Why Is Psychiatry So Defensive About Criticism? Part 2

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Continuing my response to a paper by Awais Aftab, MD, titled It’s Time for Us to Stop Being So Defensive About Criticisms of Psychiatry. I published Part 1 of this post on January 27, 2022.  Because the post was becoming lengthy, I decided to split it into two parts.  This is Part 2.

Part 1 ended with this quote from Dr. Aftab’s paper:

“Morehead references the 2012 paper by Phillips et al on conceptual and definitional issues in psychiatric diagnosis.20 This article highlights some of the most prominent names in philosophy of psychiatry and reveals the philosophical difficulties that surround the notion of mental illness and the elusiveness of a satisfactory definition. This has been a topic of interest to me for many years, and my own philosophical work in this area reflects the conceptual inadequacies of our notion of mental illness.21″

My position is that the definition of “mental illness” is not at all elusive, and that whatever conceptual inadequacies exist in “our notion of mental illness” are deliberate obfuscations on the part of psychiatrists.

DEFINITIONS

The definition of an illness is:  a condition of the body that entails subjective complaints and history; clinical signs; and abnormal and characteristic lab, radiographic, or other objective findings.  Or, to put it more simply:  a reliably identifiable flaw or deficiency in the structure or function of one or more bodily organs.

I realize, of course, that there are some psychiatrists who claim that this is not an accurate definition of illness; that the true definition of illness is:  any condition that entails a significant degree of suffering or impairment.  I’ve discussed this issue several times in various posts, and have no wish to rehash this material further.

But let me simply make this point.  Over the past 20 years, I have personally experienced a great deal of serious illness, including total kidney loss, chronic peritonitis, etc.  I have received treatment and consultations from literally dozens of physicians.

A good deal of the work done by these physicians concerned the diagnosis of my various problems, many of which are still ongoing.  And this diagnostic work was always focused on:  what is going wrong?  what organic pathology is creating these symptoms, and, of course, what can we do to ameliorate the problem?

Indeed, through all these treatments and consultations, I have never encountered a physician – nor even heard of one – who adhered to the distress-or-impairment definition of illness favored by most psychiatrists.  I suspect that if I had asked any of these individuals “what about the definition of illness as something that entails significant personal distress or impairment, but does not require any structural or biological impairment?” they would have pursed their lips thoughtfully, coughed politely, and changed the subject.  Real physicians are generous with their time, but most are also skilled at deflecting inanities and keeping discussions to the point.

And this is the critical point:  Psychiatry is a hoax, in that most of the human problems that it purports to treat aren’t real illnesses.  Psychiatry, over the past several decades, has “solved” this problem by the simple expedient of adopting an unorthodox definition of the term illness – a definition that requires no evidence whatsoever of organic or systemic pathology, and voila – out of nowhere, they have not only a slew of “valid” psychiatric diagnoses, but a license to create as many more as they choose, which has been psychiatry’s main endeavor for the past seventy years or so.

Just as there are a limitless number of ways to incur feelings of distress or impairment, so there are a limitless number of “mental illnesses” that psychiatrists can, and do, conjure up, in their relentless drive to grow their businesses and enhance their sense of self-importance.

For instance, there are a great many people here in the US who are distressed by the destructive and illegal insurrection that occurred on January 6 of last year.  It would take just a little help from the APA’s PR consultants to turn this distress into a new mental illness:  Insurrection Phobia.  We could also have COVID Phobia; Mask Phobia, and even Ukraine-invasion Phobia.  In many parts of the Midwest we could have Wildfire Anxiety Disorder; and also Groundwater Depletion Phobia.  And in other parts of the country, I’m sure people might have Rising Sea Phobia, or Tornado or Hurricane Phobia.  And the widespread concern about rising prices could be morphed, with little difficulty, into Inflation Phobia, or even Supply Chain Problems Phobia.  And so on.

But I digress.  I’ve set out above the definition of illness.  But what about mental illness?  How can we capture this “elusive” phenomenon in a definition.  Well, as I mentioned earlier, the definition is not at all elusive.

