Insane Medicine, Chapter One: The Medical Model of Mental Health Is Finished

Sami Timimi, MD
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Editor’s Note: Over the next several months, Mad in America will publish a serialized version of Sami Timimi’s book, Insane Medicine. In this chapter, he provides an overview of how the medical model of mental health has failed. Each Monday, a new section of the book will be published, and all chapters will be archived here. 

Have a go at the questions below. Just see what think based on what you’ve heard through whatever sources or media you follow:

  1. Overall, which one of the following factors has the biggest impact on outcomes from treatment of common mental health problems?
    • The quality of the relationship between therapist and patient
    • Factors outside of therapy such as the person’s social circumstances
    • Having a diagnosis-specific treatment, whether medication or psychotherapy
    • The number of sessions of treatment attended
  2. Which of the following factors (among treatment-specific factors) has the biggest impact on outcomes?
    • Having a diagnosis-specific treatment, whether medication or psychotherapy
    • Professional training of the practitioner/therapist
    • Years of experience of the practitioner/therapist
    • The quality of the relationship between practitioner/therapist and patient
  1. According to research, the following percent of people entering community mental health centres in the USA are either not responding to treatment or deteriorating whilst in care:
    • 20-30%
    • 30-40%
    • 60-70%
    • 70-80%
  1. Public education programmes that promote an understanding that mental illnesses are like physical illnesses has helped decrease stigma:
    • True
    • False
  1. In Western populations, the relationship between use of mental health treatments and claims for disability benefits as a result of a mental health condition is that:
    • Greater use of mental health treatments is associated with falling rates of disability claims
    • Greater use of mental health treatments is associated with rising rates of disability claims
    • There is no consistent correlation between the two
  1. In trials comparing the effectiveness of different therapies, cognitive behavioural therapy (the most widely promoted and recommended form of psychotherapy) has overall been found to be superior to other psychotherapies for treating depression:
    • True
    • False
  1. Psychiatric diagnoses are biological disorders that have been established through proper medical scientific research:
    • True
    • False
  • Autism is not an established medical condition caused by abnormalities in the development of the brain and nervous system:
    • True
    • False
  1. There are no reliable tests you can take to find out whether you have Attention Deficit Hyperactivity Disorder (ADHD) or not:
    • True
    • False
  1. There is a reliable way of distinguishing between clinical depression and ordinary sadness:
    • True
    • False
  1. According to research, published in 2015, of a UK national project to improve outcomes from treatment for those attending community Child and Adolescent Mental Health Services, the percentage who showed “clinical improvement” from treatment was:
    • 16-43%
    • 26-53%
    • 6-36%
    • 36-63%
  1. According to a 2018 study that re-assessed patients who had completed treatment in one of the national UK NHS outpatient psychotherapy services, the percentage assessed as “recovered” was:
    • 33%
    • 9%
    • 6%
    • 53%
  1. In a 2019 survey of 1000 young people in the UK, the following percentage believed they currently or previously had a mental disorder:
    • 38%
    • 68%
    • 58%
    • 48%
  1. According to a 2019 research paper comparing outcomes from treatment of common childhood psychiatric disorders in studies from January 1960 up to May 2017, the outcomes over the nearly six decades of studies have:
    • Outcomes in studies in the 1960s were the same in terms of rates of improvement all the way through to 2017
    • More patients got better in the later rather than earlier studies
    • Fewer patients got better in the later rather than earlier studies
    • A mixed picture with no obvious patterns over time
  1. In terms of rates of recovery and levels of functioning, according to the World Health Organisation International Pilot Study of Schizophrenia, the best outcomes were in:
    • The USA
    • India
    • Denmark
    • France
  1. Clinical depression is caused by a low level of the chemical “serotonin” which antidepressants can correct:
    • True
    • False
  1. The relationship between drugs marketed as “antipsychotics” and size of the brain is:
    • A shrinkage of brain tissue is associated with taking a higher dose of antipsychotics for longer
    • Increase in brain tissue is associated with taking a higher dose of antipsychotics for longer
    • Reversal of brain tissue loss seen in a psychotic illness is associated with taking a higher dose of antipsychotics for longer
    • There is no is association between brain tissue size and taking a higher dose of antipsychotics for longer
  1. Those categorised as having a long term Severe Mental Illness, on average, live:
    • 5-10 years shorter than the population average
    • 10-15 years shorter than the population average
    • 15-25 years shorter than the population average
    • 5-10 years longer than the population average
    • The same as the population average
  1. Psychiatric science has not helped advance our scientific understanding of mental distress and has failed to discover any brain-based abnormalities:
    • True
    • False
  1. Clinical psychiatry has helped improve outcomes from treatment of mental distress:
    • True
    • False

Read on to start finding the answers to the above questions.

The medical model of mental health is finished

Mainstream mental health services are a disaster. The problem isn’t underfunding or the scale of the mental health challenge in society. It isn’t social media, stigma, lack of education, lack of training, lack of doctors, or lack of therapists.

The problem that must be tackled before there is any real chance of improving mental health provision is the dominant ideology. It’s the concepts of mental health, mental wellness, mental illness, and mental disorder that pervade our public debates. It’s the way we have come to talk about and think about mental health. It’s the narratives that the public are exposed to, day in day out, popularising a jaundiced, scientifically illiterate idea that we know what sort of a “thing” mental disorder is, that it is widespread, and needs diagnosing, so that effective treatments can be provided. It’s the endless expansion and commercialisation of so-called psychiatric diagnoses, so that they operate as lucrative brands rather than legitimate categories that help build knowledge and improve clinical practice. It’s the ideology that guides the frameworks that organise mental health services and the professional trainings those who work in them receive.

Tinkering with these dominant ideologies and the systems spawned from them will not help. To clear up this abominable mess we must first rid our trainings, services, and culture of the pseudo-science that has delivered the diabolical outcomes we have where services are better at creating long term patients, being slowly poisoned with neurotoxins erroneously labelled “medication,” than at alleviating understandable distress.

