Suicidal Thoughts, Psychiatric Diagnosis, and What Really Helps: Part Two

This piece is the second of a two-part essay about suicide, diagnosis, what doesn't help, and what does help. This part is about barriers to seeking help and about the ways we actually can be of help to people who are considering suicide.

Paula J. Caplan, PhD
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Portions of this essay are based on the Mad in America webinar, “Issues in Dealing with Suicidal People…and What Experience with Military Veterans Teaches about Nonpathologizing Approaches for All,” April 2, 2019.

Part 1 of this essay was about the absurdity and dangerousness of pathologizing suicide as “mental illness” and about the ways traditional approaches either do not reduce suicide or risk actually increasing it. Now we consider some factors that tend to inhibit suicidal people from reaching out for help, and that is followed by description of what actually can be helpful.

What can get in the way of reaching out for help?

Barriers to asking for help—and there are good kinds of help—include:

(1) Fear of being called mentally ill and all that follows from that, including losing support from friends and family, who want you to confine your talk to a therapist behind closed doors, just take psychiatric drugs, and/or agree to be hospitalized.

(2) Belief that only a therapist can help—this often keeps others from reaching out to someone who is suffering, because therapists’ guilds have taught the public that only therapists can help reduce human suffering, that we have special knowledge no one else has, when that is almost never, ever true

(3) Feeling unworthy of taking up the time of a family member or friend. This can differ depending on one’s sex-role socialization, since traditionally, women are not supposed to ask for anything for themselves, and men are not supposed to need anything.

(4) Believing one ought to be able to manage on one’s own—whereas, in contrast, in some cultures the community considers it a community responsibility to reach out to and support those who have been traumatized, those who are feeling despair.

(5) Being labeled mentally ill because of having suicidal thoughts or made attempts to kill oneself, even though these are more common than widely assumed, and the masking of many of the causes of such thoughts or attempts, because “mental illness” is assumed to explain them.

What therapists and many others can do to help

(1) Realize that it can be very hard to predict who, even among people deemed to have risk factors, will attempt suicide. So begin by not taking responsibility for what the suffering person ultimately does.

(2) Related to (1), stop assuming therapists can prevent suicides. The truth is, we therapists don’t know how to do that, certainly not based on our clinical training. In a USA Today article, Dastagir wrote this: “experts say training for mental health practitioners who treat suicidal patients is dangerously inadequate….There are no national standards that require mental health professionals be trained in how to treat suicidal people, either during their education or their career.” Keep in mind that therapists are not supposed to work in fields in which they have not been trained.

And too often, those that do receive training are “taught” to send people who are considering suicide to the ER, get them on psychiatric drugs, and/or have them committed to an inpatient facility.  Many clinicians spend most of their time trying to treat a patient’s allegedly underlying mental illness, rather than asking the person, “What makes you want to kill yourself?”

Dastagir wrote: “Stacey Freedenthal, a suicide attempt survivor and associate professor at the University of Denver Graduate School of Social Work, says a common feeling among therapists when they realize they’re sitting across from a suicidal person is panic. Their reflex is to send the patient to an emergency room.

‘You’ve got this person who has taken weeks or months or more to work up the nerve to go to a professional and the professional is saying, “I can’t help you, you have to go somewhere else.” And that can be very harmful,’ Freedenthal said.”

(3) Stop using psychiatric diagnostic terms everywhere. Instead, tell suffering people you don’t consider them mentally ill. Teach them the truth about psychiatric labels, because just being told one is mentally ill can lead to despair. In a recent Mad in America essay, Jo Watson and I mentioned a New York Times essay by a woman who had been body-shamed by her ballet teacher for years, but it was only when her therapist told her she had an “eating DISORDER” that she said she fell to the floor and was despondent.

(4) Broaden the field of what we consider might be helpful, not just therapy and/or psychiatric drugs. Over the decades, as people have told me what helps them, I have seen two categories of helpful approaches: connection and creation.

Connection can be with people other than therapists, so the suffering person will know they won’t be labeled mentally ill or treated as though they are, and this can be anyone who will be a willing listener. That is why the Listen to a Veteran listentoaveteran.org (LTAV) project is so powerfully effective. A Viet Nam veteran who had become a counselor and listened to others’ suffering for decades had just one session in which a nonveteran truly just listened to whatever he wanted to say, and that ended his intense wishes to die.

I have referred to “The Astonishing Power of Listening”, which cannot always prevent suicide but sometimes can. And on a recent episode of “CBS Sunday Morning,” a person whose suicidal despair had been stopped because of receiving occasional, simple post cards from someone said, “It wasn’t about my mental illness.  It was isolation”—having someone reach out and show they cared.

When Hom et al. asked 329 suicide attempt survivors what they wanted, they said reducing stigma of suicidality, expressing empathy and active listening, a range of treatment options, including nonmedication treatments, addressing root problems, bolstering coping skills, and using trauma-informed care. Connection with service animals and with something spiritual or religious can also be helpful. This makes sense, given the crucial roles of isolation and hopelessness in leading to thoughts of suicide.

