Psycho-Bizarreness Theory: A Rational, Anti-Psychiatric Theory of Madness

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A major theoretical crisis exists over the origins of bizarre behaviors, those senseless, life-damaging behaviors exhibited by patients often considered “mad,” “mentally disturbed,” or “crazy.” The crisis revolves particularly around the “brain-disease hypothesis,” which attributes schizophrenia and other types of bizarre behaviors to neurological impairments.

Despite over a century of research, scientists have failed to find a specific brain abnormality associated exclusively with this disorder. Furthermore, the majority of those diagnosed with schizophrenia show no neuropathological abnormalities at all, while the same abnormalities found in some schizophrenic patients can also be found in people who do not suffer from the disorder.

Additionally, neurologists have failed to explain the large heterogeneity of schizophrenic symptoms—how the same disease can cause such extreme differences in symptomatology, ranging from paranoid delusions and murderous insanity (e.g., the Unabomber), to nonviolent, hallucinatory madness (e.g., John Nash), to disorganized speech. Another problem concerns the fact that a significant percentage of schizophrenic patients recover with the sole aid of psychotherapy, “something never accomplished by a person with Parkinson’s, Alzheimer’s, or multiple sclerosis.”

Meanwhile, antipsychotic drugs, widely prescribed and often considered a boon of modern medicine, achieve low rates of recovery and come with an array of disastrous outcomes, such as an increased risk of metabolic dysfunction, motor dysfunction, cardiovascular disease, cognitive dysfunction, smaller brain tissue volume, and mortality.

Historically, the brain-disease hypothesis gained scientific attention for no better reason than the inability of Freud’s psychoanalysis to explain correlations between schizophrenia and neurological abnormalities. Starting in the ’80s, psychiatrists expanded the brain-disease hypothesis to cover neurotic disorders as well, once considered the sole territory of psychoanalysis.

The incursion came thanks not to any new supportive data, but once again as a result of psychoanalysis’ empirical deterioration, which, as noted by Harrington, was utilized “to overthrow the Freudian and bring back the brain as the primary object of psychiatric research, diagnosis, and treatment.”

However, not only is the relationship between neurosis and brain impairments much weaker than in schizophrenia, medical theories are confronted with more difficult theoretical problems. As with schizophrenia, these theories fail to clarify the mechanism which permits symptoms within the same behavioral disorder to vary between patients.

Conversion disorder, for example, is characterized by a wide range of symptoms, including paralysis, blindness, psychogenic movements, and epilepsy. Yet, neurologists, which in the recent years attribute this disorder to abnormal neurological activity, unable to explain this symptomatic heterogeneity. Moreover, they cannot even describe how neurological defects might cause these symptoms in the first place.

An additional problem is their inability to explain the dramatic rise in recent years in the prevalence of eating disorders and dissociative identity disorder. This rise has been restricted to Western societies, and Westernization through mass media has been shown to affect the prevalence of these disorders in non-Western countries. If these disorders were indeed neurological, Westernization would have no effect.

Another difficulty concerns bizarre phobias, such as sudden extreme phobia toward neutral stimuli. such as trains, chocolate, and insects, which emerge in the absence of anxiety-provoking events and severely disrupt the individual’s daily functioning. The question of panic disorder is similarly troubling: Even after many years of exposure to a feared stimuli, and absent any aversive consequences, panic sometimes still resists extinction—a fact that bothers proponents of trauma and learning theories.

Despite these difficulties, there has, unfortunately, been a growing consensus around medical models among members of the American Psychiatric Association (APA). The APA’s task force arrived at the conclusion that “there is no group of conditions which together comprise ‘neurosis’” in 1976, and consequently the APA decided to remove this category from the DSM-III in 1980. Although pressure from psychoanalysis advocates helped to maintain the term in parenthetical phrases, it was eventually excluded entirely from the DSM-IV in 1994.

The DSM has thus become a medical text, one in which psychological disorders are categorized as neurological diseases. This diagnostic approach has been sharply criticized by a number of researchers, not least for the APA’s close ties to the pharmaceutical industry.

Psycho-Bizarreness Theory: A Reinstatement of Freud’s Vision

Given the above evidence, the inevitable conclusion is that the brain-disease model was a terrible historical mistake. Psychiatry has no scientific legitimacy to treat schizophrenia or other mental disorders.

At the same time, Freud remains one of the great scientific figures of the 20th century. His most important contribution is his vision that schizophrenia, criminal insanity, and neurosis all share the same diagnostic criteria and etiology.

Freud himself failed to integrate this insight into psychoanalysis, largely due to his deterministic assumption, common to all traditional theories, that mental disorders are inflicted by forces beyond the patient’s conscious control. Though he sensed that patients somehow chose their particular behaviors, as implied in his concept “choice of neurosis,” he did not adhere to this idea.

Similarly, although the rationality of madness is embedded in Freud’s theory, he still viewed mental disorders as essentially irrational, seeing them as running counter to the individual’s best interests. A new theory, designated Psycho-Bizarreness Theory (PBT), recently published in our book The Rationality of Irrationality, adopts Freud’s vision, but inserts radical changes in his original suggestions.

Empirical Diagnostic Criteria of Bizarreness

Research and clinical data suggest that bizarre behaviors share five major and two secondary criteria. The most important criterion is sudden onset: the individual displays dramatic behavioral changes in the absence of an event that is uniquely linked with such changes and is proven to be a sufficient trigger for occurrence.

For example, a variety of obsessive-compulsive rituals, panic disorder, agoraphobia, and conversion symptoms occur in the absence of a specific (e.g., neurological, environmental, or social) factor that can be consistently associated with them.

In some cases, the onset may be gradual, such as with conversion disorder and anorexia nervosa, which progressively deteriorate until reaching a point of radical change. However, there is no observable event that is exclusively associated with or can account for this deterioration.

Researchers often report findings that seem to indicate that a certain event is the cause of a given behavioral disorder. Such evidence only violates the criterion of spontaneous onset if the event is proven to be necessary and sufficient for developing the disorder.

The four other major criteria of bizarreness include:

  1. Impact on attention and daily functioning: Mad behaviors intensively preoccupy the individual, severely disrupt his or her daily functioning, and may cause severe social damage,  such as in criminal insanity.
  2. Unawareness: The individual is unaware of the underlying causes of his or her behavioral change.
  3. Rarity: Since people are rarely subjected to an intolerable level of stress, and madness is just one of several behavioral options (e.g., depression, suicide, and substance abuse) available to them, the prevalence of these behaviors must be low, below 3%.
  4. Social stigma: According to Carson, Butcher, and Coleman’s Abnormal Psychology and Modern Life, “almost by definition … abnormal behavior is behavior that is unintelligible to the vast majority of persons observing it.”

Two secondary criteria, not necessary for the diagnosis of bizarreness, are stress and depression. These criteria should be employed only to exclude some exceptional deviant behaviors that seem to meet the five major criteria but are not bizarre (such as autism, the onset of which is not associated with stress or depression).

Numerous case studies support the validity of PBT’s diagnostic criteria for bizarre/mad behaviors. In one of my studies, 15 psychiatrists and 50 clinical psychologists evaluated randomly-arranged deviant behaviors on each of PBT’s major criteria. Neurosis and psychosis were the only disorders that met all five of the criteria, compared to specific phobias (e.g., dentist and animal phobia) that met none. Psychosis scored significantly higher on all the five criteria when compared to neurosis. Post-traumatic stress disorder, a non-bizarre behavior, only met the second criterion of “impact on attention and daily functioning.”

Etiology of Bizarreness

PBT’s basic assumption is that when individuals are confronted with intolerable levels of stress, their behavioral options for handling the situation are limited. They may choose to remain emotionally distressed; to adopt drastic measures, such as suicide, substance abuse, or aggression; or to seek help and therapy.

At the same time, a minority will unconsciously choose to adopt mad behaviors—termed by Freud “bizarre,” but equivalent to the common term “madness”—including schizophrenia, criminal insanity, and neurosis.

Stress may be the result of environmental events, unacceptable impulses, and/or poor coping skills. It may also be, incidentally, the result of neurological impairments; the causes are not mutually exclusive. A number of studies have shown that schizophrenic patients with neurological impairments typically have severe attention deficits, low cognitive abilities, and poor social skills. As a result, they are likely to experience acute social isolation and poor adjustment over the course of childhood, adolescence, and adulthood.

PBT re-envisions the nature of “madness” altogether. Contrary to the traditional view, PBT sees madness as a rational coping mechanism which individuals adopt out of expediency. We can now reassess the relationship between schizophrenia and brain abnormalities. Those brain abnormalities observed in some schizophrenic patients constitute a source of stress motivating the individual to adopt his or her specific madness; they are not, however, the source of the disease.

Repression

PBT affirms Freud’s claim that repression is the key to understanding bizarre behaviors, yet it defines the term differently than how it is commonly understood. Based on Freud’s original definition of the term, PBT defines repression as “a coping mechanism by which the individual blocks the accessibility of stress-related thoughts through deliberate distractive means.”

In other words, people choose mad behaviors which they feel, intuitively, will block the accessibility of their stress-related thoughts. Hence, in PBT, repression is the consequence rather than the cause of madness. This is a radical departure from the psychoanalytic doctrine, which famously takes bizarre behavior to be a consequence of repressed traumas and desires.

Madness as an Economic Decision

Like a consumer choosing between different goods, individuals seeking to alleviate their intolerable stress through bizarre behaviors choose their specific madness according to three basic economic principles:

  1. Need: The behavior must increase the individual’s control over his or her stressor and/or provide social privileges, such as sympathy or monetary rewards. In times of war, for example, soldiers are more likely to adopt conversion disorders such as paralysis, blindness, and epilepsy rather than, say, anorexia nervosa. And people who blame themselves for their failures in coping with life’s demands, and thereby suffer from low self-esteem, are likely to choose a mad behavior such as schizophrenia which can inflate their self-esteem by way of delusions.
  2. Availability: The behavior must be present and available within the individual’s conscious and unconscious experiences, as are determined by unique personal events and various channels of information (e.g., mass media, family, peer group, etc.).
  3. Cost-Benefit Advantage: The benefit earned by the specific madness must exceed its cost. The individual must intuitively feel that the behavior effectively relieves his or her emotional distress.
The Development of Unawareness

We have claimed that individuals choose, through a kind of intuitive calculation, the behavior that will best repress their stressors. How do they then become oblivious to their own choice? In essence, patients become unaware of their own Knowledge of Self-Involvement (KSI) and True Reason (TR) for acting bizarrely through a variety of cognitive processes. They subsequently develop a self-deceptive belief that enable them to attribute the cause of their symptoms to factors beyond their conscious control, stabilizing their KSI/TR-unawareness.