It’s even worse than this. Our dominant ideologies are dripped daily into our consciousness, turning us into potential patients, alienating us from ordinary and understandable emotions, convincing us we have mental disorders that need experts, and terrifying us that our experiences (or the experiences of those whom we love) are markers of a deep dark problem lurking in our broken, dysfunctional minds.

How else do you explain a recent survey of one thousand young people that found that 68% believed they had or did have at some point a mental disorder? Forget the fake 1 in 4 widely advertised, this is approaching the point where only 1 in 4 won’t have experienced a mental disorder by the time they’re a young adult. We have created with our astrological, stargazing mental health ideologies a vast sea of people who believe they are broken, who see their emotional intensity as dangerous and as a foreign body needing to be excised, rather than a human experience needing more ordinary understandings.

Mental health services have become the mouthpieces of an industry of decontextualising and individualising hurt, fear, sadness, and anger, turning so many into the embodiment of caricatures we label them with. The mental health industry creates and solidifies the mental disorders it claims to alleviate. It’s horribly sick. It misses people’s natural resilience in the face of all kinds of adversity (believing resilience is something you can teach rather than innate and waiting to be discovered) and instead carves open chasms of vulnerability alongside patronising paternalism and sympathy.

The therapies we use (perhaps with the exception of some aspects of psychoanalytic and systemic theory) are just systematised versions of Western “folk psychology”; variants with a few rules and turns of language to create an aura of cleverness, professionalism, and science. From challenging your “dysfunctional thinking” to facing your fears; from creating a space for unconditional positive regard to calming down your emotions (such as through “mindfulness”), from focusing on positives to identifying trauma; these are all, when put in simpler everyday terms, things we would recognise as common sense in everyday Western cultures.

By far the worst model is the idea that our mental disorders are rooted in our genes and expressed in alien takeovers of our brain by our biology. This is just a crude version of possession states that we would criticise other cultures for their stupid superstition; only in this Western enlightened version something invisible erupts out of your biology and takes over your body and mind. Our modernist voodoo theory is arguably more sinister, as at least the idea that an external spirit takes over your mind and body creates potential room for recovering an autonomous self.

But this problem will not last. The current dominant “diagnosis followed by specific treatment model” we use is finished.  Whether it takes 5, 10, or 50 years there is no rescuing these models. Challenges and alternatives are emerging from all directions and whilst there is still huge money to be made from the commercialisation of diagnostic “brands” and therefore powerful vested interests involved, the deception cannot last forever.

In the same way that neoliberal economies write their own epitaph through the contradictions created by the inequality they breed, so psychiatry and the mental health industry’s dirty secrets are being exposed and the emperors’ pseudo-scientific nonsense is becoming visible. No tests, no markers, horrible outcomes, drugs that cause early death, more people becoming disabled after accessing mental health treatments, a culture confused as to what a mental disorder is and what mental health is. Such a record cannot sustain its institutions unreconstructed forever. And it won’t.

Our ideologies’ foundations are built upon the idea that there is such a thing as a “psychiatric diagnosis.” Apart from the dementias (where there are also problematic issues, but I will not be covering them in this book), there is, technically speaking, no such thing as a psychiatric diagnosis. It exists in our daily discourse as a fact of culture, shaping how we imagine what “normal,” “ordinary,” or “understandable” functioning and experience is. It does not exist in the same way as, say, a broken leg or pneumonia exist as facts of nature.

As you read on, you’ll understand why I am stating this as fact, rather than an opinion. Such a dreadful basic mistake has had huge consequences, determining our dichotomised notions of healthy and unhealthy, normal and abnormal, expected and disordered.

There is no more argument or debate to be had. Whatever metric you use, you can see the ideology has failed. More than failed—it makes things worse. It’s time to move on and start imagining the post-medical/technical model mental health paradigm.

We have brands, not diagnoses

Psychiatric diagnoses are not diagnoses; they are brands. They work as brands that have products like any other product in our profit-driven consumer exploitative markets. They appeal to customers with the promise that if you purchase (literally and metaphorically) and identify with this or that brand, your life troubles will make sense and be improved in some way.

Like most market consumables, they are objects of fantasy and desire; must-haves with a limited shelf life. For markets to keep growing you must convince your customers they need your wares, and continue to need to need them, hopefully with regular upgrades, to stay happy. Markets then develop around psychiatric brands; some brands develop huge markets worth billions from pharmaceutical products, to services from “experts,” to particular therapies, to research institutes, to courses, to trainings, to books, other self-help materials, and more. Get your brand to cover an area of common public concern and money and custom will flow.

In this McDonaldised culture there is some immediate satisfaction, but most have the correct suspicion that using these products to satisfy is problematic in the long term.

Some psychiatric brands are more niche and harder to popularise (such as personality disorders and schizophrenia), but where the market can reach the professional classes in sufficient numbers to allow the brand to take root, then it can, to some degree, influence public discourse too. However, brands that target mood, stress, and insecurities about the self in adults have enormous potential. Similarly brands that target the behaviour and development of children also have enormous potential (unless they are associated with blame for the caregivers).

Thus, strong brands like Bipolar Disorder, Depression, Attention Deficit Hyperactivity Disorder, and Autism demonstrate their popularity by their rapid expansion in the absence of ANY scientifically tangible discovery.

It’s the social and cultural lacunae of meaning, denial of the ubiquity of human struggle, fantasy of Hollywood “you can have whatever you dream of,” in a performance-driven economy, and therefore value system, that breathes life and vigour into these otherwise failed mental health ideologies. They tap into our universal human experiences of distress and suffering, from the mundane to the catastrophic, and supercharge it with our no-less-human desire for pleasure and the absence of the suffering.

Yes, you do not need ever suffer. The world of our emotions, intentions, thoughts and beliefs are just neurotransmitters that can be changed, dysregulated emotions that can be regulated, dysfunctional thoughts that can be corrected. Behaviours are the manifestations of these internal processes and so are amenable to expert manipulation. Mental suffering and behavioural “deviance” can be cured and eliminated. The multiple meanings that can be attached to more intense and troubling human experiences can be reduced to simple categories for which there are “special” snake-oil remedies. How could that not appeal?