Mental illnesses are illnesses (as defined above) whose primary symptoms are confined to problems of thinking, feeling, and/or behaving.  The term “mental illness” embraces:

Intellectual Disability due to Brain Problems;
Multi-infarct Dementia;
Dementia due to other brain problems, including injury;
Various brain problems (temporary or permanent) associated with ingestion of, or withdrawal from, a psychoactive substance (e.g. Cocaine Delusional Disorder, Alcohol-induced Hallucinations, etc.)
Other significant problems of thinking, feeling, and/or behaving that have clearly been caused by organic or systemic pathology.

All of these items are listed in the various DSMs and are real illnesses.  In addition, they primarily affect mental processes.  So they could be called real mental illnesses, though I personally favor the term “brain illnesses”, in that the pathology is primarily based in that organ.  Traditionally brain illnesses have been the province of neurologists with one exception:  those brain illnesses that impair mental processes (thinking, feeling and behaving) have been seen as the province of psychiatry, while neurology deals with all the rest.

So, if psychiatry had confined its assertions to what was known instead of flagrantly asserting the validity of their irresponsible, self-aggrandizing speculations, they might have a respectable profession today.  But, to state the obvious – they didn’t.  They allowed their aspirations to run rampant, and having discovered how easy it was to invent diagnoses in this particular field, they abandoned whatever initial principles they might have had and went on a rampage of destructive fabrication which continues to the present time.

In addition, the psychiatric “treatment” that they have afforded to people suffering from dementias and intellectual disability due to brain damage has consisted largely of prescribing drugs to make them more “manageable”.  This, coupled with their avid support and promotion of the various spurious neurochemical imbalance theories, casts enormous doubt on their collective fitness for any kind of health-related role.  For these reasons, I would prefer to see these brain illnesses transferred to the ambit of neurology.  How these matters will work out, only time can tell.  But at present, recruitment into psychiatry is down, which is a positive sign.

FUNCTIONAL MENTAL ILLNESSES

It follows clearly from all this that psychiatry’s functional mental illnesses have no validity whatsoever.  This is because they are not actually illnesses.  They are merely loose clusters of vaguely-defined thoughts, feelings, and behaviors, with no clearly defined or characteristic etiology.  They were simply made up by psychiatrists to provide the appearance of a nosology as a peg on which to hang their billing codes.  Let’s see if we can elaborate on this further by examining “Major Depression”, which is one of the most frequent diagnoses used by psychiatrists at this time.

MAJOR DEPRESSIVE DISORDER

The DSM-5 criteria for this “diagnosis” are five or more hits out of nine on a facile, unvalidated checklist plus the requirement that “the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.” (p 161)

As is the case in most DSM “diagnoses”, the criteria items are extremely vague.  For instance, here’s item 1. “Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)” (p 160)

How much of the day is “most of the day”? how often is “nearly every day” – 6 days out of 7? 5 out of 7? 4 out of 7?  Can a person who is heart-broken or despondent even provide information of this sort?  And how in the world can a child’s irritability be considered an indication of depression?  Irritability is much more likely to be an indication of hostility, passive aggressiveness, or rebellion than depression. So why is childhood irritability considered a sign of depression?  Because psychiatrists say so!  There is no validity to this whatsoever.  Just good old-fashioned psychiatric arrogance.

Here’s item 2:  “Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).” (p 160)

How diminished does one’s interest or pleasure have to be to be considered “markedly diminished”?  Whose observation is considered accurate?  A family member?  A colleague?  A friend?  The psychiatrist?

The fact is that most psychiatric diagnoses of depression are made by interviewing the client and possibly a short interview with a collateral informant if the client has brought someone to the office for support, moral courage, etc.  What’s often overlooked in these matters is that there is enormous pressure on the potential client and the friend to endorse the items /questions put by the psychiatrist.  A person who has taken the step to consult a psychiatrist realizes that he/she has a problem, and is vulnerable to any suggestions as to the seriousness or source of the matter.  People aren’t stupid, and it wouldn’t take a person too long to figure out what kind of response was needed to the psychiatrist’s questions to ensure enrollment as a “depressed patient”. As obvious as this is, I don’t ever recall meeting a psychiatrist who displayed much appreciation of these dynamics.