This new concept of “unawareness” has numerous advantages over the Freudian concept of the unconscious. It avoids recent empirical challenges to the latter’s validity, explains clinical evidence indicating the frequent coexistence of awareness and unawareness, and provides a precise account of the mechanisms controlling therapeutic change and facilitating recovery.

In terms of the possibilities for therapy, PBT integrates all therapeutic interventions proven to be effective in the treatment of mad behaviors, from cognitive-behavioral therapy to religious therapy, under a single theoretical umbrella. An intervention is selected not based on its original theoretical grounding but rather based on the patient’s unique symptoms, background, and needs.

PBT equips clinicians with a set of principles that guide them to the right therapeutic approach for each patient. In addition, PBT outlines a new intervention, termed “Rational-Insight Therapy,” which aims to increase patients’ awareness of their current stressors and the faulty behavioral methods they have used in response. Simultaneously, it strengthens the patient’s coping skills through targeted training.

Clinical Examples

Numerous cases of bizarre behavior can help illustrate PBT’s interpretive power. Three famous cases, the first involving neurosis, the second schizophrenia, and the third criminal insanity, together confirm Freud’s ingenious insight that bizarre behaviors share the same diagnostic criteria and etiology despite their completely different symptomatology. They also support PBT’s idea that the major psychological function of such behaviors is repression (i.e., blocking the accessibility of stress-related thoughts), and that similar to consumer decision-making, the choice of a specific symptom is determined by the principles of controllability, availability, and cost-benefit advantage.

In the first case, William Leonard, a university professor, developed acute agoraphobia and panic symptoms upon seeing a freight train from a distance. The event affected him so dramatically that for he was unable to travel a short distance beyond his parents’ home. Psychologists have puzzled over his mysterious “illness” ever since.

In the second case, Theodore John Kaczynski (aka the Unabomber), a professor of mathematics, developed schizophrenia which manifested as a delusion that the industrial revolution and its consequences were a disaster for mankind (Graysmith, 1996). Attempting to spark a social revolution, he mailed bombs to various places, killing three people and injuring 23. Though he had the option to plead insanity and escape the death penalty, he vehemently resisted doing so.

In the third case, Charles Cullen, a hospital nurse, confessed to murdering as many as 40 patients over 16 years by injecting them with overdoses of various medications. According to some estimates, he may have been responsible for the deaths of over 400 patients.

All three cases conform to PBT’s criteria of bizarreness. Each individual displayed dramatic behavioral changes in the absence of a sufficient and necessary trigger (1); the behaviors negatively affected their attention and daily functioning (2); they were unaware of the underlying cause of their behavior (3); their symptoms were extremely rare (4); and their symptoms were stigmatized as a reflection of mental illness (5).

According to PBT, these three cases share the same etiology: current stress. Leonard’s panic attack took place soon after his wife, the daughter of a highly respected family, committed suicide. Their community had always regarded him as demanding and self-centered, and likely held him responsible for her death. Theodore Kaczynski suffered from “an almost total absence of interpersonal relationship” causing “acute sexual starvation” and severe depression. Charles Cullen divorced his wife, and suffered from loneliness, depression, and bullying his whole life. He attempted suicide multiple times, beginning from as early an age as nine.

In an interview with CBS’ 60 Minutes, Cullen said, “I tried to kill myself throughout my life because I never really liked being who I was. I didn’t feel I was worthy of anything.” Clearly the major function of these symptoms was repression. They intensively preoccupied each individuals’ attention, thus blocking the accessibility of their stress-related thoughts and relieving their depression.

The choice of symptoms in all three cases was determined by the same three principles that guide a consumer’s decision-making when buying a product. Leonard’s panic disorder and agoraphobia enabled him to exercise control over his stressor. They created distance between him and his hostile community; gave him a sense of victimhood, eliminating his guilt over his wife’s death; and helped him avoid potential rejection by colleagues at the university.

Kaczynski’s delusion that he could reform industrial civilization provided him with imaginary control over the very society that had rejected him. It also helped combat his sense of failure and boost his self-esteem, Kaczynski felt he was on a mission of messianic proportions.

Cullen’s behaviors, by giving him control over his patients’ life and death, granted him God-like powers. By killing others, he inflated his self-esteem so much that he no longer felt miserable and suicidal.

The symptoms in each case were influenced by the principle of availability. At the age of two, Leonard had nearly been run over by a train. He elicited memories of this childhood incident while experimenting with self-hypnosis, and thereafter made use of this newly uncovered “trauma,” along with his familiarity with psychoanalytic theory, to claim that he had been seized by a bizarre disorder of Freudian origins.

Kaczynski’s delusions, meanwhile, were suggested to him by the technophobic philosophy of Jacques Ellul, whose book, The Technological Society, he had read six times. Other influences may have been the violent riots he witnessed in the ‘60s, as well as the high availability of weapons in the United States in general.

Cullen utilized his profession and workplace to develop a unique pathological coping mechanism that served his repression and controllability needs at a relatively low cost. As a nurse, Cullen was able to conceal his killings for many years by using medications normally employed to save people’s lives. He knew that drugs like digoxin and insulin became deadly when administered in large doses, and were otherwise undetectable.

The cost-benefit principle guides individuals toward behaviors they intuitively feel will reduce their emotional distress at the lowest possible cost. It may be argued that, in general, the cost individuals pay for their mad behaviors is not worth their temporary emotional relief. Both Kaczynski and Cullen, for example, risked imprisonment and death for their crimes. Yet studies from the field of economics indicate that when experiencing emotional distress, the choice of a product is often determined by the individual’s immediate need to relieve tension, rather than by long-term considerations.

Thus, given the emotional distress to which these individuals were exposed, their behaviors were rational insofar as they served their immediate needs. The benefit Kaczynski obtained from his crimes was apparently so high that he refused to plead insanity to avoid the death penalty. This confession would have meant not only abandoning his coping mechanism and exposing himself to the original unbearable stress, but also dealing another blow to his self-esteem, which might have pushed him to suicide.

In Leonard’s case, the benefit was much higher than the cost compared with the above two cases. He received paid leave from his university. His new status as a victim deflected his community’s rejection and blame. Meanwhile, he endured only minimal discomfort in his daily life as a result of his illness. When the university threatened to fire him for his long absences (i.e., when the controllability demands changed) Leonard and his parents moved closer to the university so he could resume his teaching duties without venturing too far away. He rode his bicycle downtown whenever he pleased, rationalizing this violation of his illness by claiming that “the speed of the bicycle magnifies my beat.” He even traveled twice by train to meet his fiancée, though he claimed the experience was like sitting in an electric chair.

Recommendations

As the Nobel Prize-winning economist Robert Aumann has remarked, Psycho-Bizarreness theory “fits in very well with the concept of rationality as understood in economics, where a person’s behavior is considered ‘rational’ if under his circumstances, it advances his goals … Thus, Rofe’s theory, revolutionary as it sounds, fits well into the frameworks of economics, game theory and evolution.” Based on this model, my recommendations for effective and lasting reform in the practice of psychopathology are as follows:

  • In line with growing criticism of the APA and its financially-motivated theoretical bias, the current DSM must be abandoned as the major classificatory system for psychiatric professionals.
  • Freud’s original diagnostic categories of neurosis and psychosis must be reinstated, in accordance with PBT’s diagnostic criteria.
  • Patients suffering from psychotic disorders like schizophrenia and bipolar disorder must be treated in rehabilitation centers under the care of psychologists, rather than in hospitals administering a medication regimen.
  • The use of psychiatric drugs must be limited to the most severe cases, namely those exhibiting therapy-resistant depression with a high risk of suicide.
  • Criminal insanity must be diagnosed by empirical criteria, such as those offered by PBT. The criminally insane should be held fully accountable for their actions and punished accordingly, with regard for the stressful circumstances that may have encouraged their adoption of the disorder.

***

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.

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Yacov Rofé
Yacov Rofé is a retired professor at Bar-Ilan University. He was a visiting professor at Rutgers Medical School and Washington University. He has published articles in leading psychology journals. Rofé calls for establishing an international association of Psycho-Bizarreness Theory whose purpose is to free helpless people from the totalitarian and anti-humanistic regime of psychiatrists in mental hospitals.
Yochay Rofé
Yochay Rofé is a co-author of several articles and a recent book on Psycho-Bizarreness Theory. He earned a graduate degree in public health, and was an assistant lecturer at Bar-Ilan University and a medical student at Tel-Aviv University. During the last 10 years of his father’s retirement, he worked with him to undermine the prevailing opinion in psychopathology within the scientific community.

60 COMMENTS

  1. First paragraph:

    1. Schizophrenia does not exist
    2. ‘mad’ behaviour is not senseless. It is often a way to saveguard meaning in front of mad circumstances
    3. We dont need a theory of madness.

    The problem with psychiatry is that people feel entitled to formulate ‘theories’ and end up defending their ego and status-invested system rather than simply caring for human beings.

    Psychiatry is not a noble cause gone wrong, catering to a systemic and epistemic need. It is not a bad theory that needs to be replaced.
    It is the idiocy and destructiveness of ‘entitled’ people that put their opinions above their fellow human beings.

  2. Psychiatry is not a noble cause gone wrong, catering to a systemic and epistemic need. It is not a bad theory that needs to be replaced.

    Hear! Hear!

    Exit just summarized my instant reaction to all this.

    No theory is needed because there is no mystery. And this piece is so steeped in acceptance of the psychiatric mentality, and its implicit assumptions about human thought and behavior, as to be hardly worth responding to or arguing about.

  3. Ah, the nostalgia for the developmental and naive decade of the 1970’s. Unlike most of the other Baby Boomers, I was only a teenager in the 1960’s. After the discovery and excitement of the Sixties, most other people my age, “got intellect,” as we formulated our revisionist plans to remake the world.