Whilst I have reduced to a caricature modern mental health discourse and practice, this is actually what it has been in the process of trying to morph into for the last century; a technical, scientific, system of categorisation, based on cause (i.e. diagnosis) that provides an explanation for the person’s mental suffering or aberrant behaviour and therefore a rational basis for treatment that has a specificity that remedies the particular abnormality it has discovered through application of the correct treatment for a diagnosis.

There is no doubt that many of the people who work in services and who have contributed over the years to developing the concepts, the research, and the practices it spawned, have genuine deep and heartfelt desire to improve people’s lives. But as the famous saying goes, “The road to hell is paved with good intentions.

The “key opinion leaders” whose life’s work has tried to accomplish this cannot face the reality of the monster they helped create. Their cobbled-together Frankenstein, born out of a desire to help, but that now marauds around the world sowing destruction wherever he turns up (and it is a “he”) is hard to face up to. So we don’t. It’s no longer excusable to avoid looking at what havoc this has wreaked, but worse to carry on defending such a destructive force, arguing that it should be further expanded.

When it comes to imagining what the good life looks like we only have ideology. Whilst ideologies may liberate us, they can also enslave us. In this book, I will set out how our current dominant mental health ideologies have enslaved us in the systems we work in, from the professionals who deliver the services to the patients who are at the receiving end. This is not because the people working with patients had or have ill intentions or wish to do anything other than help, but because the ideological assumptions that organise our responses to peoples’ dilemmas, struggles, and confusions, far from allowing the flourishing of human diversity, hypnotise individuals into viewing their mental life through a prism of suspicion, mistrust, and alienation.

Oblivious to the evidence

There are two main headings that illustrate my argument that our current systems have failed and failed spectacularly. The first is the lack of progress in science/knowledge and the second is the lack of progress in clinical practice outcomes. In this book I tap into the empirical evidence to show how and why we have failed, in both science and clinical practice, to demonstrate that the current systems have either a sound scientific basis or effective clinical utility.

I will show by contrasting with other areas of medicine, how a diagnostic system, which by definition is meant to be based on an explanation of the patient’s presentation, has failed in psychiatry. While there remain deep and important controversies in all of medicine to do with our glorification of the technical and the push toward medicalisation across disciplines, psychiatry and mental health have a unique case to answer.

Other branches of medicine have made progress, and continue to make progress, in understanding the physiological mechanisms that contribute to patient symptoms, and therefore there is an array of medical tests and procedures that can be performed to gain insight into how these physiological processes are potentially manifesting in any given body.  These are empirical tools that provide some sort of measurement or insight into biological happenings that are independent of the subjective opinion of the doctor.

Of course, such investigations require interpretation and for the doctor to bring their subjective reasoning into play, but the tests themselves provide a factual finding of the objective world out there. Doctors in a variety of branches of medicine can order X-rays, different types of scans, take blood tests looking for a variety of markers, look at biopsies, culture sputum, test urine for various substances, and so on.

This doesn’t mean the rest of medicine isn’t itself without profound problems. Many diagnoses used in daily medical practice are not supported by empirical evidence; there are many problems around management of chronic conditions, problems of over-treatment for certain populations and under-treatment for others, quandaries about boundaries, conflicts of interest that have led to many dubious interventions with poor evidence on long-term outcomes and overall safety, together with little training for doctors on how to withdraw medications or rationalise them.

Nonetheless, at least there is a basis in diagnosis in the rest of medicine that makes it possible to understand proximal causes, study a disease, and evaluate the specificity of particular treatments.

Psychiatric science has hoped, and spent most of its research funds on the idea, that what we are classifying as psychiatric diagnoses are the products of abnormal functioning of the brain. This has relied on predominately two types of research attempting to establish a similar causal framework as the rest of medicine by pointing to bodily processes. The first type of research is genetics and the second is various types of brain imaging studies.

Such endeavours create an image of science and help popularise the belief that what we do in psychiatric diagnostic practice has a solid basis in science. The utter and total failure of these lines of enquiry to produce anything useful for the science of psychiatry will be further discussed with examples in this book.

The tell-tale signs of this failure are the absence of concrete molecular genetic findings that can explain hereditary factors for any psychiatric condition (despite samples of tens of thousands of patients) and that we have no brain scan technology that identifies particular brain abnormalities or differences associated with any particular psychiatric condition (aside from the dementias, evidence for which may be seen with certain types of brain imaging technology).

In fact, it is the one area of medical practice where we have no physiological or other test available, independent of the practitioner’s opinion. The practice of psychiatry and mental health is therefore entirely subjective. It rests on clinical judgement and nothing else. This means that unlike the rest of medicine, not only are there debates about the boundaries of a condition, but that in addition, in psychiatry the parameters for defining a condition require subjective interpretation too.

Psychiatric phenomena cannot be measured by tapping into verifiable evidence that is independent of practitioners’ interpretation. Kidneys don’t have ambitions, dreams, doubts, and beliefs around the nature of suffering. But you cannot escape these subjective realities in attempting to delineate whether there is a psychiatric condition or not. There is no part of psychiatric practice that uses testing to provide empirical evidence on a quantity that is independent to the practitioner’s opinion.

The phenomena we use to classify symptoms in psychiatry are as subjective as the boundaries we make for them. Mood, impulsive behaviour, shyness, obsessional behaviour; can these be “medical” symptoms? Can persistent low mood be an ordinary part of the human experience? Indeed, for many cultures, personal growth and insight cannot happen without suffering. Could low mood therefore, in some contexts be seen as desirable, rather than pathological at any level of severity?

Mental health practice can only be socially constructed. The assumption that the phenomena that the practitioner encounters are the result of a brain dysfunction is as scientific as the Greek doctors who assumed that the phenomena that they faced were due to imbalances of the four bodily humours—blood, yellow bile, black bile, and phlegm.