Besides, questions always have the potential to be interpreted, especially by people who are feeling vulnerable, as challenges or even threats.  Many years ago I had the privilege of studying for a short while under the direction of the late psychotherapist Theodora Alcock.  One of Theodora’s favorite maxims was:  “Ask no questions, and you’ll be told no lies.”  In other words, don’t grill or interrogate your client in a third-degree fashion.  Instead, just chat and allow the clients space to tell their stories at their own pace and in their own words.  And never use a DSM cheat sheet to check off the criteria items as they are being endorsed by the client.  Of course, this kind of in-depth interviewing is not compatible with the 15-minute med checks that have become the established norm in present-day psychiatric care.

THE ORIGIN OF THE DSM CHECKLIST

In 1972, John Feighner, MD, a psychiatry resident at Washington University, St. Louis, co-authored an article titled Diagnostic Criteria for Use in Psychiatric ResearchIt was published in Archives of General Psychiatry (Vol 26, 1972).  AGP later became JAMA Psychiatry.

Here’s the abstract:

“Diagnostic criteria for 14 psychiatric illnesses (and for secondary depression) along with the validating evidence for these diagnostic categories comes from workers outside our group as well as from those within; it consists of studies of both outpatients and inpatients, of family studies, and of follow-up studies. These criteria are the most efficient currently available; however, it is expected that the criteria be tested and not be considered a final, closed system. It is expected that the criteria will change as various illnesses are studied by different groups. Such criteria provide a framework for comparison of data gathered in different centers, and serve to promote communication between investigators.” [Emphasis added]

Note firstly that the term “illnesses” occurs twice in the abstract, and it is clear both from the abstract, and from the later text, that the notion that psychiatric problems are illnesses is an a priori assumption, not something that has ever been proven.  In fact, in DSM-I, the various non-organic entries were referred to as reactions (to psychosocial stressors) rather than illnesses or disorders (schizophrenic reaction; anxiety reaction; depressive reaction; etc.).  The term “reaction” was slipped quietly to the wings in DSM II (1968) as part of the ongoing psychiatric effort to medicalize their diagnoses.  It’s difficult to maintain the fiction that one’s “diagnoses” are primary illnesses while, at the same time, referring to them as “reactions to psychosocial stressors”.

Feighner et al specified five phases for establishing diagnostic validity in “psychiatric illness”.  These are:

  1. Clinical description
  2. Lab studies, including chemical, physiological, radiological, and anatomical findings.
  3. Delimitation From Other Disorders
  4. Follow-up Study
  5. Family Study

Feighner et al mention that lab studies “are generally more reliable, precise, and reproducible than are clinical descriptions”.  They also point out that:

“Unfortunately, consistent and reliable laboratory findings have not yet been demonstrated in the more common psychiatric disorders.”

a state of affairs that continues to this day.  And later in the article:

While no psychiatric syndrome has yet been fully validated by a complete series of steps, a great deal of work has been published indicating that substantial validation is possible.” [Emphases added]  Note the word “possible”!

Feighner et al go on to provide tentative diagnostic criteria for thirteen psychiatric “illnesses”.  Earlier they had stated very clearly:

“These criteria are not intended as final for any illness.  The criteria represent a distillation of our clinical research experience and of the experiences of others cited in the references.  This communication is meant to provide common ground for different research groups so that diagnostic definitions can be emended constructively as further studies are completed.” [Emphasis added]

Here are the authors’ criteria for a “diagnosis of depression”:

Depression.– For a diagnosis of depression, A through C are required.
A. Dysphoric mood characterized by symptoms such as the following: depressed, sad, blue, despondent, hopeless, ‘down in the dumps,’ irritable, fearful, worried, or discouraged.
B.  At least five of the following criteria are required for ‘definite’ depression; four are required for ‘probable’ depression. (1) Poor appetite or weight loss (positive if 2 lb a week or 10 lb or more a year when not dieting).  (2)  Sleep difficulty (include insomnia or hypersomnia).  (3)  Loss of energy, eg. fatigability, tiredness.  (4)  Agitation or retardation.  (5)  Loss of interest in usual activities, or decrease in sexual drive.  (6)  Feelings of self-reproach or guilt (either may be delusional).  (7)  Complains of or actually diminished ability to think or concentrate such as slow thinking or mixed-up thoughts.  (8)  Recurrent thoughts of death or suicide, including thoughts of wishing to be dead.
C.  A psychiatric illness lasting at least one month with no preexisting psychiatric conditions such as schizophrenia, anxiety neurosis, phobic neurosis, obsessive compulsive neurosis, hysteria, alcoholism, drug dependency, antisocial personality, homosexuality and other sexual deviations, mental retardation, or organic brain syndrome. (Patients with life-threatening or incapacitating medical illness preceding and paralleling the depression do not receive the diagnosis of primary depression.)”