Creation can be in the form of involvement in the arts, doing volunteer work, gardening, etc., and many forms of creating also involve connection, whether with other beings, with the earth, or something spiritual. This website has more than two dozen very brief videos of nonpathologizing approaches to reducing isolation and suffering and providing real help (they come from a conference focused on veterans but are useful for anyone).

And keep in mind that another part of destructive labeling includes not just psychiatric labels but also “art therapy,” “music therapy,” etc. People find meaning, connection, enrichment, and creativity through the arts, so it harmfully sets up some people as belonging to the category of Other to say “I paint a picture, but YOU need art therapy”?

(4) Reduce or get rid of psychiatric drugs whenever possible, because it is known that they increase suicidal thoughts and suicides.

(5) Get rid of firearms, since they are known to increase suicide risks substantially.

(6) Provide real-life help getting safe places to live, jobs, healthcare, community connections, and a sense of meaning.

(7) Without being Pollyana-ish, help the person consider the strengths within themselves and their external resources.

(8) Help the person look realistically at the structural factors that may cause their despair, such as various kinds of violence, sexism and sexual harassment, racism, classism, ageism, ableism, homophobia and transphobia. CALL THESE FORMS OF OPPRESSION AND EMOTIONAL VIOLENCE BY THEIR NAMES, say they are all forms of abuse, and tell the person they are of course upset and feeling powerless in the face of such treatment. Help them consider ways to fight against these, including but not limited to political action and use of the arts.

(9) Be careful what you wish for. Don’t give up your critical thinking and think the problem has been solved when someone or some entity says it cares. For instance, the American Psychiatric Association has recently professed alarm about the lack of mental health care given to Black people. I am sure some of their members are aware of racism as a cause of suffering and would not ignore it and attribute suffering caused by racism to an alleged chemical imbalance in the brain. But given that the APA is officially a lobby group, not a service organization and not an anti-racism one, one has to wonder to what extent they are looking for new markets.

The Congressional Black Caucus rang the alarm about increasing rates of suicide by Black youth. Although this is cause for alarm, it is worrying that they attribute this to “depression” rather than to being targets of racism, and they call for more mental health research funding, reducing barriers to mental health treatment, increased use of “depression” screenings, and getting more mental health professionals into Black schools.

These recommendations are worrying, because too little traditional mental health work involves calling out racism—or other forms of oppression and violence—as a cause of deeply human responses, not of “mental illness.”

(10) Try to avoid suicide hotlines. Instead, use warm lines (see below). When I asked the directors of the Army suicide program what happens when someone calls their hotline, they said they are told to get “mental health services.” Those are nearly always the labeling, drugging, and hospitalization referred to above.

I investigated many high-profile hotlines and crisis lines and some that are not well-known. I want to describe the experiences I had when calling them. One of the best-known services, the one most often mentioned by colleagues whom I asked for recommendations, has toll-free numbers and several numbers with various local area codes that turn up in online searches. Over a period of several hours one evening, dialing one of those local numbers consistently elicited nothing but a busy signal. Over those same hours, another of the local numbers in a different location consistently elicited an automated message instructing the caller to dial 911 if it was an emergency and otherwise to call back.

A third local number in still another state also rang busy for hours, but a man finally answered. I asked what they do for suicidal callers. I said I hoped to find a line where people would listen, be supportive, and try to maintain a meaningful and helpful connection with the caller. He replied that what they do is send people to get “mental health care.” When I asked whether they have been trained at least to offer callers information about alternative, nonpathologizing, low-risk approaches that have been shown to be helpful—such as physical exercise, meditation, volunteer work, involvement in the arts, other kinds of human connection, and having a service animal—he said that they have not and that he himself does not suggest them.

When I called the main toll-free number for that same crisis line group, the automated answering message immediately gave an option to press 2 if you are a veteran. I pressed 2, and a man answered right away. I told him about a dear friend who is a veteran who takes three psychiatric drugs and has attempted suicide several times, each precipitated by a change in the drugs. I asked what the people answering their line would say if I persuaded him to phone them. He told me that he would tell him to go straight to the VA. I expressed dismay, saying that it is well known that at the VA, veterans are often put on psychiatric drugs, even up to a huge number at once, and that even some top VA people have expressed alarm about the ways the drugs so often lead to deaths. I got nowhere.

Around the United States and in other countries, people who have themselves been through difficult times and who do not rush to recommend psychiatric diagnosis, drugs, and hospitalization are creating “warmlines” for people who are having suicidal thoughts or other kinds of upset. Many such lines have small budgets and can only provide people to respond a few hours a day, usually in the evening, but from what I learned by contacting some, they are staffed by compassionate people who respond in helpful ways. Although some do not have toll-free numbers, they can be phoned from anywhere in the U.S.