    The first time I experienced the kind of problem Yacov Rofe and Yochay Rofe invasively refer to as, “psycho-bizarre,” behavior was when I was in the midst of my very dramatic nervous breakdown in 1971. For the first time ever, some of my behaviors became wedded to uncontrollable ritual. At one point during my first hospitalization, a therapist asked me if I was, “feeling anxious,” as he witnessed me having trouble controlling what I was doing. For years afterwards, I then attributed this new problem I had to nebulous, “anxiety.” Those were in the days before it was understood that compulsive ritualistic behaviors were not always the product of overall schizophrenia.

    I’ve always hated it whenever I’ve been having trouble with rituals in public. A certain fear I have that I’m being observed is tantamount to the impulses I feel, making it even more difficult to recover. On those occasions when I do so only to discover somebody really IS watching me, my embarrassment and shame go existentialist.

  4. Psychiatry simply fails and this may be the tragic irony of it all because it implicitly and explicitly denies the brain and its preeminence over the entire functioning of the individual. They basically cause the brain to be turned into mush through drugs, therapies, and a multitude of trivial, idiotic treatments. If they considered the brain important, they wouldn’t drug it, electrify it, therapize it, etc. But, no, the psychiatrist’s main job is to trivialize the brain and thus the human being. This is why the most useful information about human behavior, potentials, and basically how the brain and body work in each individual comes from outside psychiatry/psychology circles, which really upsets those in this terribly misguided profession. Just maybe, as far as “madness” and “bizarre behavior” exists in human being perhaps we should take lessons from the pre-psychology times of the middle ages; these behaviors might be of “demonic” origins. Just maybe, an exorcist might be more useful than a psychiatrist and considering what happens with the drugs, etc. there seem to be less long term effects. Thank you.

      • My mother once explained her concept of the mind to me – that it is the totality of all of the inputs to the collective nervous systems. That’s still probably too reductionist for folks here, but at least it doesn’t reduce it to grey matter inside the skull. And as we learn more about other parts of the body besides the brain – the enteric nervous system and our microbiome – that function independently of the CNS and ANS, I think it’s a reasonable start.

        I’m not at all sure I believe that the mind runs the body, though. I think it’s more like the old adage – I AM my body. Taking care of my body has been for me the foundation of staying well. I am not sure whether it was Sera D. or Meghan W. who wrote about the lengths to which many psych survivors go in their self-care habits, but it rang true for me. When my body suffers, so does my mind follow. And when that is taken out of my control – like how sick I’ve been this year with multiple infections and repeated courses of antimicrobial drugs in span of just a few months, there is no getting around that the mind suffers from the physical state. It seems to me that if the mind really ran the body, then I could just mind over matter myself into wellness. That has not been my experience. The best I can do is keep putting out the spot fires so the whole house doesn’t burn down.

        I also think this is why people who are suffering get upset at notions of self-control. Why people who are severely depressed say if they could get out of bed, they would. And it’s why I bristle at psychological theories that present behaviors at these times as choices. We know enough about sickness behaviors and their evolutionary underpinnings to know fundamentally that the body is responding as it is for a reason even if we don’t fully understand the reason. Non-human animals also display sickness behaviors and it obviously isn’t because of a conscious social conditioning to play a patient role and get better.

        We also know that one of the highest risk times for suicide is during the convalescent period when the body is just beginning to feel enough energy to act on the impulse to end it all. That is why I am somewhat confused by this particular framework presented by the authors here that places extreme states in a bucket of choices like suicide and drug use. It’s far too simplistic and these actions all occur at different times of the coping/recovery process. This is why professionals theorizing about those who experience these states will never truly understand us. They are on the outside looking in on something they don’t know and can only speculate about. Their theorizing replaces one set of labels with another. Psychiatric disorders become “madness” and there are all too many who are ready to embrace the concept of madness when even the authors here admit that “madness” is a rational response to undue levels of stress. (I use “stress” here in the loosest sense of collective inputs.) So again, is it the mind choosing to go mad or is it that the set of inputs to the body result in chaotic processes? I argue for the latter. (I’d also say that whoever designed the BSOD in computing and the task of ctl-alt-dlt to kill processes that are no longer responding understood this on some level.)

        You don’t have to believe in psychiatric jargon OR psychological theories of various flavors of “madness” to understand that inputs = outputs. At best, mind and body are symbiotic. And, you know, I could get behind the idea of neurodiversity if it weren’t used to distinguish “normal” from “abnormal”. If it were truly a spectrum and a fluid one so that it could be normal to be abnormal and to move through states of normal and abnormal as inputs overwhelming the processor. But I find that the labels are mostly used to “other” folks who seem to have reasonable responses to their inputs when those inputs are placed in context.

        I think this also provides a framework for taking responsibility for controlling the inputs. Madness is not something I embrace as a part of who I am. It is, at best, a response to poorly controlled or out of control inputs. It is certainly my experience that the more control I have over the inputs, the more controlled (healed, well, stable) the outputs become. But that’s not mind over matter – mind running the brain – it’s more mindfully attending to matter in a circular never ending process.

      • Steve McCrea, You are right, psychiatry doesn’t allow mysteries, because it is their solemn goal to create them and make a terrible mess doing it. I am not sue if psychiatry mistakes the BRAIN for the MIND. Maybe, the entire general public is. Maybe, we are by definition, “splitting hairs.” I would like to think the BRAIN and the MIND are as one. We do sometimes, in the vernacular, use them interchangeably. It could be that the BRAIN describes what we might call the more scientific, while the MIND defines the more SPIRITUAL. I am not sure that matters. Perhaps, it needs to stay a MYSTERY. But, whether, it is BRAIN, or MIND, or BRAIN/MIND, it must be fed and attended to appropriately to the individual person living inside. Psychiatry, as fraudulent as it is, and like all other possibly less fraudulent medicines and more and more so other institutions, including government, education, etc. easily and dangerously forget the sovereignty the person and I could argue that the sovereignty of the person is the sovereignty of God and vice versa. Thank you.

        • I would say that the brain is an organ, while the mind appears to be an agent of controlling the body. It is certainly within the realm of possibility that the mind does somehow arise from the brain, but that is certainly not proven, nor is there even evidence to say it is so, other than materialists saying, “It must be, because what else could it be?” But regardless of that, there is tons of evidence that the mind, whatever that is, is able to control the body, including the brain, in many, many different ways. The placebo effect is a great example. How can believing that something will work help the body to heal or change? Obviously, there is some form of agency that uses beliefs and goals to move the body to do things. Perhaps the concept of a “programmer” is the best analogy. Lots of people refer to the “hardware” (the brain) and the “software” (whatever programs the brain is running), yet no one seems to remember that someone has to WRITE the programs for a computer to run! So who is the “programmer” of the human brain? That’s what I’d call the mind. And again, it is a mystery – no one really has a clue what it is or how it works, but it is clear that it DOES exist and it DOES work, and pretending that we’re just a brain is as dumb as pretending a computer is just a bunch of electronic components and wires. Try to run a computer without software and see what happens! Try to program a computer without a programmer and see how far you get.

          • Steve, the placebo effect does not cure infections. The mind can influence the body for sure, but let’s be more specific about the limits of such.

            It is certainly within the realm of possibility that the mind does somehow arise from the brain

            This is a far cry from what I said and is not at all what I believe.

          • I am sure they don’t cure infections, but they have been noted to have strong effects on pain, nausea, emotional conditions, fatigue, etc. These effects are apparently measurable and observable in the brain.

            https://www.mdlinx.com/article/7-potent-powers-of-the-placebo-effect/2cO3HNrMslvxpW4qQ1hZpg

            More convincingly, how the brain is used has been shown to alter the function of the brain itself. Taxi drivers develop an increase in areas of the brain associated with geography; meditating monks have an increase in areas of the brain associated with calmness and relaxation, as well as alterations in brain wave activity.

            https://www.theatlantic.com/health/archive/2015/07/dalai-lama-neuroscience-compassion/397706/

            One can say, “Well, they’re using that part of the brain more, so it’s more developed.” But WHO or WHAT is using that part of the brain more? And HOW is that decided? These are things we simply do not understand.

            The mind is and remains a mystery. It appears to have effects on the body, but how these effects are created is not remotely understood by any in the world of science. What “the mind” even IS is not understood by scientists. I don’t claim to have any understanding of it myself, I’m just pointing out that claims that understanding the brain means understanding the mind are similar to claims that understanding electrical circuitry is the same as understanding computer programming. They are very different things.

          • Well, you’re defending something different from what I was talking about. I don’t believe the mind exists within the brain or that the brain controls it. I just don’t personally believe the mind is some psychic or spiritual phenomena that is separate from the body.

          • I am not a brain scientist nor do I have proof of what I say outside of my own perspective from my experience of living and healing, but this exploration is so relevant I think, that I want to add my voice to it from what I’ve learned so far, been thinking about this very thing.

            At this point, I’ve reached the conclusion that the mind actually creates the body, and the brain runs it (also part of the “body creation,” obviously, like a “manager”). I believe the mind creates everything, it is from where our vision begins, and pre-natal, it would be the mind of the mother which influences most, until a child becomes aware of their own vision, as their reality comes into clearer focus.

            What fuels a vision is the power of the emotion behind it, and together these become a projected reality, not just a vision, but the feeling of that reality as well. That begins inside us, if we can visualize that which we desire and feel it, by imagining it with the mind. The brain can command the body to register these feelings through our nervous system, and that leads to feelings in the body, to be determined by how we feel about that which we are imagining, dreaming and visualizing–with the mind.

            The mind is consciousness, of what we are aware, and that is expansive as we take in more life experience and the wisdom from it. The brain depends on what the mind takes in, neural pathways develop in response to the environment, and how the mind is perceiving it, simply as reflex. This is malleable, as environments change, so can neurons. We can also shift neurons by shifting how we perceive anything, literally “changing our minds,” that is, what information we are including in our assessment leading to a feeling response. When we desire change, we have the choice to change our environment or to shift our thinking about it, or both.

            However, if the mind remains in the past, it will not perceive the update because the brain is still thinking in past time, the neural pathways have not shifted, causing dissonance. Alignment is bringing the body into present time, which means the mind has to perceive present time, which isn’t always the case, especially when we’re trying to work out trauma.