It is noteworthy that these nine criteria (A, and B 1-8) are essentially the same as the nine criteria for major depressive disorder as listed in DSM-III through DSM-5.  In many cases the wording is almost identical.  The requirement of five “hits” out of the nine criteria is also a feature of the DSM’s.

So, although Feighner et al stressed that their criteria were provisional, and would need amendment in the light of further studies, the same criteria are being used to this day, 50 years later.  So either Feighner et al were unbelievably lucky or, no progress whatsoever has been made in the endeavor to create a scientifically validated nosology from Feighner et al’s tentative beginnings.  In addition, DSM-5 (2013) acknowledges that “…no lab test has yielded results of sufficient sensitivity to be used as a diagnostic tool for this disorder [major depressive disorder]” (p 165).  DSM-III; DSM-III-R; DSM-IV, and DSM IV-TR have all made similar acknowledgements, not only for major depressive disorder, but for the vast majority of the other so-called diagnoses.

In other words, the notion that “major depressive disorder” is a bona fide illness is nothing more than a working assumption adopted by Feighner et al and others in the late 60’s and early 70’s to make psychiatry seem like real medicine.  Psychiatry has made no progress in validating its criteria for this loose grouping of vaguely-defined thoughts, feelings, and behaviors.  The lab tests and other characteristic biological markers that psychiatrists at the time insisted were “just around the corner” didn’t materialize – and still haven’t materialized.  This is what Thomas Insel, MD, then the Director of NIMH, meant when he stated publically, in 2013, with regards to DSM diagnoses:

“While DSM has been described as a ‘Bible’ for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been ‘reliability’ – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.” (here) [Emphasis added]

The fundamental basis of psychiatry – that it treats real illnesses – is still just an unproven assumption despite a staggering expenditure of money, effort, and cognitive acrobatics to try to prove otherwise.  But the real illness (“just like diabetes”) fiction is crucial to psychiatry’s credibility.  Once this fiction is exposed, it becomes obvious that they are simply providing mind-altering fixes in the same manner as the street-corner vendors: “something to help you feel better”.

DEPRESSION AS AN ADAPTIVE MECHANISM 

(I have written in more detail on this topic in an earlier post.)

Far from being an illness, depression is actually an adaptive mechanism.  It is nature’s signal that something is not going well in our lives.  Just as pain provides a signal that tissue is being damaged, and encourages us to take prompt remedial action, so depression alerts us to the fact that we need to take analogous measures with regards to relationships, lifestyle, goals, etc.  Depression is an unpleasant feeling and it is only natural that we would want it to end.  We want the pain to stop precisely because it is unpleasant.  And if we don’t or, for whatever reason can’t, take appropriate remedial action, then the pain of depression/despondency will likely become worse, and the individual may reach the point of self-depreciating despair.

Depression is NOT an illness.  The fact is that humans are born with feeling “mechanisms”.  There are good-feeling mechanisms, that when activated induce feelings of joy and even elation; and there are bad-feeling mechanisms, that induce feelings of depression and heartache.  The good-feeling mechanism is activated when our lives are “on an even keel” and they encourage us to try to stay on an even keel.  The bad-feeling mechanisms are activated when our lives are – for whatever reason – off-kilter, and they encourage us to take steps to improve our situation.

Here are some of the ways that our lives can go off-kilter, resulting in feelings of depression:

    1. being stuck in a job that one dislikes intensely;
    2. being discriminated against (racism, gender, age, etc.);
    3. being a victim of spousal abuse;
    4. being a victim of any kind of abuse;
    5. living in substandard accommodation;
    6. living in chronic poverty;
    7. being entangled in relationships that are not helpful or satisfying;
    8. recent bereavement.
    9. family conflict
    10. chronic illness
    11. being exploited
    12. loneliness

etc.