There is a deeper problem

The outcomes, at a population level, from treatment in mental health services in Western societies are disturbing. Wherever we look, there is a distressing picture of worse outcomes appearing to be associated with more developed mental health services and/or more developed market economy systems.

I will outline, from a number of sources, how figures for those who are considered disabled due to a mental health condition have been rising. I will also look at the figures we have for what happens in real life mental health services in terms of outcomes, and some of the evidence that we have for the classes of medication that we use. Unlike other branches of medicine, where research and growing knowledge often lead to improved patient outcomes, the outcome research in mental health has not shown such improvement. In fact, some research suggests that outcomes were actually better following treatment in the past than they are today. Like the failure for any scientific breakthrough, the reliance on a medical/technical paradigm to shape mental health services has also been a profound failure.

My awareness of the scientific and clinical outcome literature, together with my experience, over many years, as a consultant child and adolescent psychiatrist, has awoken my consciousness to a deeper problem. Our language has been trapping us into a fear of, and alienation from, the richness and intensity of our emotional lives. Our way of talking about mental health as if it’s a “thing” that we know, or at least that doctors know, encourages people to believe that our emotional experiences, especially when they become intense, are signs of an abnormality, of something going wrong, of symptoms, of weakness, of some sort of dysregulation, dysfunction, and disorder.

We have come to believe that such experiences are dangerous and devoid of meaning, that they should be got rid of, expunged, ignored, distracted from, faced up to even, but particularly that they are something that needs to be “treated”; that they are beyond the ordinary. We have got so far from the ordinariness of suffering, unhappiness, and struggle that we have created a culture of fun morality where there is a problem if you are not having fun, if you are not happy in some kind of superficial Hollywood-like version of happiness.

And we think everyone else but us is. That we alone are suffering in this awful way that cannot be admitted. Even the cultural instruction to talk about your feelings has a mechanistic superficiality—talk about them, but don’t show them.

The labelling of our experiences with pseudo-diagnostic labels entrenches this fear of, and alienation from, our emotional experiences. It extracts the possibility of meaning and creates an antagonistic relationship towards aspects of the self. Our mental health education campaigns have made this worse.

Far from normalising the diversity of our emotional experiences and helping create an awareness of the variety of reactions to all the things that happen in our life being ordinary and/or understandable, even in those more extreme states, we have instead made more people suspicious that their experiences are a signal that there is something deeply wrong with them. That they need healthcare professionals to understand what is wrong and provide the right intervention. Do modern doctors make better healers than priests?

The concepts we use have undermined our natural resilience, sensitised us to an idea of our vulnerability, and encouraged us to transfer our agency to practitioners who use a system as if it has scientific validity and is clinically useful. It seems unarguable to me that we have created a whole system and language that is proficient at creating more long-term patients rather than helping people make creative sense of distress. This is a catastrophe that must be fought and reversed.

***

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.

57 COMMENTS

  1. Excellent Sami.
    This is all stuff that every dissident knows, but nice to see it in print and you must realize that survivor voices
    mean nothing to the general public and boy does psychiatry love the public.

    I guess every psychiatrist better sharpen his wits to see where an “alternative” practice might benefit their income.
    So I do hope that The CP network keeps chipping away at the old block. If they do, if they become more vocal, more action based, perhaps they can save a respectable shard of the biz.
    But I would highly suggest to call it anything other than psych once you are done. And WHO gets to rejoin the new and improved psychiatry?
    All those who had to be forced and only changed to keep their “honor”? Changed due to fashionable beliefs for the sake of keeping a job?

    Because as you know, beliefs don’t change just because the rules did.

  2. The Medical Model of Mental Health Is Finished

    How can anyone fail to see the blatant contradiction inherent in this title itself???

    If you speak of “mental health” you are USING the medical model. Not to mention profiting off psychiatry in the guise of being “critical” of it.

    The psychiatric system cannot be reformed and must be abolished. (Point #26 in principles approved at the International Conference on Human Rights & Psychiatric Oppression, Toronto 1982.)

    • Ohh OH, I think psychiatry is on it’s way to being rebuilt. The reinventing and rethinking has been ongoing. It was ALWAYS based on “mental health”. But I’m sure the new psychiatry will be a HUGE improvement.
      I can see it now. No more talk about just MY MH. No more power inequality. No more penciling down my many problems for the world to see and judge me by.
      Perhaps Sami thinks that writing down that I have a learning disability will get me better treatment than say “ADHD”.
      Or perhaps saying that I suffer from life’s problems will get the MD to treat me with more respect than if it says I have “bi-poLar”.

      I hope Sami discusses how sharing private talks in an office should not only NOT lead to crap “diagnosis”, but how talking to someone about personal issues is between 2 people.

      I’m not sure that people really understand that it is a breach of privacy to discuss you in any way shape or form, when you have no knowledge of who or what is being discussed ESPECIALLY if that breach of privacy affects every area in your life.

      If that VERY important detail does not come up, I’m outta here.

    • “Medical Model of Mental Health”….

      I get your point. No one referred to mental health till Dr’s came along and offered to take in the Mad – for a nice wallop of money. Now nearly everyone talks of mental health when they mean state of mind.

      The colonisation continues.

  3. The “psycho-medical” model you describe is on its last legs, but studying the biological conditions that lead to “psychiatric diagnoses” is likely just beginning. This means that your future “psychiatrist” will need to have a extensive knowledge of psychiatric trivia to be able to grasp a proper diagnosis and treatment for his patients’ mental state (no more immediately treating fat people extremely sensitive to cold with SSRI’s- or any other antidepressant, for that matter).

  4. We “have created a whole system and language that is proficient at creating long-term patients rather than helping people make creative sense of distress.”

    Indeed, it is a “catastrophe that must be fought and reversed.” Yes, psychiatry’s on-going modern day Holocaust needs to end.

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

    The scientific fraud based “mental health” workers are killing 8 million innocent people every year.