            I think it’s most helpful to know the difference, and then we can make better choices in the moment. “Am I in past or present time with this thought?” is a question I ask myself in reflection. That guides me to the next step of awareness, and whether or not action is appropriate, based on that.

            When we sleep, the brain continues to tell the body to breathe, we don’t have to do this consciously, it is natural survival instinct, programmed in our being, so to speak, the breath of life. Our minds can be quite active separate from our “normal” reality, these are our dreams. We can dream asleep or we can dream awake, have fantasies about anything we want, and this will affect our feelings in that moment, we can actually drive our emotions this way. That is the unlimited creative nature of our minds.

            If our brains are not burdened with overcomplicated, stressful thinking (which would be habits from chronically high stress living, which I believe to be a universal condition on Earth right now), then the freedom of our naturally expansive minds will influence the body in an uplifting way, and it will feel good, or better than before at least, a bit more relaxed.

            The problem now is that we constantly talk our way out of feeling uplifted. What the real mystery is to me is why good feelings, happiness, and positivity are constantly being judged, denied, invalidated, shamed, and ridiculed. I know that is a hot topic here and I somewhat get how this can happen, and why. So I guess the mystery is how to remedy this because honestly, I believe that this is, in reality, the endless loop which keeps suffering and oppression alive and well within humanity.

            Changing our own minds in an expansive way and using them to generate relief from chronic stress rather than adding to it, would allow the brain to relax, which would make our bodies feel a whole lot better, just from allowing happiness to exist on the planet, in peace, and without judgment or negative speculation. I believe solutions would occur with more ease in thought, and less dissonance between mind and body, and I’m including “brain” with body; I see the mind as more than just “the body,” not separate from it, but greater than.

            Who knows for sure, right? But that’s my vision, so far, from what I’ve learned in my healing process.

        • I am not sue if psychiatry mistakes the BRAIN for the MIND. Maybe, the entire general public is. Maybe, we are by definition, “splitting hairs.” I would like to think the BRAIN and the MIND are as one.

          Steve is right, at least as this relates to psychiatry (though I don’t consider it a “mistake”). This is a vital point — Rebel I think you’re missing this, if you don’t mind me saying so. Maybe parsing this will be my self-“assignment” for the afternoon, as it’s way more than “splitting hairs; within this contradiction lies the key to deconstructing psychiatry for once and for all. (None of this is my “opinion” btw; it comes straight from Szasz).

          Let’s start with a basic principle you presumably are familiar with already:

          “Mental illness” is a semantically absurd concept which falsely conflates the abstraction known as the “mind” with the physical brain to mislead people into believing they have literal diseases.

          The conflation of “brain” and “mind” is the basic deception of psychiatry. The misleading idea that thoughts and perceptions channeled by the brain and nervous system are caused by the latter is like saying that the content of phone conversations is “caused” by the switchboards and cell towers used to transmit them. Szasz said that calling a “doctor” to “cure” unwanted thought or behavior is like calling a TV repair person when you don’t like the program. (This is sort of a simplification.)

          The “mind” is an abstraction, like the “ego,” and does not conform to physical laws. This doesn’t mean that it’s not “real,” but it can’t be conceptualized in physical terms, which is problematic given that we’re focused in a material continuum. “Minds” do not have colors, shapes, textures — or diseases; once one starts ascribing material characteristics to a non-material concept such as “mind” one leaves the sphere of science and enters that of metaphysics, bad poetry and psychiatry. Even Torrey once said (in his younger, less sold-out days) that one can no more have a “mental illness” than a “purple idea.”

          I would add that arguments about whether “mind” and “brain” are the same, different or “part of” one another, or the mind “leaving” the body, or moving around in physical space, are also rooted in physical experience, viewing “mind” from a material frame of reference, as a “thing”; but the consciousness or energy known as “mind” does not obey physical laws, by definition. And unlike “brain,” definitions of “mind” are considerably more subject to subjectivity. [sic]

          It is the essential deception of psychiatry that “mental illness” is not a figure of speech (such as “spring fever’) but a literal disease. This saddles the “diagnosed” with an internalized self-identification as being “defective,” which in the long run is likely to be as destructive as are SSRIs.

          Going back to the above principle, therefore: once the workings of our mind — including our perceptions, thoughts and emotions — are seen as being “caused” by the neural networks which channel them, it’s a short leap to the conclusion that “bad” thoughts and feelings are the product of defective brains.

          Defining what the “mind” or “soul” comprise would be a highly abstract, philosophical, metaphysical discussion/debate, which I imagine has been had over & over over the years. [sic] Though an interesting one, no doubt.

          • “once the workings of our mind — including our perceptions, thoughts and emotions — are seen as being “caused” by the neural networks which channel them, it’s a short leap to the conclusion that “bad” thoughts and feelings are the product of defective brains.”

            Not necessarily. What we feel in our hearts also matters. In our guts, too. They all interconnect to create a wide variety of life experiences. We have choices on what to focus and how to interpret things, which can evolve over the years. Many things interact inside of us to create our personal reality and life experience.

          • I’m talking about system “logic,” not my personal beliefs. Once one equates the channeling system (brain/nervous system) with the information being channeled (mind), it’s logical to conclude that a “defective” mind is one and same as a defective brain. The problem with that being the premise.

          • I’d never use the word “defective” to describe the human brain or mind. It is what it is, but it is never fixed in one place. We can go in and out of clarity and our minds can shift focus for a different experience. That is reality as I understand it.

  5. The thought that “schizophrenics” are reacting to altered perceptions in a way that would be normal if we knew their components, seems too complex for shrinks to understand. Of course, an introduction to altered perceptions via hallucinogenic experience seems to be too dangerous for the psychiatric mind to understand. Maybe it’s too scary and they’re afraid of becoming permanently bonkers in the twinkling of an eye.

      • A common quote goes, “it is not paranoia if they really are out to get you.” Almost all of those labeled as paranoid schizophrenics can one up that with, “it is not paranoia when they already got me and millions of others and almost no one cares.”
        Psychiatry forcibly jails people and then forcibly drugs them with disabling drugs that take 20 years off a lifespan. Drugs with effects occurring in about half of users that are described as torture. The Soviets in fact did torture people with the same drugs. Luckily for psychiatry anyone pointing this out can be insulted as “mentally ill” and ignored/drugged.

  6. While Exit has a good point–what E it forgets is how an alternative theoretical framework can help trapped psychiatric patients and their allies push back against the propaganda they have been spoon-fed! I agree that swapping out one leaky liferaft for another is pointless in the long-run–but seeking individuation and personhood and the opportunity to develop an individual life narrative that counters the strong social currents–as defined by the treacherous, overwhelming pressure faced by hapless I individuals who must subject themselves to harmful psychiatric ‘treatment’ or risk all hope of acceptance and community–can be overwhelming! Another replacement framework sounds good to me! People are not looking for intellectual dogma–just life preservers!

    • Yes but I tend to think that humans are unable to do that.

      A ‘framework’ always have a policy that ends up being a police, and supporters and priests who end up invested in a dogma, at the expense of people in need.

      I think an alternative can be useful, but it is too risky and it is simply not needed.

      We just have to focus on people, in my opinion.

  7. oldhead, saying “no theory is needed” is a little over the top. Alternatives frameworks for are needed simply to convince so-called professionals that the current paragigm of care for bizarrely behaving individuals is harmful. Caregivers for individuals who tend to act bizarrely are just trying to survive from day to day, trying to maintain a cloak of invisibilty around a loved one because of the risk of psychiatric detainment and chemical straighjacketing is so high. I think its been a long time since you babysat someone who wanted to run naked into traffic, used poop as a hair conditioner, etc. trying to make sure that somone you love doesn’t land in a locked back ward, rocking back and forth on neuroleptics is a full-time job and the more allies who are willing to push back against the current framework, the better. People with privilege, safety, and privacy can afford to criticize and nit pick every attempt effort to push back against the medical model, putting it through the an orthodoxy smell test. Jeesh!

    • Madmom, I am not defending Oldhead but I can’t entirely disagree with him that additional frameworks aren’t necessary. I would only add that the pontificating by outsiders over the meaning of the experiences of those labeled with madness are not really useful to those experiencing such. The phrase “nothing about us without us” rings true for me here.

      “Caregivers for individuals who tend to act bizarrely are just trying to survive from day to day, trying to maintain a cloak of invisibilty around a loved one because of the risk of psychiatric detainment and chemical straighjacketing is so high.”

      I appreciate this. But I think the needs of caregivers is dramatically different from that of those who are actually living those experiences. I also think that the delineation between caregiver and the person being cared for is sometimes quite fluid. Many people with lived experience of distress are also caregivers – and quite competent ones at that – for others experiencing distress. I am sometimes surprised by how quickly I can shift modes from needing care to providing care. I am also surprised at how rewarding caregiving can be at times while at others, it is very distressing. I think we can honor these experiences in a better way than placing a hard line between caregivers and those they are caring for and without looking to professionals to explain behaviors that those who live them do a fine job of explaining already.

      I also think that you criticize those with privilege, safety and privacy while saying that’s exactly what you’re providing for your loved one. I’m more concerned with those who don’t have someone providing that. We shouldn’t need privilege, safety and privacy!

      The authors here are professionals with a book to sell. They say nothing about their own lived experience or about collaborating with those with lived experience. They researched us and theorized about us and I think the pushback is appropriate. Coming up with ever more frameworks is a pretty good example of the “publish or perish” culture in academia.

    • madmom: But, is it our “job” to convince the already questionable psych professionals or is it our job to convince the public? Perhaps, it is our job to convince ourselves and take responsibility for our mistakes; that following the path of psychiatry, etc. is nothing less than a Faustian Bargain of which we essentially pay the price one way or another. But this is Easter Sunday and there always remains and is redemption. And, sadly, I have yet to see redemption in theories or theoretical frameworks as they like alleged scientific modeling only cloud the issues, when we really need to see clearly what is actually at hand. Thank you.

    • oldhead, saying “no theory is needed” is a little over the top. Alternatives frameworks for are needed simply to convince so-called professionals that the current paragigm of care for bizarrely behaving individuals is harmful

      What I do is anti-psychiatry. I’m not a “caregiver” or interested in convincing “mh professionals” of anything. I’m more interested in helping people make connections that may lead to them rejecting the whole “professional/client” paradigm, and the political structures which perpetuate the alienation and pain that provide an endless stream of such “clients.” Psychiatry like slavery and genocide requires no “alternative,” it just needs to be rejected and abandoned.