The feelings of depression are nature’s way of telling us – in the only language that nature has – to make appropriate changes in, or adaptations to, the status quo.

Depression is not an instance of something going wrong in our brains.  Rather, it is an instance of something going right.  Tragically, the depression-as-an-illness notion which has been promoted by psychiatry for the past hundred years or so, has come to be accepted widely in our culture, and pills have become accepted as the appropriate “treatment”.  But the pills are not much better than placebos, and entail a wide range of adverse effects, some of which can be life-threatening.

Depression is not an illness.  It is an adaptive mechanism that encourages us to seek and find ways to improve our lives, realize our goals, and find a measure of peace and happiness.

Almost all of us encounter depression at some point in our lives.  Most people are able to take the appropriate remedial action either from their own resources or perhaps with the help of a close friend.  In other cases, the depression-causing circumstances are overpowering, and the individual may need additional help to resolve the problems or extricate him or herself from the depressing situation.  In this regard, self-help groups, life coaches, counselors, etc. can be particularly helpful, but in extreme cases more formal support, or even police protection, may be needed.

Tragically, there is a great deal wrong with the world.  Exploitation and discrimination abound in almost all walks of life.  Women are victimized more frequently than men, which is presumably why women report more episodes of depression than men.

I would like to say that the world is improving in these regards, and indeed in former years, I thought that this was the case.  Now I’m not so sure.  I see wealth and income gaps widening and little motivation on the part of politicians, or others in power, to do anything about this.  I see people all over the US living in tents or in their cars.

And, of course, I see psychiatry – the supposed helping profession – making a living by selling happy pills to the victims of all this exploitation, sadness, despair, and discrimination.  And even the happy pills carry warnings of suicide risk!  How do psychiatrists manage to live with that reality?  And how can psychiatrists continue to propagate the falsehood that …your depression is an illness caused by your faulty brain chemistry, and needs to be treated with our safe and effective drugs and electric shocks?

THE STATUS QUO

At the present time there are far more non-illnesses in the DSM than genuine illnesses.  Psychiatrists insist on retaining these non-illnesses in their catalog and in their practices because it’s good for business to do so.  And then they shed crocodile tears because no definition of mental illness can ever be entirely satisfactory.  Statements to this effect are included in every edition of DSM from DSM-I to DSM-5.  But the fact is that the true definition of mental illness is patently obvious – an illness whose primary symptoms are confined to problems of thinking, feeling, and/or behaving.    But this doesn’t suit psychiatry’s expansionist agenda.  The present operational definition of mental illness (i.e. the actual definition used in the compilation of the DSM and in psychiatric practice) is:  every conceivable problem of thinking, feeling, and/or behaving that can be sold to real doctors and to the general public.  Real doctors should have seen through this hoax from the beginning, and it’s quite likely that many of them did.  But as drug therapy became increasingly the norm in many areas of medicine, the real doctors realized that they could supplement their business by providing services essentially similar to those provided by psychiatrists (i.e. med checks).

Psychiatry’s expansion of its turf has been decades in the making.  They had to remove the notion of pathology from their definition of illness.  This they accomplished by the simple expedient of declaring that pathology as such is not needed for a condition to be called an illness.  All that’s needed is significant levels of distress or impairment in one or more areas of functioning.  Once that was done, and was widely accepted by real doctors and by the general public, the next step was to grow the DSM to include an ever-increasing number of new mental illnesses.  They simply had to remember to include distress or impairment in the definition, and voila – more business.  And their latest complaint is that there’s so much business out there that they cannot keep up with it, and many “patients” have to resort to GPs for their psychotropic prescriptions.  Oh dear!

Back to Dr. Aftab:

“Morehead says that ‘the time has come for all psychiatrists to consistently speak out on behalf of our patients.’ Indeed, it has, and I would add that we can only do so genuinely and meaningfully if we also speak out on behalf of our patients who have been harmed by psychiatric care. Not only that, but we should go a step further and facilitate the process of empowering our patients to speak for themselves—as is the goal of the service user and lived-experience communities, as well as movements such as neurodiversity and mad pride.”