    And the vast majority of their clients are misdiagnosed child abuse survivors, not “dangerous” people, as the psychiatric propaganda claims.

    https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo

    https://www.madinamerica.com/2016/04/heal-for-life/

    And all this misdiagnosis of child abuse survivors is by DSM design.

    https://www.google.com/amp/s/www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1%3famp

    Our society would be a much better place if we got rid of the scientific fraud based, systemic child abuse covering up “mental health” industries, and started to arrest the child molesters and traffickers instead.

    No doubt, this multi billion dollar, primarily child abuse and rape covering up, “mental health” system was the brain child of sick men. But many of the women who work within the system are traitors to humanity as well.

    Thank you, Sami, for speaking out against psychiatry’s and psychology’s evil and scientific fraud based system.

  5. “We have a duty as psychiatrists not to brush over these inconvenient episodes, but to face them, understand them, and learn from them, so we never repeat those horrors.”

    This from your last article.

    Now my question relates to where in the above you mention the brutality of forced treatment. It seems you talk about ‘products’ and ‘market forces’, but where among that is the boot to the back of your head if you refuse to eat the Big Mac instead of the Whopper? Why have you ‘brushed over’ this rather inconvenient truth about the use of terrorist tactics to enforce this ideology on the community when the grooming of ‘product placements’ fails?

    Of course I don’t expect an answer, your writing your own history here. Sure people have for the most part stopped smoking these days as a result of the facts being known, and I hope the same can be said of these drugs that are doing significant damage some day too. Marlboro Man replaced by Prozac Pete as a symbol of the money made by charlatans and frauds at the expense of the health of others. Though I never saw people being gang tackled and forced to light up because they wished to maintain their health when others could profit from their addictions. No lawsuits for my passive Prozac use as a result of being around others using the ‘products’. (though perhaps the fact I can be ‘spiked’ with benzodiazepines without my knowledge before State sanctioned interrogations a means to have me consume the drugs? Especially when the State is allowing doctors to prescribe these drugs 12 hours after they were administered without knowledge to ‘patient’s they haven’t even met? Why not start forcing people into drinking alcohol too by putting into their ‘consumables’ without their knowledge?).

    Our Prime Minister describing the concealing of items in peoples food as being disgraceful and toughening up on the criminal offence, and yet then on the other hand allowing doctors the right authorise [post hoc I might add] the ‘spiking’ of citizens with date rape drugs to allow them to be subjected to acts of torture on the other? “Editing” the documents to slander the victims as being paranoid delusional having the precise effect you mention of doing psychological harm to the victims of these mental health professionals who are after all not being held to account for their criminal conduct.

    We have got to the stage in my country where citizens can be snatched from their beds by police after being ‘spiked’ and made into mental patients before anyone even leaves the hospital. My documents show my status changed from citizen to “outpatient” as a result of a telephone call, police summoned to assist in detaining a ‘mental patient’ with a knife (hence the need to drop me with the ‘spiking’ because it is difficult to plant items on someone who is conscious) and the appropriate fraud on the sworn statements manufactured to ensure anyone who looked falsely believed there were “reasonable grounds” for detention and forced drugging. So i’m with you in some sense, I can’t see the public putting up with this sort of conduct for too long. The National Socialists in Germany didn’t last too long, and they were a little better at it than the government we have, so I hope for some rapid changes once their arbitrary detentions, torture and ‘unintentional negative outcoming’ of whistleblowers is exposed. They will of course double down at first by increasing significantly the numbers of police with false claims of a need, with the intention of what use they will be put to concealed from the public. The ‘added protections’ method of putting more boots on more necks.

    Seems the duty you spoke of in part 1 got lost somewhere in translation Doc.

  6. “Wherever we look, there is a distressing picture of worse outcomes appearing to be associated with more developed mental health services and/or more developed market economy systems.”

    Yes Sami. And would you like to know why? The “market” is within one word. “Mental health”.
    There is the whole can of worms, the flip side of same coin is “mental illness”. It does generate
    business though. Because if we regularly hear about “mental health” and are told what THAT looks like,
    then that would be why all those teenagers in the data identified as having had or having a “mental issue”.
    Not a human issue, A “mental problem”.
    As you can see, there will still be LOTS of business under that marketing.

    So I ask why you as a CP use that word?

  7. Anyone who can sit down and calmly answer these questions with a straight face has already been indoctrinated into the idea of seeing human conditions as medical/scientific ones — a more deadly result of the psychiatric system than the “mere” effects of neurotoxins.

    On the other hand robots are easier to maintain than humans.

  8. Thank You Dr Timimi,

    I’ll need to read this article carefully.

    Macdonaldisation:- about 2 million people are in jail in America, 1% percent of people in America are estimated ‘Schizophrenic’ , 1% estimated Autistic, up to 10% with ADHD, several per cent estimated Bipolar, and several per cent Depressed and Anxious. So theres lots of ‘unreliable’ people in the Country.

  9. The only things that are really of interest to us are:

    1 Stopping forced prolonged drugging of neurotoxins causing terror, horrendous harm and fear as a matter of urgency.

    2 Exposing psychiatric ‘hospitals’ for what they really are: closed cultures of abuse that cause horrific harm – when a human is forced to take drugs everyday that cause akathisia and other horrendous iatrogenic harms, being locked up, verbally and physically abused. These are crimes against humanity.

    3 Abolition and outlawing of psychiatry for past and present major crimes against humanity.

    Right now the general public are seeing what psychiatry is all about – they just don’t know it, but they are getting alarmed alright – being locked up in their own homes with the prospect of forced vaccination treatment, for the ones who don’t run to their goverments begging for it.

    • Interesting that our government is trying to remove any judicial oversight of their actions. Not surprising given the laws they are passing knowing they are human rights violations and not wanting to be held to account for the deaths and destruction somewhere down the track when they are ‘holidaying’ on their new yachts on the Mediterranean.

      Heaven forbid that their cover ups are exposed and the joint enterprise be seen for what it is. If nothing else I at least hope we learned enough from the Royal Commission into Child Abuse to recognise the need for keeping good records about our experiences, in spite of the “editing” of realities to conceal their human rights abuses, and the claims of “insufficient evidence” when they refuse to examine the proof of these crimes.