      That doesn’t mean I reject “caregiving,” any more than I reject auto repair; it’s just not my focus. As for theory, how about “Oppression Theory” — could delineating that get me a job as a critical psychiatrist? 🙂

  8. completely agree with you mad mom walk a day in our shoes.. Trying to survive to your own detriment no life and no hope you look at “normal ” families with such envy and know your total isolation.. Many deny this reality.. My best friend who was the only person who understood the situation died suddenly 8 weeks ago and I am unsure how i will now move forward

  9. KILLERS IN MEDICINE

    “…In the third case, Charles Cullen, a hospital nurse, confessed to murdering as many as 40 patients over 16 years by injecting..”

    NOVEMBER 24 1986 IRISH RECORD SUMMARY

    This Record Summary Deliberately OMITS Requested Adverse Drug Reaction Warning concerning drugs (Fluphenazine Decanoate Depot Injections) that NEARLY KILLED me.

    Adverse Drug Reaction Warning Request Letter sent to Galway Nov. 8 1986

    Adverse Drug Reaction Request ltr Pg 1
    https://drive.google.com/file/d/0B0zhbh8V4MBAZlVTbHdBRDFFSHc/view?usp=drivesdk

    Adverse Drug Reaction Request ltr Pg 8
    https://drive.google.com/file/d/0B0zhbh8V4MBAZ0otNjFyN0NJajA/view?usp=drivesdk

    Adverse Drug Reaction Request Ltr Pg 9
    https://drive.google.com/file/d/0B0zhbh8V4MBAcExwMzhEMVRzdm8/view?usp=drivesdk

    ADVERSE DRUG REACTION WARNING REQUEST LETTER
    Pages 8 and 9:-
    “…I’m a bit worried that if I ever needed treatment that I might be put on long term depot injections against my will…

    When I was on these injections I had very bad side effects… like extreme restlessness.., very unpredictable behaviour…,the worst feelings of my life….
    Dr Carney..called it oversensitisation..

    This is the thing that worries me most if I should ever in the future need treatment….

    So if you made sure this was on my File at Galway and that they would know about it at the Central
    Middlesex Hospital if I ever needed treatment…”

    Irish Record Summary Pg 1
    https://drive.google.com/file/d/0B0zhbh8V4MBATlNoNTlpYy11X28/view?usp=drivesdk

    Irish Record Summary Pg 2
    https://drive.google.com/file/d/0B0zhbh8V4MBAMmlqS18xQVZlcms/view?usp=drivesdk
    …”

    “…In the third case, Charles Cullen, a hospital nurse, confessed to murdering as many as 40 patients over 16 years by injecting them with overdoses of various medications.
    According to some estimates, he may have been responsible for the deaths of over 400 patients…”

    AKATHISIA: SUICIDE ASSOCIATED WITH DEPOT FLUPHENAZINE 1983
    https://drive.google.com/file/d/1cFZYpg0AbHiJSyUspnO16JWcCYGmR2L9/view?usp=drivesdk

    https://drive.google.com/file/d/1cBDnEct692otxAnOtWYBYj8PSQRignW0/view?usp=drivesdk

    [There are Dead Bodies at Galway].

    • OFFICIAL PERMISSION TO KILL = NO EXCUSE

      Supposing these Medical Killers were given Official Permission to kill and cover up, for the sake of ‘Industry’ (Ireland having a large stake in pharmaceuticals). Would the Medical Killing then be Okay?

      No It wouldn’t. This has been tried and tested elsewhere following the 2nd World War. Doctors that murdered the Mentally Ill were Executed in the same way as those that killed the Jewish people the Communists and the Disabled.

  10. Choice is what matters. I have known people who are devotees of psychiatry and feel better with it. I have known people who feel hatred of psychiatry but adoration of psychology. I have known people who get better on kindness and soup. I have known people travel back and forth revisiting all of these choices, depending on whatever distress is happening to them. It is easy to shout it must be this way and not that way. My way or the high way. But I think there should be no dominant religion of treatment at all but all sorts of options and choices. Anything “rational” has bullying connotations in it in my experience. It seems an unfortunate and off putting term. “Stop being mad…try to be like us sane people…be rational!”

    But I know loads of people get a rush from following logic. They see in its hopeful orderliness the prospect that feelings could become orderly, neat and tidy. Feelings are n e v e r neat. Never will be.

    It does seem that the therapy outlined in this article might go to war on feelings in order to tidy things up so that there are only the “right” feelings, or feelings agreed upon by societal consensus. Finding the elusive “cause” to messy feelings seems to want to block feelings with rational thought or rational eureka moments. I can understand this for intolerable distressing conditions but it has been my observation that distress is often caused by not feeling nearly enough! Logic bars feelings. “Feeling” feelings discharges distress. But I hope there will be lots of many different funds and provisions and clinics and houses and styles of treatment for helping people overcome distress. I hope these will be on offer for all of us “different” people with our “different” choices.

    I would like to add one point however. Having a delusion of being God-like is an awful job. Being God-like is nothing like sane people think it is. They think it must be grand to expand on the silken cushions of egotism and solve the problem of personal failure by winking in a golden hand held mirror all day. That presumption is so inaccurate and silly! Being stuck in a God-like delusion is a unique form of existential torture few could survive. Being God-like is a full on herculean chore, full of guilt about not being able to reach everyone overnight and save everybody. I think the authors are making the same mistake popular culture does in swapping psychotic grandiosity with psychopathic imperviousness to other people’s suffering. It would be fantastic if I were impervious to other people’s pain. But I am schizophrenic and feel I have to do

    “e v e r y t h i n g”

    I can to save the world and let me say it is no heaven to feel that way at all. So trying to imply that drifting in that direction is a quick fix to my low self esteem is an insult to my intelligence and detracts from the abyssmal, terrible anguish that comes from being as a God.

    I would say that most delusions are not tricksy ways to avoid processing old traumas, like school kids avoid doing homestudy, but delusions are more akin to fevers from the rumbling on of traumas, and sometimes mysteriously no traumas at all. As fevers, like covid fevers, the main focus should be on caring for the befevered to help them get well again. The haste to find “causes” implies a search for “cures” but so often in the past the “cures” have been crueller than just accepting the fever is what it is and being kind and swaddling the distressed in cosy blankets.

    That is not to say any relative should be left to bear the burden of feeding, washing, clothing, the feverish. And it is not to say we should not search for “cures” but the latest research about covid fevers suggests that those who allow their feverish high temperature without taking pain relief to reduce the fever Get Better Faster. The fever IS an immune system working robustly and healthily. The fever IS the medicine. The madness is the cure. That is perhaps why psychosis improves quicker in rural communities where there are no cures.

    But dismiss me do, for what do I know? I can only speak for myself and hope nobody is listening. And I hope this does not come over as a grumpy shin kicking to a fine article, an article itself so wonderfully brimming with an understandable God-like impulse to offer a rational treatment that will save the world of those with God-like big problems. I like all pioneering therapies, no matter how rational and logical, because the world is not all about me, me, me. Other people are “different” from me. Other people shall want the “choice” to do rational therapies, and may speedily thrive on them…like people get better on biscuits.

  11. PSYCHOTHERAPY
    I was happy to initially refuse Psychiatric Drugs and even though I came off Neuroleptics (aka Major Tranquillisers) responsibly, I still suffered from a type of nearly Disabling Anxiety (which I had never experienced before), that could have driven me back onto these drugs.

    But I was able to get a Picture of how the anxiety ‘worked’ and to figure out ways of dealing with it. Eventually I overcame it, and at the same time learned to successfully live with more rational fears.

  12. For this next comment you will need to listen to “She”, song by Alice Phoebe Lou.

    Just slow dancing and wish to add a further point. Although being God-like is exhausting and far worse than any trauma such a delusion might have miraculously sprung from, I will say that, for myself, feeling somewhat grandiose is a joyous, unmissable pleasure. I want everyone on the planet to enjoy feeling grandiose. Though I am tea total the alcohol business is founded on the aim of increasing people’s grandiosity to melodramatic effect. Children are excellent at being grandiose. A child will daub a wall with paints and feel supremely pleased with his or her accomplishment. No criticism can permeate the certainty of magnificence of that flawless artist. We come from such grandiosity. It is kicked out of us by “the reasoners” at school, who get us to “compare” our dribbly naive masterpieces with the state sanctioned ones. Our grandiosity is chipped away at by criticism, like chisels to marble, intent on moulding us, hurrying out another lookalike, Greek statue, chill in its artificial perfection.
    There grows a longing to return to celebrating a simple childhood grandiosity, of the “unearned” variety, a juvenile grandiosity that says “I am special just because I know I am”. When you rediscover it as a mad woman you don’t ever want to let that healing feeling go. Look at nature. Is not the bird of paradise grandiose? The noble lioness? The mighty moose? The glitzy koi carp fish? They luxuriate in their grandiosity. It is not like the pomp of egotism, it is raw splendour that seeks nothing from anyone, it already has the lot, in the core knowingness of specialness. A natural birthright!
    Sit the sumptuous bird of paradise, its feathers exploding upside down like a champaign magnum, in a rational office or a CBT office, to pursue a cure from logic and I can see that lovely supportive grandiose feeling withering. I can see the splotty colourful painting disintegrating. And I can see someone orderly, rational, neat and tidy emerging. Perhaps they will feel saved because rationalising has curbed whatever causes their distress, maybe a tendency to think they have to stay awake all night in God-like desperation to save the globe, but will rationalising have knocked the lovely feeling of exuberant grandiosity all out of whack? That grandiosity is a food, childish lumpy breadcrumbs to sustain the desperate God-like sufferer. In other words many therapies in attempting to tweak out psychotic thorns pull to pieces beautiful natural aspects that are so healing the rest of sane society does not even remember enjoying feeling that way themselves. They assume everything going on in the mad mind is to be replaced with reason, it is a reason that alone can sustain nobody for very long. Not without a good stiff drink…

    Some moves the mad do are incredibly wise even though the rest of them may be miserable and desperate for torment to end. It is too easy to say everything inside the madness is counterproductive and should be chipped off…chip…chip…chip….