When providing someone with numbers to call, it is important not to overreact to their having mentioned thoughts of suicide. A simple and kind, “Here are some numbers for you if you continue to have thoughts about suicide. They are staffed by warm and caring people who will not rush to recommend psychiatric care, diagnosis, drugs, or hospitalization. I am providing them in case you decide you would like someone to speak to about these feelings.”

The primary aims of this two-part essay are to save everyone time and worry when trying to help prevent suicides by describing the absurdity and even the harm caused by psychiatric labeling and drugging of people who are thinking of killing themselves, by providing a list of “What Not to Do” and providing concrete suggestions for “What to Do.” I hope this is of use.

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

42 COMMENTS

  1. Paula, this is an extremely important article and hope it stays visible for a bit.
    This is valuable information for readers.
    I agree with everything you have said. Thank you so much for being
    that person who keeps working because you believe in what you do and the people
    you serve.

    I have sat in some pretty infantilizing chairs. And as we say, I wish I knew then,
    what I understand now.

  2. “Fear of being called mentally ill and all that follows from that, including losing support from friends and family, who want you to confine your talk to a therapist behind closed doors, just take psychiatric drugs, and/or agree to be hospitalized.”

    You are understating this.

    It is absolute terror of being locked up, abused and losing all control over your life.

    I’ve been locked up for alledged suicidality and there is no way I’ll talk to any psychiatrist about how I feel ever again.

    • beokay,
      It is like trusting a rapist. Seriously. And I have had to deal with being attacked physically by a random stranger, and the attack by the medical system was much worse. And I no longer make distinctions between the medical system and psychiatry. The docs got the drugs and pad, it’s all they need for a “diagnosis”. I wonder what people imagine when their Medical Physician prescribes psych drugs? You think you are free from a diagnosis? What do you think he writes in his charts, as to the “reason” he prescribed them?
      One has to behave like a good compliant sheep no matter where we go.

      • Sam,
        Gladly I’ve never been raped, but it is the only analogy I can think of. Total powerlessness.

        I’ve had my life believably threatened by someone and there was a moment I thought I’d die, but I called the cops, he got sentenced and it took a whileybut I’m over it now. Thoughts about it are rare and not threatening anymore.

        Being locked up in a psychward was so much worse it wasn’t in the same ballpark, the same league, the same friggin universe. It haunts me to this day. I’ll never get justice. (But I have a bottle of Champagne reserved for the day coercive psychiatry gets outlawed here.)

        And I got lucky. It was just 7 days. I did not take any drugs. I got rid of the alledged schizophrenia diagnosis. I’m certain I walked with minor injuries compared to many others. Survivors guilt ain’t no fun either.

        I hope you can find a doc you can trust for physical needs.

        • “I’ll never get justice. (But I have a bottle of Champagne reserved for the day coercive psychiatry gets outlawed here.)”

          Stranger things have happened beokay. I’m sure the people in the camps never thought they would see the day when Albert Pierrepoint was doing his work and dealing with the lunatics’ that took over the asylum in Germany.

          I don’t drink alcohol, but I might just ‘raise a glass’ with you on that day.

          I turned on the television yesterday and realised how much the term “mental health” is being used on tv these days. It was literally 15 seconds before someone used the term. I really am sick of hearing it, especially now I know what happens to those who go looking for ‘help’ with their ‘mental health’. I know when I was at college one of the tutors spoke about the fact we didn’t have an issue with ‘stress’ many years ago, it wasn’t a thing.

          I feel very fortunate to have gotten out in 7 hours beokay. Though my experience was under the influence of a drug I had never taken (and which is the drug of choice of nite club rapists) and I wasn’t informed I had been ‘spiked’ with. I guess telling me they were going to torture me wouldn’t have been as much fun (and they can conceal simply anything when they can provide fraudulent legal narrative to lawyers). And of course they could not deny that they knew it was torture, as the State has ratified the Convention against the use of Torture stating they will ensure officers engaged in the incarceration of citizens are fully trained in what does and does not constitute torture. They knew.

          Article 10

          1. Each State Party shall ensure that education and information regarding the prohibition against torture are fully included in the training of law enforcement personnel, civil or military, medical personnel, public officials and other persons who may be involved in the custody, interrogation or treatment of any individual subjected to any form of arrest, detention or imprisonment.

          2. Each State Party shall include this prohibition in the rules or instructions issued in regard to the duties and functions of any such person.

          Mind you when you are ignoring the Convention to the point where you are unintentionally negatively outcoming people in Emergency Depts, you don’t need to worry about anything you signed. Most people who have been tortured would fit into some sort of diagnosis and then are made “Ghosts of the Civil Dead” and you never hear from them again. The proverbial ‘Dead Person Walking’ who they turn their eyes to the wall for when they walk past, or God forbid, utter the words “i’d like to make a complaint”. Now the State will ‘fuking destroy’ you and your family, while the ‘advocates’ turn a blind eye, and police assist in retrieving the documented proof.

