioned herself well to ‘hijack’ these people and profit from the ‘treatments’, an exclusive private clinic, and the counselling service of the most prestigious University in the State. (My freak situation of ending up in the clinic, son of a bricklayer pure coincidence). And so the people who were likely harmed by this pair of ‘medical professionals’ (because I really can’t say what they were doing was illegal, simply unethical) probably were the children of wealthy people.

        But I did care, they were people. Not their fault they were born into money. And well, the psychologist was also aware of the money I had received and i’ve no doubt was disappointed at my response to the suggested ECT treatments (ie shove a car battery up yer own …..did someone say KFC? Serious though, my response was not what she expected).

        So now, two well resourced organisations (with political connections) ensuring that the use of their fine establishments for such unethical purposes needs to be concealed. And the State is more than happy to assist in that regard, their human rights abuses and the subsequent use of fraud by the hospital to conceal torture a problem that disappears also. They all have skin in the game, and a whole lot of people were harmed as a result of the dereliction of duty by those charged with the protection of the public.

        So Boans is a nut that even his own family has been warned to not speak to, because we don’t like the truth of what he is saying. In fact i’m surprised i’ve even been allowed to voice my concerns here at MiA. But, land of the free, and home of the brave, maybe it’s true, maybe you do have so much more than we do here in this National Socialist State. Or maybe these people are secure in the fact that no one can possibly hold them to account, and given the fact that a doctor can ring police and have anyone delivered to a hospital for an unintended negative outcome that will be ‘overlooked’ by authorities………

        I don’t know, should I care if what is going on over the barbed wire fence seems a little strange? Should I have jumped the fence and taken a look, only to be shocked at what I saw? And heaven forbid that I try and inform the public, only to be reported and taken to meet Dr Mengele? I just wasn’t convinced by the sign in his office saying “Happiness, we’re all in it together” [one for the Brazil fans :)]

        I find myself wondering about ‘Chop Square’ in Jedda and the way we do the same thing but in locked wards (okay they remove them, we damage them if you wish to quibble over technicalities). Maybe given the way that the public is being given what they want (Euthanasia Laws) we can start having public executions again? Rather than hiding them from the public in these places disguised as hospitals we can do it in the village square? I can see no reason there would be any complaint from the public if we were to throw them a mental patient or two once a week, given what we are allowing to be done to them in these psychiatric prisons. Of course physical distancing would need to be observed, so please consider televising if the public does express a large interest.

        Only people who have been subjected to these psychiatric interventions would truly understand the brutal truth of the depraved nature of these people once they get into a lynch mob. Our Minister for Health should seriously consider this. There are votes in it from people who are living in fear of the mental patients they are forced to share their public space with.

        P.S. for anyone interested in the way psychiatry can be used as a political tool, see the case of Malker Leifer currently in the Courts in Israel. The law a farce when psychiatry becomes involved. She’s nuts, she’s not, she’s nuts, she’s not…….. they will need to settle it, because they can not afford to have psychiatry put on trial, the fraud cases would go on forever lol

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  10. Caroline,
    “The “mentally ill” really need an effective PR campaign that sets the record straight in the eyes of the public.”

    You are absolutely correct. It has to be spoken to anyone possible. Advertised to hold meetings in neighbourhoods. People have to be informed before they ever set foot into the arenas.
    And in Canada, that arena of psychiatry has penetrated into the real medical system in a worse way than psychiatry can wield. Absolutely “disordered” nurses have power to make anyone’s life hell, right up until death.
    Although after death, who cares anymore. They got their way, because it means everything to them to get their way.
    For some it’s a moronic belief, for others it is nothing but ego. And not much any citizen can do about ego or moron with licence, except escape.

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    • Thank you, sam. Bringing what is commonly known on MIA to the mainstream may take a lot of time, and be extremely difficult. I have read at least one horror story about people’s adverse reactions to psychiatric drugs in mainstream publications, but they basically forgive psychiatry. I read one in The Guardian about a woman who became psychotic and homicidal after taking an antidepressant, but started with a disclaimer that went something like this, “Millions of people are helped by antidepressants.”

      I have a cousin who is an ObGYN. She doesn’t prescribe medications, but helps deliver babies. She has some awareness of the corrupting influence of the drug industry on how medicine is practiced. When it comes to the profound corruptions in the mental health industry, she isn’t fully aware of all of it, but she has a really open mind. She has “treated” a few women with “Postpartum Depression” in part by telling them to take at least one hour out of every day for themselves. She once told me that she wished she could prescribe people an M&M to make them feel better. She explained that you might get a little chocolate, I guess as a side effect. I feel that she is unusual in her awareness of corrupting influences in medicine and open-mindedness as someone in the medical profession in the US.

      I feel if people really knew the truth about the mental health industry that is so commonly known here, public opinion would turn against all that has been done to innocent people in the name of good mental health.

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      • A lot of docs know, but they would not be liked by their peers if they spoke out, and besides, they only think “mental illness” doesn’t exists for a few. If one of their friends was “diagnosed”, I doubt they would question it. Perhaps a few feel good words such as “that is awful”.

        I had “post partum” and “post partum” as such does not exist. An hour to myself would not have been enough. 30 years later I know what “IT” is, and “IT” is not “post partum” as a “mental illess”.