  13. Psychiatrist Thomas Szasz wrote a whole book lambasting antipsychiatry. The book is entitled Antipsychiatry: Quackery Squared. Ironically, Szasz was often labeled as being an “antipsychiatrist”, even though he vehemently rejected the label. Szasz rejected the label of being antipsychiatry mostly because, according to him, a significant number of antipsychiatrists still embraced psychiatric coercion and nonconsensual psychiatry.

    I believe we can redefine antipsychiatry as meaning being against psychiatric coercion and nonconsensual psychiatry. If we define antipsychiatry as such, then I identify as being part of the antipsychiatry movement. If antipsychiatry is some mystical mysterious idea that still embraces psychiatric coercion, then I, like Szasz, reject the label of antipsychiatry.

    Interesting article. Thanks.

    • Wrong. What Szasz rejected was the phony “antipsychiatry” then being pushed by psychiatrists such as Cooper and Laing, who were not anti-psychiatry at all, but a “chic” school of psychiatry, and Szasz wanted nothing to do with them, understandably. Additionally, as a libertarian Szasz rejected outlawing psychiatry, nonetheless he rejected all the false premises on which it is based.

      Your attempt to “redefine” anti-psychiatry is what is known as “revisionism,” and is nothing new. Banning forced psychiatry would be a big first step towards abolishing abolishing psychiatry altogether, but if it is the only goal this is simply reformism. Anti-psychiatry is dedicated to eliminating psychiatry altogether, and we don’t need that watered down.

      Regardless of how he parsed certain terms, Szasz remains the godfather of the anti-psychiatry movement.

  14. I want to apologize to the authors for sounding a tad catty. I imagine tossing a beloved article into the comments section is like being hurled into a bear pit. And you article writers are only trying to help. You have the best intentions. And in reimagining an alternative care to psychiatry we need to encourage innovators to come forward with their ideas. We live in an age of instant shouting and cancelling and this may begin to background any inspired visions for a better care. Mostly theories are games that are neutral. A person can elegantly dissect theories with not a spark of emotional sour grapes, because theories are not personal. But because the survivor activist camp are so devastated by some theories ending up “In The Wrong Hands”….and let’s face it half the professionals who might implement such neutral theories may have the wrong hands, simply because they have not had enough life experiences to make them humble, and what happens is a survivor reads the neutral theory, sees it being warped out of shape and meted out by a mini dictator, and all the alarm bells in the comments section start shrieking “Hands Off Our Brains!!!”

    But really the theory itself is neutral and not dangerous but benign and only meant to be an alternative amidst many. People confuse the theory with the zombie of psychiatry getting back up off the floor after being lamped by an ashtray. But it means we do this platform a disservice if we cannot let good people with their neutral theories pipe up.
    That is not to say don’t growl at the bleeding obvious.

    I just want to mention a couple of other things that were stimulated by the article. I said choice is important because we so quickly forget that who we are now is not permanent. Fad treatments come and go. In my teens I used to love a book on rosharsh inkblot tests. In my twenties it was about Freud. Then Jung. Then Gestalt therapy. On and on. People need these tarzan ropes to leap to before they fall. The next new exciting one gives a placebo lift. So a broad selection of many care options is all to the good, not just to cater to a population of fusspots each choosing their darling therapy style but to cater to one wandering fussy life.

    The brain you have on today that only likes herbal treatments may be a brain tomorrow that really wants a person centred approach.

    Having said this much I do enjoy joining in the rowdy sport that goes on in the comments section and I feel the exacting standards are necessary.

    Lastly I want to offer a word. “Enmeshment”. People think psychosis is to the mind like a demon or big bit of furniture in a corner of a room. There it is see? And they think it got there by trauma. As if trauma were a vehicle like a lorry that crashed into the person and left such wreckage that the person, attempting to avoid thinking of the trauma, unwittingly shoved a big bit of furniture called psychosis into a room’s alcove, to stare at it all day. My experience of my psychosis is more like my mind is like conjoined twins with a mutual veinous network. The intricacy of the dominant twin’s capilaries are so “enmeshed” with mine that it is really finicky to try to snip apart those blood vessels to free my own. The blood vessel analogy I am using refers to thoughts. It is difficult to snip aside the psychotic thoughts and leave my own thoughts independent because they are meshed so much that the beginning of one thought may belong to the conjoined twin but the centre of the thought may belong to me, and the end may belong to the conjoined twin again. Any brutal surgical or chemical attempt to divide that mesh invariably kills both twins. And the sometimes innocent idea of focusing on removing the big lump of furniture in the corner of the room, by revisiting the car crash of trauma, tends not to appreciate the finicky state of “enmeshment” of thoughts. A therapist may say “Try not to think that way or this way”. But it is like telling a conjoined twin to try to not to let blood flow left or right. Now I am not saying my experience is anyone elses. And I am not saying that therapy is not a wonderful way to care and support the psychotic. It definitely is. But to me the Voice Hearing Support Groups offer the best in terms of respecting “enmeshment” or “conjoinedness of thinking”. Nobody wants to be “conjoined”. Nobody wants intrusive thoughts. I have not met one person who has a love of psychosis. It may have uplifting perks but mostly psychosis is so tormenting that I struggle to see how anyone can think a person chooses it even subconsciously as a sticking plaster or a better bet than being just plain sobbingly traumatized. Give me sobbing any day! Sobbing is serenely lovely. Torture is not. And all psychosises are abject miserable torture.

    Where I do agree with the article is in its wonderment at the ingenuity in the psyche of the suffering, ingenuity to make creative adjustments within them that involve very nice fantasies. Splendid organic survival mechsnisms do occur, and it is a relief to talk about these. Like a conjoined twin getting lonely relief by whispering to a therapist that she keeps a hidden diary all secret from the dominant twin. Having more therapists for the psychotic to unburden to is all to the good. Certainly so.

    But I also must say that many with psychosis can probably mend themselves by coming off chronic doses of pills that sedate their “mesh” to a standstill. And as for criminality, akathesia is probably where to look, more than trauma, I would guess. Akasthesia is a bit like dosing someone on ketamine and crystal meth and speed and downers and drink and asking them to give back the dropped pocketbook to the nice little old lady.

    • Daiphanous Weeping, your description of enmeshment as an alternative way of framing intrusive thoughts and your metaphor of conjoined twins is absolutely brilliant! I think you are spot on and your comment/description really resonates with what I have observed in my daughter plus its a good push back as to why the Bizarreness Framework presented her is so oversimplified but your description also underscores the fact that romanticizing ‘psychosis’ or going around saying that ‘mental illness’ doesn’t exist, except in the minds of the observers or in the minds of the socially dominant who simply want to control others, is also an oversimplification that can be used to offer a free pass for tight fisted taxpayers to ignore other people’s suffering because it is a ‘choice’ or because it is a figment of our imagination

      • Aw, Thank you Madmom. I like your comments also. I really do. Thank you for affirming the enmeshment. I am new here so still feeling my way around the volcanic leylines.
        I was mulling over today that there is a link between passion and anxiety. You cannot have passion if you are sated and content. Passion is always restlessly searching, looking for the beloved, thinks about him, or her every hour of the night and day, dreams about a triumphant union where a huge reconciling healing of yearning and the anxiety takes place. Activism is passion in action. It is vibrant and energized and beautiful to see. However, it can be so overwhelmed with anxiety at not quite getting the desired for beloved thing, a union of consensus or longed for fresh paradigm of care, that the anxeity tips over into anger and frustration. But in any romance, (and I include activism as a kind of romance of a prospective utopia), such passion that thunders into belicose anger, whilst attractive and stirring in protests, can occasionally start to sound almost as oppressive as the old paradigm. The passionate tend to bear the Olympian torch of a shiny new vision and this is exciting, necessary and thrilling. But I know from times when I have lived in a state of intense brooding passion for change that I become rather bullying of anything that gets in the way of me and my beloved cherished vision or craved over outcome. I find it good to mother my anxiety and sit with it and not try to outrun it but respect it as a still small voice within me that just wants to cry at my own life’s experience of rotten unfairness. Once the anxiety reduces, I can better enjoy the passion for change and take up the activist flame with a more cheerful vigor.

        Activists come in all shapes and sizes and personalities and trying to steer it all in a homogenized gloop of consensus opinion gets so fraught, because what heals me may harm another, and what heals another may harm me. Bickering breaks out and this in itself feels harmful and unsupportive and increases anxiety. This doubling and trippling of anxiety continues until the comments section resembles the coming-adrift costume of a pantomime horse, with the upper part going one way and the nether part going another way.

        I think the best healing is for everyone to feel welcome to follow what feels true and right for themselves. There is a similar thing going on with some gender activists wanting to almost typex out the word “woman” as a legal definition. To those impassioned activists in such gender circles the word “woman” seems yo offend and exclude them as that is not the vision of the new paradigm they want. They want a paradigm where there are no acceptances of healings that they regard as harmful. But to many women the word “woman” is innocuous and healing for them, even though they did not invent that word but were given it regardless and even though it is a word still used to oppress and even beat them. In this world grown giddy with word wars, where suddenly any word can be the making or the breaking of you, I refuse to play. I think I just want left alone to sing my own song in my own words. When the wish for consensus power costs you your individual preferrence for your familiar language does it any longer feel like power? If it doesn’t why want it?
        These thoughts I pondered today as I washed my dishes…as a natural born “woman”.

  15. 2 comments, one more psychological, one more physical:

    This article would have greatly benefitted from analyzing Freud’s work through Dr. Carl Jung’s work & his relationship, interpretation, & understanding of Freud’s life/work. For example, Jung’s notions of the personal (largely via Freud) & collective (via Jung) unconscious, relationship of both the psychogenesis & neurology of schizophrenia, neuroses & psychoses, the movement away from Freud’s ‘psychoanalysis’ to Jung’s ‘analytical/complex’ psychology in the broader field of ‘depth’ psychology. As well as comparing & contrasting the notions, research, & experience of psychosis vs ‘individuation’, spiritual experience, archetypes, & dreams.

    The fact that there was NO mention of Jung borders on ignorance, certainly unfortunate. I suggest his book The Psychogenesis of Mental Illness and his specific essays & letters on Freud’s work and Jung’s relationship/ex-relationship with Freud.

    Here, I would prefer not to have an extended discussion on the ‘reality’ of ‘mental illness’, although I will try to briefly qualify my statements below.