          My argument has always been that good people don’t need to kill to maintain their good reputation. Seems “reasonable” to me but ….. not to my community who are obviously living in fear. Always good to know who the hypocrites are though. And the places that are best to avoid. I’m sure National Socialist Germany was a great place to visit, but it got a little out of hand there for a while.

          Article 11

          Each State Party shall keep under systematic review interrogation rules, instructions, methods and practices as well as arrangements for the custody and treatment of persons subjected to any form of arrest, detention or imprisonment in any territory under its jurisdiction, with a view to preventing any cases of torture.

          ‘Spikings’ with stupefying drugs before interrogations by police? Who is it doing the reviews of the rules? Doctors signing prescriptions for these acts of torture by police and mental health workers and no one gives a damn? Seems a little strange to me. Oh that’s right, they thought the evidence had been retrieved. That’d explain the copper knowing that “your not supposed to have these”. Well, unfortunate that I do I understand Senior Constable, but lets see how you go second time around when your made aware of citizens being tortured. Where ya gunna run? Straight to mental health services with a referral for “hallucinating”. Come pick him up and deal with it. How clever to make speaking the truth a mental illness that can result in some serious brain damage to ‘treat’. And a ‘stitch up’ with the “I’m going to arrest you for having these documents”. And the real bother is the low level at which police can actually authorise these acts of torture. The real concern is with the higher authorities such as the Chief Psychiatrist charged with the protection of the community neglecting their duty. Anyone care to see the letters? Arbitrary detentions and torture, no problems, nothing to see here, we got the documents back and have ‘fuking destroyed’ the victim, move along. And look at the ‘advocates’ turn and run when it turns out they hadn’t got the proof back. Best give them some more time on the cover up eh?

          • I am at times flabbergasted when I think about what occurred.

            My wife calls the Mental Health Emergency Response Line and tells them she has assaulted me by ‘spiking’ my drink with benzodiazepines without my knowledge (s. 305A of the Criminal Code. Assault on Persons. Intoxication by Deception. No defense as they tried to conceal the act with further offenses, and so the only available defense falls at the first hurdle), but tells them that she will assist in concealing her crime by planting items on me for police to find, take me into custody, and then hand me over to them to inject with a ‘chemical restraint’ that would make me very sick, and then call that sickness a mental health issue, and start treating me for the trauma and sickness they actually caused.

            I try and imagine some similar situation where I could call police and confess to sexually assaulting someone and then asking them to help me conceal that crime because I will help in making the victim into a prisoner. I’ve no doubt now that certainly some victims of ‘spikings’ and rapes end up being thrown under the bus by police, their knee jerk reaction in making referral of me when I turned up with an inconvenient truth in their station very telling.

            Imagine, you turn up in a police station and claim you have been ‘spiked’ with intoxicating drugs, and their first response is NOT to take any evidence, but to call mental health services and make a referral of a person who is “hallucinating”. We can drop her down there for treatment if you like. And if you keep putting the video of the assault in front of us, we will arrest you for having it, that’s a serious criminal offence wandering around with proof of crimes that we would prefer are not crimes because the perpetrator needs to play football for us on Saturday.

            So my world is a little upside down because of the need to conceal this very serious misconduct by a number of public officers who are engaging in acts of torture and kidnapping, and are receiving some heavy weight assistance from their superiors.

            Unless I’m missing something here. Anyone?

            On one hand we have the government saying that putting items in peoples food or drink is worthy of long prison terms (see the people caught putting needles in strawberries) and on the other they are encouraging the ‘spiking’ of citizens to make the planting of “reasonable grounds” to detain in order to make arbitrary detentions and torture available to them. Are these even the same people?

            I look back and I am still licking my wounds from this experience 9 years later. But at least I’m not the one addicted to these psychiatric drugs I was ‘spiked’ with. I have since found out that my Hell may be mildly warm compared to the Hell my wife will suffer if she ever decides to no longer remain silent as a result of being threatened by the State (“she said it would be best if I didn’t tell you” Note “she” not “he”), and they cut off her supply of drugs.

            “They wouldn’t do that”

            You have no idea the lengths these people have gone to in order to conceal the fact they are torturing and kidnapping citizens and concealing their vile deeds with fraud, slander and in some cases actually physically harming victims. And they have the full authority of the State to do this. “we’re all in it together” 🙂

      • “I wonder what people imagine when their Medical Physician prescribes psych drugs?” Sam, the doctors lie to us calling the psych drugs “safe … meds.” But once one complains of the common adverse effects of those drugs, the doctor writes a misdiagnosis in the patient’s medical records. However, the doctor doesn’t bother to tell the patient about the doctor’s misdiagnosis, at least according to my experience and medical records.

        “there is no way I’ll talk to any psychiatrist about how I feel ever again.” I agree, beokay, nor would I ever speak to any psychiatric DSM “bible” believer, other than to point out psychiatry’s systemic crimes and fraud.