Note that Dr. Aftab concedes that some psychiatric “patients” have been harmed by psychiatric care, but doesn’t offer any estimates of the numbers involved.  Nationwide, are we talking about ten people, a hundred people, a thousand, more than half, or the great majority:  And how severe is the harm?  Negligible?  Mild?  Moderate?  Severe?  Life-threatening?  In this sort of context, the prevalence and severity of the problem are fundamental.  However, Dr. Aftab has conceded that some psychiatric “patients” have been harmed by the care they have received, and this is an important and honest admission.  It’s not entirely new.  Other psychiatrists have been writing and saying similar things for decades.

In the same paragraph, Dr. Aftab also writes:

“Not only that, but we should go a step further and facilitate the process of empowering our patients to speak for themselves”

But why limit ourselves to just one step further?  Why don’t psychiatrists routinely help their customers figure out why they’re depressed or habitually inattentive, etc.?  Why have they effectively barred such questions from the process known as psychiatric care?  Why do they routinely leap to the false, and indeed inane, conclusion that any episode of depression which meets or exceeds the facile and unvalidated five out of nine DSM criteria items inevitably indicates a brain illness which has to be “corrected” with anti-depressant drugs?

We know that depression, far from being an illness, is actually an adaptive neuro-mechanism, whose purpose is to alert the individual to the need to make changes.  But one can’t help people make fundamental life changes without first assessing what needs to be changed.  What incidents have occurred, or what abiding adverse circumstances are present in the person’s life, that are precipitating these kinds of negative feelings?  The assumption that the neuro-mechanisms are simply broken, is not only false, it is stigmatizing, disempowering, and destructive.  Yet this assumption is encased in the fifteen minute med check for the simple reason that psychiatrists can double their incomes by adopting the latter course.

SO WHAT’S NEEDED?

I have written many times that psychiatry is essentially a wrong turning in human history.  The pivotal moment occurred when decisions were made in both Europe and America to place medical doctors in charge of the asylums.  The notion was that this would humanize the care and lead to better outcomes.  But the results were disastrous.  Treatments were more like medieval tortures than any medical treatment, and discharge rates declined steadily.

Psychiatry has tidied up its facade considerably since then, of course, but the erroneous notion that medicine should be the primary care-giver in this area is still deeply embedded in our language, in our practices, and in our institutions.  And the results are still disastrous.  The catalog of errors has been exposed by many writers and activists, but psychiatric practitioners, with the exception of a very small minority, have remained arrogantly and self-servingly blind to these realities.

The great irony here is that the most successful period in modern psychiatry was the Moral Era, which extended from about 1800 to 1850.  Moral treatment is associated with Phillippe Pinel in France, William Tuke in England, and to a lesser extent, Benjamin Rush in the US.  Here are some quotes from Ullmann and Krasner, A Psychological Approach to Abnormal Behavior, 1975:

“Moral treatment strove to create a complete therapeutic environment – social, psychological, and physical.  Although emphasis was placed on the relationship between physician and patient, moral treatment embraced a much larger psychological approach than individual psychotherapy.” (p 135)

“Humanitarian treatment based on a psychological model and the expectation of improvement (Goldstein 1962) was a major reason for the effectiveness of moral treatment.  Reports that are available for this period (see Bockoven, 1963 and Dain, 1964) indicate a higher discharge rate than for previous and most subsequent periods of time.” (p 136)

“Moral treatment involved a way of life, a teaching program in how to make friends and develop outside interests. The goal was to help the patient enjoy life and take part in society.” (p 136)

And here are some quotes from James Coleman, Abnormal Psychology and Modern Life, 1972:

“During the early part of this period of humanitarian reform, the use of moral therapy in mental hospitals was relatively widespread.  This approach stemmed largely from the work of Pinel and Tuke and was based on the view that most of the insane were essentially normal people who could profit from a favorable environment and help with personal problems.” (p 43)

“There seems little doubt that moral therapy was remarkably effective, however ‘unscientific’ it may have been.” (p 43)

“Some recovery rates were reported to be as high as 80 to 90 percent.” (p 43)

“Despite these impressive results, moral therapy declined in the latter half of the nineteenth century – in part, paradoxically, because of the acceptance of the view that the insane were ill people.” (p 43)

“In any event, hospital statistics show that recovery and discharge rates declined as moral therapy gave way to the medical approach.” (p 44)

Similar accounts of Moral Therapy can be found in most textbooks that cover the history of these matters.