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        • I definitely agree that “postpartum” does not exist, and I think my cousin would agree. Obviously without really knowing the entirety of a situation, a person can only do so much to offer suggestions that may or may not help. But my cousin definitely is a very kind person, and always open to new learning. My cousin doesn’t think of me as “mentally ill,” despite the fact that I was at one time “psychotic.”

          My primary care physician, on the other hand, wrote down as one of my medical diagnoses, “Psychosis.” I had previously thought that we had had a good relationship. This made me not really want to go back to him so much, unless I really had to.

          I do not know how much the average doctor has really bought into all that psychiatry teaches. Their livelihoods do not depend on it, like psychiatrists do. But like you said, there can be enormous peer pressure. Also, there is the fact that much of the public in general is so ignorant of psychiatry altogether, and that includes doctors. This is one of the reasons why I feel an effective PR campaign could be so beneficial. This is why books like those written by people like Robert Whitaker and this website are so important, because it does help to get the word out.

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  11. I realize that Dr. Aftab’s field is philosophy of psychiatry, and not clinical training.

    However, in general psychiatrists, who almost always do nothing but prescribe drugs, are very weak in understanding the basic pharmacology, interactions, and adverse effects of the drugs they give the public every minute of every day.

    No matter how philosophically sophisticated the psychiatrist, this practical barrier to providing responsible patient care cannot be overcome. The specialty is dangerously ignorant of the powerful psychotropics it wields with such abandon. Unfortunately, no amount of “conceptual competence” addresses this. Ultimately, it is irrelevant to patient care, and patients remain endangered by its silence on the underlying rotten paradigm leading to gross deficiencies in clinical training.

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    • Altostrata says, “…in general psychiatrists, who almost always do nothing but prescribe drugs, are very weak in understanding the basic pharmacology, interactions, and adverse effects of the drugs they give the public every minute of every day….No matter how philosophically sophisticated the psychiatrist, this practical barrier to providing responsible patient care cannot be overcome. The specialty is dangerously ignorant of the powerful psychotropics it wields with such abandon. Unfortunately, it is irrelevant to patient care, and patients remain endangered by its silence on the underlying rotten paradigm leading the gross deficiencies in clinical training.”

      This is reality. And Aftab wants to sit around the campfire and smoke a peace pipe while the forest is burning.

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    • Altostrata says, “The specialty (psychiatry) is dangerously ignorant of the powerful psychotropics it wields with such abandon. Unfortunately, no amount of “conceptual competence” addresses this.”
      BINGO!!!

      Mouthing phrases like “conceptual competence” is psychiatry’s way of distancing itself from its countless moral crimes of bias and discrimination. It’s a feeble attempt to save face, but hiding behind intellectualism will do little to alter its inherent depravity.

      Psychiatry’s “conceptual competence” means serving people tea before sending them to the guillotine.

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    • Altostrata says, “Ultimately, (not “unfortunately”, my bad) it (“conceptual competence”) is irrelevant to patient care, and patients remain endangered by its silence on the underlying rotten paradigm leading to the gross deficiencies in clinical training.”

      Wake up and smell the coffee, Aftab! Philosophy is the pursuit of truth, but there’s no truth in psychiatry.

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      • How is there no truth to psychiatry?
        Because it’s diagnoses aren’t real and its drugs aren’t medications. It’s legalized drug pushing masquerading as medicine, and no amount of armchair philosophizing can change that.
        Psychiatry has no place in medicine. It’s nothing more than biological mind control.

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      • Altostrata says, “Ultimately, (not “unfortunately”, my bad) it (“conceptual competence”) is irrelevant to patient care, and patients remain endangered by its silence on the underlying rotten paradigm leading to the gross deficiencies in clinical training.”

        Psychiatry needs to wake up and smell the coffee. Philosophy is the pursuit of truth, and there’s no truth in psychiatry.

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  12. Just what the world needs. Philosophical drug pushers.

    The world needs wisdom, but not from inexperienced, wet-behind-the-ears philosophical thumb-twiddlers.

    Aftab hasn’t lived anywhere near long enough to know what he’s talking about. He has yet to discover the difference between fantasy and reality. But people who like spending their time in ivory towers rarely do.

    And he mentions, of all things, humility—and he’s a psychiatrist – which is the exact opposite of humility! Talk about irony….but when I think about it, psychiatry and philosophy actually do have something in common: both are wordy and pretentious.

    He seems happy enough to paint the house, though. Too bad he doesn’t know it’s condemned. But how could he when he spends so much time playing in his philosophical playground?

    But he’s such an eager beaver, trying to change psychiatry! Which reminds me….what that’s saying about about putting lipstick on a pig?

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    • And as for “reification” of “psychiatric constructs”. THAT’S a real beaut, a great example of intellectual masterbation.

      Reification: “is a fallacy of ambiguity, when an abstraction is treated as if it were a concrete, real event or physical entity”.
      How do you like that? Psychiatry actually gaslights itself!

      Time to give it up, psychiatry. The world’s not gonna fall for your DSM bullshit forever. And here’s another fun fact: psychiatry itself is a “psychiatric construct”, or “fallacy of ambiguity”. Imagine that!

      And when psychiatry gets bored with “reification”, it can always try its hand at “deification”. And who knows? They just might find there’s little difference between the two in psychiatry.

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