      • “The docs got the drugs and pad, it’s all they need for a “diagnosis”. I wonder what people imagine when their Medical Physician prescribes psych drugs? You think you are free from a diagnosis? What do you think he writes in his charts, as to the “reason” he prescribed them?”

        I wonder though Sam Plover how a “Serious Mental Illness” is defined by law in the different States? Surely psychiatrists are not going to hand over the ability to destroy someone’s life with a pen to just your average General Practitioner? That’d be like handing over sniper work to the army cook.

        I ask because what I noticed was that in order to obtain consent to a physical examination of me a Senior Medical Officer didn’t tell me that he wasn’t the psychiatrist and could then claim when I mistook him for a psychiatrist that he had “implied consent”. I’ve no doubt this is allowing him to have people remove their clothes for him on other occasions also. Maybe the G.P.s are using the same methods? That you think they have the powers to do something they don’t but that means your giving them implied consent to do it? Make sense?

    • “It is absolute terror of being locked up, abused and losing all control over your life.

      I’ve been locked up for alledged suicidality and there is no way I’ll talk to any psychiatrist about how I feel ever again.”

      I agree beokay that it is terrorism, and don’t the people using that fear against their captive population know it. For a Nation that values “Life, Liberty and the Pursuit of Happiness” they sure place little value on Life, Liberty and the Pursuit of Happiness.

      I think that whilst it may be the case in the US that you have the right to remain silent, in my State if you should chose to exercise that right you can be ‘spiked’ with drugs and have some rather nasty ‘coercive methods’ used against you by police to have you talk. All in the name of ‘healthcare’ of course.

      Whilst police tend to be a little careful (for now) regarding the use of known torture methods, mental health services are fully aware that their raison d’etre IS to enable the torture of people with the status of “patient” and exploit the “inherent in or incidental to lawful sanction” loophole of the Convention.

      And of course as we regress the police are increasingly using the provisions of the Mental Health Act to enable the torture of citizens and then refer anyone who has an adverse reaction to said torture to mental health services for a ‘cure’ (as it works so effectively as a means to cover up acts of torture and brutality by police. Surely you would have to be insane to make a complaint about any State sanctioned torture? That’s a given so ….. treatment will follow). And the gods who rule over us and who are passing laws to make them immune from prosecution (whose dumb idea was that anyway?) actually have the support of the public in bringing about their own human rights abuses.

      In my State any citizen can be made into a “mental patient” based on someone making a telephone call the Mental Health Emergency Response Line. As was done to me, a call was made and I became a “patient” before the Community Nurse even left the hospital (he was completing Forms titled “outpatient case notes” when he rang police to ‘assist’ him in having me talk to him, aka ’cause “acute stress reaction” combined with ‘spiking’ with benzos’). And as your probably aware police tend to treat “mental patients” who happen to have had a knife ‘planted’ on them very differently to ‘citizen’ asleep in their beds.

      Good news is I don’t live in China where they have laws that make arbitrary detention possible. In my State they need to ‘suspect’ (but no longer require any “reasonable grounds”) that you require locking in a cage and force drugged before they can do it. And that suspicion is raised the second they receive a phone call, and they can then beat you until you tell them what they want to hear. Well, I say that but the truth is they use the corrupt practice of ‘verballing’ and simply write down what they wanted to hear, knowing that their lies will never be subjected to any scrutiny. And this of course eliminates the need to beat people to within an inch of their lives to have them say the words they want to hear, called informed consent where I live.

      Truth be known, I’d feel safer in China, given the way our “liberties” are being “protected” here in this State. We are being warned about the dangers there, and not being warned about the ‘enemy within’.

      Is it possible to ‘spike’ someone with date rape drugs in the US and then have a doctor write a prescription for that ‘spiking’ 12 hours after it was done? And hours after the same person was subjected to police interrogation? I’ve no doubt that the paranoids among us will be attributing all sorts of reasons to suspect to me (they must have had a reason to torture him right?) but the truth is that my wife simply didn’t like my refusal to speak to an abusive psychologist at a clinic I had a report written by for insurance purposes. How dare you refuse to pay me money when your wife wants you to seek bad advice? Your decision to leave your home must be a mental illness. And therefore any action taken to have you delivered to a psychiatrist to torture you until you see that your decision is irrational is justified. Well, it wasn’t, and the psychiatrist released me after 7 hours because he could find no reason to continue the abuse. My decision to leave confirmed as rational.

      I guess the good news coming out of it all was that I had been pondering my spiritual beliefs before this and this was the final piece I needed to finally revert to Islam. I had been pondering the images of what was done to people in the name of “freedom” at Abu Ghraib (where’s the rest of the pics Mr Obama?) And what I know is that most ‘psychiatric survivors’ can appreciate what those images show. For some reason though people didn’t see it as being ‘healthcare’. Perhaps the lack of a Red Cross painted on the wall or something? Maybe Lynndie England can wear a Nurses Uniform next time?