      What kind of fools do they take us for? Is there more than one kind?

      I guess they have resolved the issue of what to do when someone expresses a wish to commit suicide, pass an “assisted dying” law. Why fight the flow of the water, as Sun Tzu says. It will always settle at the lowest point, so use that power. And if they want drugs? Give them drugs, and plenty of them.

      • It’s interesting isn’t it we’re being told that front line workers will be the first to be vaccinated which means doctors and nurses and other health care workers. I wonder where psychiatrists will be on that list of priority.

        Reading Dr’s Karina Reiss and Sucharit Bhakdi’s book: Corona False Alarm? Facts and Figures, page 111 at the end of Gene-based vaccines, you will read two words: ‘utterly terrifying’. This is from two level headed, softly spoken professionals totally qualified to speak with authority on all this.

        Then you have to wonder how much these health care workers can hold out, thinking of their income, roof over their head and the truth to the public that they are withholding. Some like nurse Kevin Corbett and former GP Vernon Coleman let loose early on becoming activists.

  10. “turning so many into the embodiment of caricatures we label them with.”

    Perceived as “caricature?” This would explain why people feel dehumanized, dispirited, and chronically wounded in this industry. That would cut very deeply in anyone at all.

    • At least in religion one could atone for the bad character flaws. Or just plain be forgiven. I just don’t see the point of psychiatry talking badly about people’s bad experiences? So a person goes to see them for their sadness, chaos, or being down about the chaos, and psychiatry labels them as having character faults.
      Then, they try to tell the public NOT to have “stigma”. Why does psychiatry accuse people of the very things they are guilty of?
      What kind of disorder is that? Of course it should be abolished. I would like to know what area of psychiatry would be tidied up and made people friendly? How and what do CP’s want to change?
      The marks of shame? The “treatments”? The hoax itself? The fact that people have to beg for civil liberties and still don’t get them? Because psychiatry presents them as not being civil? Whose fault is that? Ohh it must be the courts, not the fact people are presented to the courts as wicked and sick? How can something be “saved” that got to this point?
      Psychiatry is insanity. Why a CP would think insanity can be “made” sane is beyond me. So do the practitioners all get drugs for their “insanity” and resulting “insane” behaviours? Obviously those drugs help behaviours, so perhaps the ticket is not changing “psychiatry”, but it’s practitioners. And I have therapy for that.
      I see Sami calls it “insane medicine”. Not insane psychiatry. So it is the “medicine’s” fault. Not the pencil or the dogma coming from the mind of the psychiatrist. It could NEVER EVER be the practitioners.

      • Is not “the psychiatry”. Is the psychiatrists. They initially may be fooled like everybody else that is some branch of medicine that heals the patients but at some later point, either in medical school or at the beginning of career, they realize is a hoax that traumatizes the ones it should help. But out of greed, they accept this moral compromise and most continue with it all their professional life.

        Also, this moral corruption is supported by doctors from other branches as well, some of whom too will realize that something is wrong with psychiatry but will keep silence, as being vocal about the scam would harm their careers too.

        • It is not necessarily out of “financial greed”. There are many institutes in my country where psychiatrists make little money compared to what they could have if they went into private practice.

          But stature is definitely a thing. Stature doesn’t have to be financial. It could be respectability as well. That’s something that’s important for any human being in life. But in the context of psychiatry, it’s different because of what they aim to do but actually end up doing in practice.

          Unfortunately that stature also means an unwillingness to come down to the level of the people you want to help and provide help as a person compared to as a professional.

          Again, even “coming down to the level of people” carries risks that few are brave enough to take. Your own profession could ostracise you. Families of patients could ostracise you. You could be blamed for being “unprofessional”, ruin your career, or worse end up serving time in jail.

          It really is a very difficult issue.

          But most important of all is honesty. A lot of psychiatrists refuse to admit these facts. They simply brush aside the harmful consequences of anything they do (even if unintentional), by saying that they are random criticisms of unsatisfied customers, or that people are blaming them purely out of bitterness due to their infirmity.

          Even worse, some basically talk down to you like you’re a moron for criticising them, and cite X or Y study or fMRI this and MRI that, a lot of which is pointless to the end user.

          Trust between two people comes if you are honest. Admit the bad things about psychiatry. Admit that lives have been ruined due to behavioural labelling and drugs. Admit that gaslighting takes place. Admit, that sometimes, people (not necessarily psychiatrists, but families) use psychiatry to keep people under control or to ruin their reputation. Admit the trap like nature of psychiatry which creates revolving door patients (as the gentleman who has written this article has admitted). Admit that you are not helping people as people but as professionals and that that’s not a good thing to do sometimes.

          Don’t hide them. Don’t lie about them. Tell the truth.

          Though I do wish psychiatry eventually goes defunct. People have more access to information than ever before. I wish not only psychiatry, but a lot of diagnostics can be done by ordinary people for themselves, by themselves and they could prescribe themselves drugs. Surgery is different (but even there we could make advances).

          It would truly be a great day when terms like “don’t self-diagnose”, “you’re not a medical doctor”, “don’t give medical advice if you aren’t a licensed professional” become a thing of the past.

          It is tragic that something as fundamental to us as our own body, our own vessel of existence, and also our reputation and sanity is beholden to the mercy and charity of random individuals.

          It’s a pipe dream now, but one has to work to make it a reality.

        • Psychiatry is a eugenics movement – it never went away after WWII and it’s doing very well. If you think of it from that perspective – that they don’t see it as gone wrong, they see it as stopping the defective genes being spread to the rest of society and feel totally justified in the abuse. The decent doctors who take a peek into this world get out real quick. The acceptable facade of critical psychiatry – it’s front if you like is now showing itself to try to save itself from being upended by an impending technocracy app to diagnose and put them out of business, but psychiatry will never stop being eugenicist – it has to be outlawed for major crimes. Our job is to tell the truth to the world of our horrific experience by these monsters. We are the modern day holocaust survivors.