    The authors suggest there are no scientific ‘findings’ on specific brain abnormalities in schizophrenia, but they emphasize ‘exclusively’, while they give credence to some people that have/are labeled with schizophrenia do show certain ‘neuropathological abnormalities’, just not in ‘most’ and are not ‘exclusive’ to schizophrenia (which they still accept IS a DISORDER, usefully subsumed under one term). Here I would refer to Dr. Hoffer’s & Dr. Osmond’s work on schizophrenia, which generally considered schizophrenia as a ‘syndrome’, not always a single ‘disorder’. Rather a syndrome that has many etiologies, but a possible common end-pathway, though most are connected with chronic pellagra & vitamin B3 dependency. On the authors statement that a ‘majority of those diagnosed with schizophrenia show no neuropathological abnormalities at all’: the ‘majority’ of people ‘diagnosed’ aren’t ‘studied’ (let alone completely & competently) so they can’t ‘show’ anything. Nor does this postulated ‘population’ consist of those who ARE’NT diagnosed.

    One reason neurologists haven’t understood why the same ‘disease’ shows such heterogeneity of symptoms is partly a false pretense, assuming there is one disease, ‘schizophrenia’. My impression is neurologists aren’t equipped to study the psycho-social-environmental-political contexts of their ‘disease’ inquiries, so no wonder they are often stumped, & the authors do a fair job of realizing this, without following up on ANY neurological leads, which granted, are so much of a jungle, with so many false trails in an already infinite matrix of the nature of the human body. The authors feel comfortable using the phrase and judgment of a ‘significant percentage of schizophrenic patients recover…..’, reinforcing that ‘it’ is a ‘population’. This comment is made in regards to using psychotherapy ‘only’ as a means to ‘recover’, recovery here being assumed to be easily understood and measured/evaluated; although the reference that the article links does put ‘patients’, ‘schizophrenia’, ‘mental health’ professionals, & ‘recovery’ in quotation marks, so this suggests a great sensitivity to these areas. The MiA authors say ‘a significant percentage of schizophrenic patients recover with the sole aid of psychotherapy’, and it’s not clear to me what ‘significant’ could mean here. The notion of psychotherapy being ineffective as a ‘sole treatment’ of schizophrenia has long been used as a sign that it IS schizophrenia, in that psychotherapy ISN’T properly effective for schizophrenia. However, psychiatrists like Hoffer suggested that ‘schizophrenia’ has a 50% ‘natural recovery’ given good food, good shelter, & dignity/respect. This, while not explicitly including psychotherapy, no matter what type of ‘psychotherapy’ we are actually talking about. Jung felt the same to a degree, yet both were not convinced nor optimistic that many ‘cases’ of schizophrenia could be dealt with so easily. They each used the word & diagnosed ‘schizophrenia’, studied ‘it’ in hospital, in-office, historically, and in the larger society. Unfortunately, they readily used the descriptor ‘schizophrenic patient’. (Note, so do the authors of this MiA article). Yet upon close analysis, Hoffer & Jung had a remarkably complex & nuanced view on all this, helped—really helped—many people, & largely transcended stereotypes while questioning their own many assumptions.

    Having said all this, I am fully aware that I have skipped over & not qualified many of my statements, suggestions, and references, although I have tried. Any reality, social construct, conventional & unconventional ‘treatments’, & total contexts of schizophrenia & psychosis are EXTREMELY complex, any one angle being enough to fill a lifetime of either lived experience or research, or BOTH. So much is open-ended if not apparently closed. I haven’t had to arrest or imprison people like the Unibomber (was he diagnosed simply with ‘schizophrenia’?), nor have I had to involuntarily commit a ‘gravely disabled psychotic patient’ in a hospital. I hope to do my work on these issues in other roles and by different means. Sometimes I’m glad I can think & reflect on all this at all, rather than deliver pain & control as a means AND an end to this issue.

    I hope someone gets my drift here.

    • Evan, I think this is very close to my own understanding of the multiple etiologies and, indeed presentations, of what is currently labeled schizophrenia. It seemed a few years ago that there was going to be a shift in thinking, with researchers declaring schizophrenia amounted to at least nine different diseases/disorders. Except that push seems to have stagnated since. My own knowledge on this has expanded since my lyme diagnosis as schizophrenia is one of the many misdiagnoses of people with tick borne diseases like lyme and especially bartonella. And being infected with more than one TBD is the norm rather than the exception. But most patients who manage to get treatment for lyme do not also receive treatment for the additional organisms they are infected with, contributing to the ongoing symptoms many of us continue to live with. It is unfortunately very common for lyme patients to receive one or more psychiatric diagnoses, including schizophrenia. This contributes to the delay in diagnosis and treatment of the underlying infections causing the psychiatric phenomena. And the failure to treat for co-infections can contribute to ongoing psychiatric labeled illness. I continue to regard myself as lucky to have gone down the DID/Bipolar pathway rather than the schizophrenia pathway, if for no other reason than the doses of neuroleptics are usually much lower for those labeled bipolar than for schizophrenia.

      One of the things in the literature on psychotic disorders that I find especially intriguing is the connection between those disorders and CVD. I suspect a great deal of that is directly due to the social and medical factors that strongly influence those so labeled. The lack of self-care that heavily drugged individuals tend to exhibit seems to be strongly causative from my viewpoint. Interestingly, though, I have independently noticed that when my episodes of derealization are strongest also tends to correspond with noticeable cardiac effects. Since I have been off the drugs for nearly five years, lead a fairly active lifestyle, haven’t smoked in over a decade, and my episode of pericarditis was diagnosed and linked to the active lyme infection, I have no reason to believe that lifestyle factors are related to the cardiac effects I am dealing with. But I am clearly having cardiac involvement in conjunction with the times when the mental effects are worst. Usually severe joint pain follows within a few days. This leads me to believe that I am indeed living with ongoing infection. (I’d like to point out that I received standard lyme treatment of 30 days of doxycycline and NOT IDSA’s own recommended treatment of ceftriaxone infusions for nervous system disease which cardiac involvement always indicates. Like most lyme patients, I was undertreated for the stage of disease I presented with.) So now two years after my lyme treatment, I am slowly deteriorating again back to as sick as I was physically when I was first diagnosed with the lyme. And mentally it isn’t much better.

      So I guess what I’m getting at is that it is frustrating to me to see the sort of either/or approach to these experiences – that they are either psychological or physical. I suspect for many people there is a great deal of overlap between the physical and psychological depending on the specific etiology of the mental experiences. I appreciate that you point out Dr Hoffer’s work on pellagra and B3 deficiency. I get excited myself when I read new advances in understanding on the connection between inflammation and mental experiences as the primary effect of TBD infection is widespread inflammation. I am hopeful that the study of long-Covid will usher in greater understanding of acute and post-treatment infectious diseases and their mental effects (also seen in PANSS).

      I often hear pushback of the trauma/psychological model of psychotic disorders from those with lived experience who claim to have no experiences of severe trauma and don’t believe that is the source of their experiences and my immediate thought is of the other known etiologies of these effects and so I feel a great deal of sadness at the lack of will in the medical/psychiatric community to find what is actually effecting the person from the long list of potential causes that could potentially be treated and bring the person back to a state of health. It also causes me some distress to see the demands for the right to be mad when I believe many more of us could and should be demanding the right to be well – to have our physical illnesses treated appropriately and without psychiatric labeling or drugging. I am not mad. I am lucid and aware of what is happening to me, including mental deterioration during flares of physical illness with lyme symptoms. And like a great deal of lyme patients, being taken seriously and receiving appropriate treatment by a doctor who takes insurance (because so many LLMDs do not) is proving to be a cruel joke.

      I guess you could say I’m on a mission to raise awareness that the presence of physical illness in psychotic disorders merits treatment of the underlying physical illness and not merely attempts to suppress the mental effects (either through psychology or psychiatry) in order to make the person in an extreme state less problematic to the community. Psychiatric drugging will never truly treat the known physical causes of psychotic symptoms and they don’t appear to be very effective for the effects of psychological trauma either. Nor will psychotherapy or mad pride treat ongoing infection or vitamin deficiencies or genomic errors or the host of other known causes of these effects.

      Some days I just feel like giving up because I feel like there is no place for me, that my experiences of trauma, of psychiatric oppression and of ongoing physical illness are too contradictory to various communities to make me an effective advocate for anything. All I really want is to feel better and to help others do the same without being labeled and drugged by one group of dogooders or told there is nothing wrong with me by another.

      Long-winded way of saying I appreciate your analysis here.

      • kindredspirit,

        For some reason I wasn’t notified that you responded, and I found your comment after sort of randomly checking my original post; sorry about the delay. I’m glad I rechecked!

        That is all very, very interesting what you say. I resonate with so much of it. I certainly wish you good luck and strength with your complex nexus.

        I want to clarify two things though. I really referenced ‘chronic’ pellagra and vitamin B3 ‘dependency’, both of which are related to but technically different from standard pellagra and vitamin B3 deficiency. The Hoffer, et al, literature on all these differences are really interesting, and the work is virtually never mentioned in ‘conventional’ circles and outlets.

        Thanks for your response.

          • A number of people have been saying they are not receiving notifications despite being subscribed to an article’s comments section. James is aware of this and is working on figuring it out.

          • Generally, yes. If something doesn’t show up and I haven’t sent you a note, by all means, check in with me. Sometimes I think I’ve approved things that somehow don’t get approved, and sometimes I forget to write the note to ask you to explain. It is rare that I change or remove something without connecting with you in some way, so please check back in with me if you are wondering what happened.

      • kindredspirit,

        I’m not sure you received my response because I didn’t receive yours at the time due to a glitch in the commenting section. I just wanted to put in this notice 2 weeks later to try to make sure you got it. Thx

  16. @Kindredspirit, I must say that I am sorry you have suffered from lyme disease and got gaslighted by medical professionals you say and diagnosed as schizophrenic. A misdiagnosis like this which then gives you the wrong treatment can be tantamount to medical negligence. As someone with a friend whose husband died of lyme disease I can appreciate the seriousness of the need to clinch the diagnosis speedily. You should never have been put on vile antipsychotics. I am convinced your pericarditis was likely caused by the neuroleptics but I am no doctor. I got pericarditis from those drugs. I understand how it feels to have your bodily symptoms met with the insistence it is all in your head. It is devastating to call upon medical help and be treated like you are the problem when you are sane and reasonable.
    I hope you continue to explore any avenue of proper treatment that will ease your lyme disease.