      And it was bad advice form the psychologist, she had enflamed the family conflict already. And i’m a once bitten, twice shy kinda guy. So I will be doing my best to maintain my silence should I be arbitrarily detained and tortured ever again, but I am also aware of the lengths these people will go to in order to have you open your mouth so they can fill it with the words they want to hear. And unfortunately they have the law on their side when police can’t find a copy of the Criminal Code and they can Fail to Perform Duty despite that being a serious criminal offence. They can smile while they commit that offence on camera and in full view of the public. In fact they have got to the point where they are literally engaging in public executions for what seem to be no other reason that the person is black these days. Not too far from the ‘rock star’ photos of the National Socialists with the Einsattsgrupen Tour of Europe.

      • “For a Nation that values ‘Life, Liberty and the Pursuit of Happiness’ they sure place little value on Life, Liberty and the Pursuit of Happiness.”

        Yes, the beliefs of the DSM “bible” believing psychologists and psychiatrists are about as anti-American as you can get. Thus the DSM “bible” believers are the “enemy within.”

        “And as you’re probably aware police tend to treat ‘mental patients’ who happen to have had a knife ‘planted’ on them very differently to ‘citizen’ asleep in their beds.”

        Not in America. In America, if an alcoholic husband calls the paramedics, because his wife is dealing with a, once ever, sleep walking and talking issue. The day after that alcoholic husband refused to have a wedding anniversary dinner with his wife and children.

        Five paramedics will drag that woman out of the comfort of her own bed, while the sixth paramedic is telling the other five that “what you’re doing is illegal, since she’s neither a danger to herself, nor anyone else.”

        Let’s hope and pray the DSM “bible” believers, who destroy marriages, with your “invalid” stigmatizations and neurotoxic drugs. So you may profiteer off of covering up child abuse for your mainstream “Christian” pastors – and the wealthy, “cocaine dealing,” Bohemian Grove attending, Baal worshipping, child sacrificing, pedophiles in your church – are judged fairly by the real God soon.

    • That’s my feeling, too. In my life, the more “help” I’ve gotten, the more suicidal I’ve become.

      I’d love to actually talk about it, but I don’t want to be locked up over and over again, so I don’t mention it to anyone. Not to family, friends, doctors, therapists, anyone who has power over whether or not I’ll be strip-searched, put inside a “safe” room, and forced to take their “treatments.”

      • Well 30-watt,
        “treating” people never works. Forming alliances has been shown to work. Few know how, it’s a gift, or a deep understanding. It cannot be taught so to go to a school to “learn” how to be an ally with one’s patient is not possible, not even if they called it ally school.

      • 30 watt,
        I can relate. I luckily have some friends who know the story and are sympathetic. I’ve also lost some people. They usually gave the “advice” to talk about it with a therapist.
        I never know when to bring it up with new people.
        It has been a significant contributor to losing a romantic relationship.

    • Wholeheartedly agree. I have told “professionals” I was thinking of suicide and have been incarcerated in lockdown psych wards, the worst being here in Georgia. I was held for over a week, had no say in when I would get released, saw the dr. for 3 minutes in which he asked me what drugs have worked in the past. The majority of patients were people in detox, not mental health patients. We were warehoused and marched to and from meals, with untrained, barely educated staff attempting to run “groups” once a day, wasting all our time. The rest of the time was inane TV in the main room, little to no reading material.

      I missed my exercise, as they take away your shoelaces so it’s hard to even walk the hall! I missed my cats. The psych hospital experience was more traumatic than whatever got me thinking about suicide in the first place! Then when they release you, it’s presented like some kind of reward. Meanwhile they get paid thousands per day from my insurance company (and about $1k from my pocket total) for holding me, so they seemed in no hurry to release me. Again, I had no say in the decision, nor was I told what I need to do to get the hell out of this pseudo-jail.
      I will never tell a “professional” or really anybody I am feeling suicidal. I will never be locked up indefinitely again, not in this state. I’m still angry about it, as you can see!

      Great article!
      Rich in Ga.

  3. It seems like people just need what humans need, which is others that will take in their feelings and put them in a soft understanding place. The best kind of support is not one time or limited, but the kind that feels like it will last forever.

  4. There’s a lot of stress in my little family. I like to think of attachment points as the little, individual filaments of a spider web. The more points of connection I can make between my wife and our son, the more we are all held together so that we can bear the stress and turmoil we face.

    I email our son and the 8 girls in my wife’s system every single morning. I played PS4 with him over the internet 2-3 times a week. I share a mug of coffee with my wife each day of the weekend. We take tandem bike rides. We always eat together and watch tv together, sitting next to each other. We run our weekly errands together, go to church and bible study together and whatever else we can when I’m home from work.

    The more points of contact I have with each of them not only hold them to me when they are facing hard things like his 4th year of his PhD program, or all the stress she has healing from her trauma and dissociation, but they also serve to hold me when I’m struggling with the overwhelming despair and despondency that have plagued my adult life.