          • I can’t help but wonder if the attempt by our current government to provide our elected representatives from immunity from prosecution is as a direct result of being made aware of the crimes being committed under the guise of psychiatry.

            Consider the effect of being forced into reporting to the ‘watchdog’ authority, and receiving a report back about the levels of criminal misconduct in the ‘industry’? A failure to act on such information would, under our laws, mean that they would now be complicit in the offences by compounding or concealing them, and failing to perform their duty. Hence the need for an Attorney General to make complaints regarding acts of torture a question of the sanity of the victim, rather than a question of law.

            This may mean that they need to conceal any criminality they are aware of until they can ensure there is no judicial oversight of their role, and that the failure to act on crimes which have been concealed as ‘medicine’ using the Mental Health Act can continue to be concealed from the public. This would allow police to continue to deny access to the courts for crimes by passing criminal matters over to the civil arena and ensure that no action over these matters is ever allowed to see the light of day in the courts. They continue to discriminate (against the ‘disabled’ which is what psychiatry actually does, disable citizens) using the fact they don’t have a copy of the criminal code in the police station, thus making what they know to be crimes to be passed over to the civil lawyers, and then threaten them into inaction and the “editing” of documented crimes. Thus these human rights abuses could then be used to conceal human rights abuses, which is effectively what is being done here.

            Something the National Socialists thought would work too. By placing the Office of Jewish Affairs under the secrecy of the Gestapo, any actions they then took became lawful only because of the fact that they could conceal any criminality from the public? They effectively become unaccountable.

            Similarly any acts of State sanctioned torture (etc) is to be reported to our ‘watchdog’, but could be concealed by that body after they made report to our Parliament. The ball is then in their court as to whether they maintain the silence over the matters (which could be considered criminal, hence the need for immunity ie place themselves outside the law) or hold these people who they rely on to maintain power to account for their crimes.

            No more unintended negative outcomes that require civil non action if they are required to act on the ‘accidents’ that are being enabled in our Emergency Depts. Hence the current need to “edit” documents showing criminal acts requested under FOI. Who is authorising these “editing’s”? (if your with me, check the fact that the only person who could actually do this without being held to account is the Minister due to them not being held to scrutiny under the Ombudsman Act. The Operations Manager is a criminal, but if the Minister checks her ‘work’ and is prepared to sign off on it, then they are good to go unless it ends up in the Federal arena, ie Family Court etc)

            This would of course require an ‘agreement’ on both sides of the House so that they could never be held to account under law. Lest one side use the MHA for purposes of, for example, the forced sterilization of children without parental consent, and when the other side take the reigns they bring these crimes to the attention of the public.

            Thus they need both immunity AND an agreement from the opposition to maintain silence.

        • Andrei, yes I totally agree psychiatrists who realize something is very wrong but stay silent do so because their only concern is protecting themselves and their career.
          The oath of “Do No Harm” they took when they became doctors doesn’t mean a thing to them.

          • As a psychiatrist for the last 45 years—one who has considered himself a subversive agent when he was employed within the system—I can testify that most psychiatrists are so caught up in the trance that they actually believe it. To survive medical school, internship and residency you almost have to become a fact memorizing, authority-trusting, algorithm-following robot. You are then, unless you are incredibly willful, and surrounded by supportive others, you are hired by a huge corporation to be essentially an assembly line worker; moving product through the system. Long hours, perpetually on call; any time for reflection is stolen time. Neoliberalism and the DSM project hit just as I finished my training in the mid-seventies. It’s been going to Hell ever since.

  11. I love Timimi’s work. This is the clearest expression I have read by anyone working in the psychiatric industry that it is all dangerous bunkum. It is refreshing to see it clearly laid out.

    A survivor of psychiatry might write something similar but with justified anger and venom.

    I have been reading interviews with Raul Vaneigem, an anarchist who was central to the Situationists (an anarchist movement whose hay day was the 1960’s) and whose book The Revolution of Everyday Life was essential reading for those involved in the uprising in Paris in 1968. Timimi’s text reminds me of many of the concepts central to situationist ideas that Vaneigem talks and writes about, for example he said this on an interview; “I just do what I can to see that resistance to market exploitation is transformed into an offensive of life, and that an art of living sweeps away the ruins of oppression.”

    That modern society is so sick that it takes our desires for happiness and our refusal to face the misery of everyday life that late capitalism provides and then sells that desire back to us as fake and poisonous medicine, then locks some of up and forces these poisons us is a sick culmination of what Vaneigem and the situationists called “The Specticle”, ie the all enveloping miasma that is late capitalism.

    Perhaps to end psychiatry capitalism needs also to end?

  12. Yes, the Medical Model in Mental Health is finished; because it defines each person by their “symptoms” and their “illnesses.” But, in my opinion, the Medical Model in all Forms of Health Care or Medicine should be finished; as it does the same thing. In the Medical Model, we are all sick, either physically or emotionally. They are are scared of the morally or spiritually “components” of each individual. Yes, traditional Christian Religion speaks of each person as having sinned whether they know it or not or acknowledge it or not. However, even traditional Christianity has a way towards grace and forgiveness. The Medical Model in its errant simplicity just keeps pounding away at you and shaming you for whatever “sins” they see. Their “sins” are known as symptoms of an illness. Thus, they continue to cause a situation where it is nearly impossible for an individual to achieve well-being again. Thank you.

  13. Thank you MIA, and thank you Sami Timimi, for saying so clearly and boldly the things I, as a human being trying to be useful to others after being credentialed as a psychiatrist, have been foaming at the mouth about for the last 40 years. I look forward to reading your forthcoming chapters.
    This looks like it just might be the book I have been wishing I had the disciplined scholarship and artistic flair to write. Now someone is doing it. I can’t say that anything about this fraught territory makes me happy, but I’m grateful for the help in spreading the word and focusing my rage.