    I won’t get into a chat about mad pride as I do not know much about that movement, so I don’t know what my response would be. But speaking only for myself and nobody else, I feel my madness is the most healing place for me just now. My “mad” is my “well”. I do not especislly want to be encoursged to be anyone elses idea of “well”. I do not enjoy feeling ill and tormented by my schizophrenic intrusive barrages but I am as yet not convinced that these come from brain or mind but from something I call spirit. I do not mean possession or anything like that, even though my hallucinations do imprison me, but that the symptoms of hallucinations come from a weary soul, my own weary soul. My exhausted battling jaded spirit. I do not believe my schizophrenia has a physical or mental cause but is more like “a real disease” of my tired spirit. I have more of an Amazonian tribal Shaman’s outlòok. If anyone were to visit far flung indigenous peoples on our planet, one may find that in the queues to see various Shamans, folks would name their own private bodily or mental ailments according to their personal familiar pet words or choices. An Inuit person might call their hangover headache by a name that a Polynesian person would be appalled at. A Siberian reindeer herder might call their stiff shoulder something that a Cypriot might shudder at. And as individuals, much like children conjure up names for bodily places, we name our own illnesses in whatever way pleases us. It is fine to want people to not use descriptions of themselves that have alot of baggage, but if the person themselves is quite happy to call their illness a name nobody else likes I do not think it is up to anyone else, from Polynesia or Alaska or Siberia or where ever else in the massive world to judge. I do not think a person with lyme disease would welcome a comment that read “I just want to help people realise they have other options for their ‘so called labelled lyme disease’. Really anyone who is an adult should feel unembarrassed to use whatever name they wish for their own body and their own illness or disease. I think everyone has the memo about how the psychiatric system denigrates people by dishing out iffy diagnosises. Those who don’t want to describe themselves in such and such a way need not ever regard themselves in that way. Those who want em can keep em.

    But I shall end here. The main thing is you have my sympathy for your having lymes disease.

    • DW, thanks. Though I’ll clarify that I wasn’t actually diagnosed with schizophrenia, just strongly warned that I would be if I went to a certain medical institution that didn’t believe in dissociative disorders. Funny that I reject those now as well, and I can’t help but notice the timing of my DID diagnosis coming so close on the heels after I was polydrugged.

      My point about schizophrenia is that it seems clear that a significant portion of that population is living with some kind of treatable medical condition and that if doctors would pay attention to what is going on in the body, more of those folks could be properly treated and regain their lives. Although the results of certain psychotherapeutic interventions like Open Dialogue make it clear that another significant portion is dealing with something psychological/spiritual. In any case, what psychiatry has to offer is not medical care or psychological support but instead labels and altering brain chemistry – neither of which is a treatment of the underlying issue.

      I think it’s also really important that the diagnosed individual retains the agency to make whatever meaning they can from their experiences. It is never my intent to cause someone upset by sharing my thoughts on the greater political ramifications of certain beliefs. Your point is well taken that at least those commenting here have gotten the memo about Psychiatry’s Book of Libels. But I find myself regularly either holding my tongue or starting a dialogue with people close to me about psychiatry, the labels and the drugs, when they start talking about their “mental illness” and their “medications”. And it is clear that the mass delusion about such – at least the way such phenomena are explained by the APA and their DSM – is alive and well. The general public seems to still be under the spell. Certainly, those in positions of authority are happy to wield the labels to maintain control. It’s just in my nature at this point to challenge beliefs about the diagnoses when I see them coming up. But, if the label works for you, by all means. I have certainly had times in my life where I embraced them as well and I understand their utility. It isn’t my goal to remove agency from anyone and I regret that attempts at dialogue – which for me are for the purpose of understanding, no necessarily convincing – become far more adversarial in these pages than they might if we were just sitting over coffee discussing opposing viewpoints, which I think we need to do more of even when it’s uncomfortable.

      As for the lyme, it is maddening in that it is another instance where a medical society is impeding progress. The IDSA acts as a gatekeeper to proper treatment with their long outdated lyme treatment guidelines that are woefully inadequate and downright antiquated just as the APA acts as a gatekeeper for better and radically different care for those in mental distress. I’d go so far as to say there is a lot of appallingly harmful medicine (and medical research) being practiced in pursuit of profit. It’s hard to even blame the individual doctors who have been taught erroneous concepts in medical school and have them reinforced by their respective medical societies. And doctors who have taken the risk to treat patients more aggressively outside of the accepted guidelines have lost their medical licenses. In fact, that is still happening and just did last year to a lyme literate physician in Virginia. And we all see how some professional critics of psychiatry have been ostracized and shamed as at best looney and at worst actively harming people and making people afraid to “seek help”. So I think it’s prudent to be aware of the interests that keep doctors in line as well. You’ll notice that most of the outspoken critics of psychiatry are retired or near the end of their career and no longer have to worry about censure and losing their livelihood for standing up to these Goliaths.

      I did not know that the neuroleptics can cause pericarditis though I can’t say I’m surprised. I’m sorry you also know what it’s like. I remember it being terrifying not being able to breathe when I lay down. But I was years off of the drugs when I developed pericarditis. My case was the result of a hapless urgent care doctor not understanding my massive wrist swelling and throwing drugs at it. The lesson to be learned is that you never treat a bacterial infection with steroids. Or at least not on their own without antibiotics. The steroids suppress the immune system allowing the bacteria to grow out of control. On the other hand, that appears to be what made me sick enough to get properly diagnosed. I had a smoldering infection for many many years (with the medical receipts to prove it), which is the common course for late lyme patients as psychiatric effects are the most common presentation in adults with lyme.

      Anyway, I’m so sorry about your friend’s husband. Suicide is the number one cause of death for Lyme disease. Heart failure and sudden cardiac death are also common among those with late diagnoses. Cancer is also frequent due to the inflammation from active infection and a damaged immune system. The announcements of deaths of well known figures with Lyme come far too frequently to the community. I suppose I know that my days on this earth are numbered even with treatment. Between the damage from years of psych drugging and ECT, poorly treated Lyme and now Covid – which ran through the house in January – this body is just tired.

      I keep raising awareness primarily because the impact of this disease gets far too little coverage in psychiatric reporting – even here at MIA – despite millions of new infections every year feeding fresh victims into the psychiatric system, and medical propaganda that insists lyme is both easy to treat and that the post-treatment symptoms are evidence of psychiatric illness definable by the DSM. The same has been used on those with CFS after Epstein-Barr reactivation and is now being declared about “post-Covid” patients. The bottom line for me at this point is to pushback against narratives that keep people ill – a “mad” identity will never cure a systemic infection, though it may make an individual feel better, at least for a time, about emotional and behavioral effects they don’t understand. And like I said, I’m all for people making meaning of their experiences. But I want to remind that there ARE physical causes of psychiatric effects beyond the typical thyroid and immune diseases and that those people deserve proper medical care that doesn’t dismiss us as psych patients. Although, as one last note, I’ll point out that even when there is a physical cause, it’s common for those people to ALSO be psych treated and psych drugged under the guise that those conditions *cause* psychiatric illness. So for me, all I see is a system that insists psychiatric “comorbidity” is a thing, a system that reinforces the labels and uses the physical illnesses as a launching pad so that either way, with or without an underlying physical illness the drugs and labels are doled out like candy because it is profitable and serves a convenient narrative.

      • You are truly so sensible KS. I know you are super busy, but take time to write and I so appreciate to be able to read your responses.
        I hope you are able to continue writing for a long time to come.

        I remember long ago you made a response to something I wrote and it felt like a mild spanking, and since then, I can say that it would have been well deserved.
        Can’t even recall what it was about 🙂

  17. Beautiful, illuminating dignified, comprehensive response.

    Have you considered becoming an alternative health practitioner? You would be great at it I feel.

    If I might puff on my peace pipe and pontificate and offer my own appreciation with good intentions here, I would say that I see that for you there are three enemies.

    1.Your life erroding lyme disease illness. 2.The cruelly negligent yet bullying doctors.
    3.The indifferent, callous, stupid and easily duped society, who defend such doctors rather than your truth.

    In the midst of it all you are a warrior spinning around trying to thrust the dagger of your honesty at all these enemies to defeat them. But no sooner do you floor one of them then the other two pop up to squash you into “their” idea of the truth you suffer. And so you feel determined to crush “their” uninformed, uneducated idea of you, since all of these three enemies are combining into a big destruction of your need to not just survive but blossom in good heath. So these three enemies combined come to symbolize “death”. And all the paraphernalia associated with these three enemies also symbolizes “death”, such as the language surrounding them, be it medical jargon or societal indifference. The very words linked to these three enemies seem like the calling cards of “death”.

    Certain other people may not mind such language and their three enemies might be quite different, such as the enemy of being told they are a bad person for speaking words any way they wish to, which is something my psychosis bullies me to do and insists I do or he will kill me. My warrior moves are more focused on not letting anyone tell me how to think or what words I use. This is very similar to your warrior ways in that both of us champion the ability to assert our truth or experience without any bullying coming back at us. We are both about diminishing the scourge of bullying. It is just we do do in subtly different ways. Ways that may make us seem to one another like the enemy, the indifferent society or a cold logical bickering doctor, or a cruel disease that won’t let up.

    What I find best for me is to remain focused not on the paraphernalia or outward signs and symbols of endemic and systemic bullying but rather focus on its hidden pulse. The outward signs that send a shiver down the spine because they have come to resonate in a PTSD flashback startle are probably merely harmless paraphernalia or turns of phrase or language that “trigger” the old memory of approaching “death”. But as any veteran will say the PTSD jumpiness about the battlezone proximity of “death” may just be the harmless thud of a fridge door and not an actual danger like a grenade. Sometimes it helps to rootle around and figure out if something really is an enemy that signals “death” or is just one of the many props or behaviours or dimeanours or words that have come to symbolize it but are not actually the real pulse of bullying. It is clearer to thrash aside the brambles and thorns of symbolic death or the symbolic props a bully may use to intimidate a victim and instead observe the actual bully themselves. Actual bullies are often terribly small.

    Must go and eat my frugal food which is growing cold yet again…

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