    Sam

  5. “And keep in mind that another part of destructive labeling includes not just psychiatric labels but also ‘art therapy,’ ‘music therapy,’ etc. People find meaning, connection, enrichment, and creativity through the arts, so it harmfully sets up some people as belonging to the category of Other to say ‘I paint a picture, but YOU need art therapy.'”

    I agree, as an artist I looked into getting a masters in art therapy, but I couldn’t do it, because I refuse to stigmatize anyone with the “invalid” and disempowering DSM labels. But, absolutely, non-stigmatizing arts are helpful in healing from trauma, including trauma caused by psychiatric labeling and drugging. And some day the art history books hopefully will include the “too truthful” artists’ work, which visually documents today’s modern day psychiatric holocaust. “8 million” innocent people killed every year, please help make it end!

    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2015/mortality-and-mental-disorders.shtml

    “the American Psychiatric Association has recently professed alarm about the lack of mental health care given to Black people.” I hadn’t heard that, do you have a link to that recent APA statement? Especially since I’m pretty certain the “schizophrenia” label has been used to drug black men for decades.

    I recently educated some social workers in my area, who are going into black people’s homes, under the guise of help, regarding the dangers of the psychiatric drugs. I also told them that if they really wanted to help those families, they should keep them away from the psychiatrists.

    Thank you for being honest about all the harm being done by those who utilize the DSM stigmatizations and psych drugs, Paula. The DSM “bible” really does need to be flushed, and forced treatment with the psychiatric neurotoxins needs to end.

  6. One thing that stands out to me in both parts of Paula Caplan’s essay is how normal human reactions to life are “medicalized” and thus, needing treatment, i.e. drugs and therapy, etc. Two normal reactions to life put me into this terror zone; vocational planning and grief. I say vocational planning, but, it’s just asking that age-old question, “the what and why of my life.” The grief part was in the loss of my sister and best friend to cancer. In actuality it was the state’s vocational rehabilitation agency that sent me into this wild goose of “hell!” It is beyond tragedy, dare I say evil, that normal life occurrences and questions are considered “worthy” of being diagnosed. And, as far, as my grief, was concerned, it was delayed “years” because of the drugs and therapy. But, the question is, who is really is afraid of death and dying? Perhaps, it is not us, but those who propagate this terror. Now, I think, when it is my time, I’d rather go peacefully than be subject to the horror and terror of these drugs and therapy. Yet, while even , under the effects of these “drugs”, I realized an odd thing about the word, “therapist.” Take it apart and it becomes, “the-rapist.” This is tragic, for those who really go to school with good intentions to help others in their life changes and suffering. But, these drugs and therapy, do absolutely nothing to mitigate the suffering and as far as life changes, your life is only changed for the worse. This is why so many in this hellishly awful mess, begin to think that only in “death” will have they have relief. Thank you.

  7. Suicide prevention lines are “insane,” I clearly don’t know what to say about it.
    I had called one years ago (more than 30), not because I was suicidal, but because I felt that I was so distressed that I wasn’t taking care of myself, I was spending the whole night on my parents porch, smoking and drinking coffee. I had had quite a bit of societal betrayal, and didn’t understand it at all. I had specifically told them this (that I felt I wasn’t taking care of myself drinking too much coffee); to add on to this, the amount of coffee I was drinking did help to make me paranoid, but I told them how much coffee I was drinking.

    I was invited to come talk to them, where they had a building; clearly I wasn’t at risk enough for them to send police over etc. It’s one of the most bizarre situations I’ve ever had when I went to their building. I couldn’t hardly have a conversation with the lady that was supposed to be there to talk to me because the phone kept ringing and she’d pick it up. And they get really serious, all activate as if there’s some critical thing going on, which wasn’t at all, one lady took such a stance it looked like she was ready to give me an anal probe or something. Any sort of conversation I had amounted to really nothing, but that at one point they even told me that they wanted to have me committed, but I mentioned that I had a therapist (maybe they had tried to call my parents who weren’t home, I don’t know) but they got the therapist, this was just a lady I went to to talk about my dreams for dream interpretation, but she was some kind of legitimate therapist, so they did listen to her who told them that I was fine, that I lived with my parents etc..

    And this was supposed to be a suicide prevention line. I have to admit that’s incredulously unwitty to call a place like that, but I didn’t know who to call. I was just concerned about myself; but simply going there and talking to them was incredibly dangerous. And although I told them about the amount of coffee I was drinking — which I mentioned as a sign I wasn’t taking care of myself, although I wasn’t suicidal at all — there wasn’t ONE peep about that, or that maybe I shouldn’t drink that much coffee (or smoke), or that if I was really upset about stuff that I should relax, take a walk, do something to calm myself like meditate, sit by a lake, all of a host of things, NOTHING was said about this, but one lady actually, when I told her I liked to write poetry, had the false indoctrination to tell me that she was concerned about me because she wanted me to do creative stuff, and if I took “medications” then I would be able to write poetry. Just absolute brain washing. Utter nonsense. Medications that turn off self initiative, that dull the mind, that cause one’s thoughts to recede as if they’re being cut off, that’s what I’ve heard from other people, and seen myself; and that was supposed to help me write poetry.