  14. Yes Gene,
    I became conscious of a psychiatrist’s work after having met a few.
    I could see the prison they themselves created for themselves, going
    into it while they were young. I think the more defiant ones left long before
    the indoctrination. I have always felt a hint of sadness for them because most
    are no longer able to see reality, and really, are doing a lowly state job, nothing
    fancy, no life saving surgery.
    I do think that most realize at some point in their lives and are happy when it’s over.
    They can’t understand until it hits them one day. Cults are like this.

    The few that get it, try to survive in an insane system, when they should really all
    be working towards eradicating the system.
    I do not for a second believe it is fixable. That is simply wishful thinking, and really a way to
    hold onto some part of it EVEN if no good parts can be found that are not demeaning
    or dehumanizing to the clients who earn their bread and butter.

  15. There seems to be a growing literary field of works by psychiatrists explaining how they have been misleading people all their lives…until now. The odd thing is that these are rarely presented as “true confessions,” but rather as “critical psychiatry.”

    Good work if you can get it.

  16. Can psychiatry be defeated? How? And how long would it take? No predominant power gives up power willingly. I support those who move to defeat psyhciatry. Another front is to create something new. Actually it is very old. Before psychiatry people suffered. If the suffering was in the form of madness, at least as seen by the prevailing culture at the time; people suffered the prevailing beliefs of those times. Madness created fears and fears led to protecting society. We have learned in these last hundred years about intergenerational transmision of trauma and the ravages unrepaired, unacknowledged and unresolved trauma causes to our psyches and souls and physiology. We have also learned that healing from trauma (resulting in madness) comes through healing conections with others who have experienced there own traumas. We know being in a safe place with compassionate others who appreciate our situation engage with us in an empathic way over time helps.The basics help. Perhaps a dream but psychiatry would crumble over time if it is deprived of it’s victims. Once you’re in the system you are a potential victim of coercion. If we establish places in our communities where young adults in crisis can go and BE WITH others who understand, help is present. Once we are “free” from the medicalization of emotional distress we are free to be with others and use the basics. It is just being human to be with and care for another when in distress.

    • Can psychiatry be defeated? How? And how long would it take? No predominant power gives up power willingly.

      A lot of what you say sounds good on paper Kenneth, and these are all good questions worth pursuing in more depth than MIA sound bites will allow. But yes, psychiatry can be defeated.

      I support those who move to defeat psychiatry. Another front is to create something new…Perhaps a dream but psychiatry would crumble over time if it is deprived of it’s victims.

      Many of these are not merely unwitting victims of psychiatric fraud, but are only involved in the psych system in the first place because they have been physically coerced. Eliminating forced intervention would deprive psychiatry of the critical mass of its subjects, and the fear of “going crazy” (and being subjected to such force) is the motivating factor in many seeking “voluntary treatment.” Without being able to coerce its subjects psychiatry would be in dire straits.

      As for “another front” — there are several problems with the assumption that psychiatry will disappear once there is “something better,” if by that one means an “alternative” technique or school of thought designed to accommodate people to toxic social systems (which is psychiatry’s actual purpose). For sure, people need to shed the alienating lifestyles and economic relationships to which they have been conditioned, but calling this an “alternative to psychiatry” gives psychiatry undeserved status as the standard against which all else is measured. And once again, people in distress are seen in your piece as in need of “places to go,” rather than the goal being for all of us to recognize and accept the experience of our fellow humans freaking out as an inevitable consequence of capitalism, and learning to support one another pending the achievement of an “alternative” social/political structure based on the fulfillment of human needs.

      Still, defeating psychiatry is not dependent on creating mutually supportive social structures, though they are related. Psychiatry is not a flawed branch of medicine, and should not be approached as such; its social function is not “help” or “healing” but control. It is literally a parallel police force and must be dealt with as such before a coherent strategy to defeat it can be devised.

      “Helping people” is nice too and is an admirable motivation. But this is a separate topic, and has nothing to do with psychiatry.

  17. It would be so great to make psychiatry and psychiatrists illegal; just as it would be great to make all these “psycho-drugs” that have harmed so many of us illegal. But, we tried that with prohibition over a hundred years ago and it failed, because, if we did, there would be little “psychiatric and psycho-drug parties and bars” hiding in people’s basements and attics. Those that desired this “stuff” would find a way to get it. There might even be those willing to re-create this horrible “mental hospitals” and “ECT” in their basements and attics. Since, this is Halloween Eve, it does sound pretty ghoulish.
    The main thing we all need to remember and many in these types of businesses would like us to forget. And, since, we’re looking at about seventy years since, this was signed after the Nazi Holocaust Horrors is the Nuremberg Code. According to the Nuremberg Code, no governmental or other entity can force “medical treatment” on a person without their informed and knowledgeable consent. But, of course, so many so conveniently forget this; “Ah, it’s for your own good” or even worse, “Ah, it’s for the greater good or the good of others or all.” When you hear those words, walk away very quickly, because if it’s not good even for you as an individual person; it’s good for no one. Thank you.

  18. According to a staffer in the office of my federal representative in Washington, DC, there is NO law that requires the American Psychiatric Association to use treatment that restores patients’ mental health. She also said the US government will NEVER try to tell the APA how to treat their patients and, she added, “The leaders of the APA are free to choose whatever approach they like.”

    In fact, to ensure they stay in power over America’s entire mental healthcare system, the APA partners with drug companies to have their lobbyists sit in Congress, making sure no legislation is ever introduced that might change any law in mental healthcare. They like the way the system is already set up.

    The APA has chosen the approach that brings them the most power and profits – but cures no one – and that’s just how they like it. They have been fighting a restorative approach in mental healthcare, namely, the orthomolecular approach, since about the 1940s.

    And that’s the main type of care I used to restore my family member’s “incurable bipolar with psychosis,” although I also had him treated with other natural therapies, too, including NAET, which I believe is probably key to my family’s mental wellnessl. At one point, after giving my family member the right homeopathic remedy, his psychosis disappeared in about 10 minutes. Homeopathy did not cure another family member who currently has “schizophrenia.” Hopefully, she will be cured with orthomolecular combined with NAET for the B Vitamins.

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