    You also can easily do a search about how coffee can cause paranoia, and it’s chemically explained quite clearly.

    And I say that it was unwitty to call a place like that, but clearly I didn’t have anyone to talk to, even though my parents are both psychologists, they never understood simple things about children needing to feel free to express themselves, so they can relate to their own instincts, their own feelings, their own perceptions, experiences and intuition; but my parents were more interested in using stuff like the Myer Briggs to analyse our personality, assign us personality traits; and then more stuff at home I won’t get into that’s just too sordid. Not a healthy environment for emotional health.

    Neither was it helpful to call a suicide prevention line just to have someone to talk to. They had no idea of how to just make someone feel there was someone to listen, and when they tried to make out they had concern, along with acting so alarmed that any sensitive person would feel threatened, they said things to me that I already knew were totally untrue, and I just simply didn’t respond at all. Like talking to robots, you can just hear them going through indoctrinated prefabricated snippets, and acting really concerned, which at that point could have been someone trying to tell me what could happen would I not sacrifice a goat, or a dove, or something worse I won’t mention. It’s just amazing how childish those people are, and you can go to any indoctrinated bunch of good doobies working the system, and you get the same kind of inexplicable responses. Only this involves a person’s life, and people that have already been seriously traumatized, in a way that society ends up discarding them do they actually show signs of what they’ve been through. Having the police pick them up and escort them to a place where they will get more abuse really ISN’T going to help: where they are told that medications that don’t help them they have to take for their whole life, that their brain has been broken, and after having suffered through questionable wars find themselves part of one against feelings, and the brain itself, the way such drugs disable natural brain functions.

    My heart goes out to any veteran that has ever had to do with those people….

    • It is strange that suicidal thoughts and uttering them brings people to be locked up.
      Obviously if many people have thoughts of ending life, they must be normal thoughts and obviously since we are generally afraid of death and suffering, the uttering of such thoughts is simply a way of telling another human that one feels helpless and scared.
      The “MH” industry is designed in such a way that one should not repeat the thought or behaviour, even though it is normal. But if it led to taking up someone’s time, it should not repeat itself.
      So they do not care if a suicide happens, it is just not supposed to happen on their time or turf.
      So scaring and belittling, making the person know that the suicidal thought was absolutely abnormal and bad, simply leads to not ever wanting to tell someone. Which is of course when suicides are most likely to happen. And to top it off, the liability drugs can cause suicide, the very thing that they say they want to prevent.
      Why do they want to prevent suicide or the thoughts? Is it an illegal act? Do they like these people personally? Is life ‘sacred’?
      Every single person would know that there is a reason behind the feelings of helplessness or despair. And ANY normal being would understand that if things are perceived as bad enough to opt for desperation, it probably comes from a place of needing something and that something is not at all what has been created.

      And psychiatry knows this. They have more and more desperate people, so obviously what they are doing is not working and with evidence, contributing to desperation. So why would psychiatry continue to do what does not work but harms? Is it not obvious then that in fact it is not that life they care about?

      Only greedy, stupid and egotistical people keep being part of a biz that is harmful.
      If they cared, they would be horrified and want to turn it into real help. But long involvement with ‘needy’ folks is not a moneymaker.

  8. Hello Dr. Caplan,
    Your essays are full of tenderness towards suffering that is the alpha & omega in an ideal response. It feels like the proverbial ‘safe place’ where honesty will NOT produce the recoil, fear, & smothering of a reaction to calamity and exhaustion that the culture supports as ‘best practices’.

    I considered suicide once. It was a logical option to the last, worst assault by psychiatry. I wasn’t alarmed when I added it to my ‘options’ list….it had a calming effect. If I didn’t make it out…..MY choice. I knew institutionalization awaited; a diaper, wheelchair, & staring out a barred window…and waiting for the drugs to finish what they had started.
    You’re the only person I would ever admit that to…knowing what it signals to the industry.

    As I am still a big fan of irony, the thing that was supposed to help me ‘fix’ my financial stress & resultant insomnia with a damning label and drugs, led me in the most direct way to the brink…but not before they sucked every dollar from my private insurance, then Medicaid & Medicare-state & federal….& on to the next carcass.

    Sometimes a parasite fails at keeping the ‘host’ viable.
    Well done, APA.

    Paula, you are a rare and valued treasure. Thanks.

  9. Thank you Dr. Caplan for your profoundly wise and important blogs. As I read the comments of others so much resonates with me. It’s appalling to realize psychiatry operates in such a standard mode of dehumanization and discrimination.

    As always God bless you for your wonderful wisdom, integrity, humanity and compassion that is so sorely lacking in the psychiatric industry.

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