. . . . . . . . . . . . . . . .

It comes to this:  it is entirely normal for people:

  • who are victims of systemic discrimination, to lose their sense of purpose;
  • who work long hours for meager returns, to feel weary;
  • who are being exploited, to feel resentful;
  • who have been unable to afford the basic necessities of life, to feel pessimistic about the future;
  • who have been beaten down, to feel undervalued;
  • who have been unable to provide adequately for their families, to feel pessimistic concerning the future;
  • who have known nothing but drudgery and failure, to give up trying.

For psychiatrists to declare that people in these kinds of circumstances are actually suffering from an illness is essentially a condoning of the real precipitating problems, and serves as a formidable barrier to meaningful social reform.  The people and organizations that abuse and exploit and discriminate can simply say:  these individuals are ill.  They have mental illnesses.  It’s not our fault.

And as long as psychiatry and its bogus diagnoses reign, there is no counter argument that can prevail.

***

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.

44 COMMENTS

  1. I have been heartened by Dr. Hickey’s two articles and the excellent research he has provided in an effort to fight the pernicious effects of psychiatric diagnosis and the inherent psychotropic drugs that have and are causing irreparable harm.

    However, I have to take issue with the definition of “illness” as discussed here. Dr. Hickey mentions that “traditionally brain illnesses have been the province of neurologists with one exception: those brain illnesses that impair mental processes (thinking, feeling and behaving) have been seen as the province of psychiatry, while neurology deals with all the rest.” So, aside from the organic brain problems causing “illness”, we have accepted the idea of “mental illness” that causes a number of unwanted symptoms in the area of “thinking, feeling and behaving”. My contention is that none of these should be labelled as “illnesses” since the domain of “illness” is, as Dr. Hickey points out: “a reliably identifiable flaw or deficiency in the structure or function of one or more bodily organs”. Thinking, for example, is defined by the Cambridge English Dictionary as: “the process of using your mind to understand matters, make judgments, and solve problems”. NOW, we come to the essential matter–what is the “mind” and what is the connection between brain and mind? Do the chemical/electrical workings in the brain produce “thought” or for that matter, “consciousness”? Science has tried to tackle this problem without success. I suggest that this is because “consciousness”, “thinking”, “feeling” and “behaving” are areas that can only be dealt with using philosophy, especially in such areas as metaphysics, ontology and epistemology.

    It is absolutely true that psychiatry has been allowed to conjure up all sorts of spurious diagnoses to deal with what are normal quandaries in everyday life. It is also true that people have been deceived by psychiatry which has, in turn, deluded itself. But I think that there IS a counter argument and that I have stated it here.

    • Phil, thank you for this post. I am going to have my 25 first-year clinical psychology students read the Aftab article and your two replies to facilitate a critical discussion about DSM diagnoses and psychiatry’s biomedical model. Thank you for your contribution to this important dialogue. I want you to know that your work is making a difference.

      Louisa, you have identified a critically important issue in this discussion: reductionism, or how to understand the connection between mind and brain. Psychiatry’s clear contention, rarely acknowledged out loud but clearly evident in its DSM and biomedical model ideology, is that the mind IS the brain. This means a problem of thinking, feeling, and/or behaving (i.e., every DSM diagnosis) is, by definition, a brain problem. After all, there can be no mind without the brain, so what else could it be? And psychiatrists are medical doctors who treat illnesses of the body, so therefore it makes sense for them to be in charge of treating psychological problems which are fundamentally brain problems. All other “mental health professionals” are ancillary because they are not qualified to treat the core pathology. Only medical doctors can do so. This is the core philosophical assumption of psychiatry and of healthcare systems based upon this assumption like that of Australia where I live.

      This reductionist philosophy is the equivalent of assuming fussy eaters have stomach pathology, by definition, because the stomach digests food. After all, there is no eating without the stomach. Therefore, fussy eaters need to see internal medicine specialists to treat their presumably broken stomachs, perhaps with drugs, surgery, electric shocks, magnets, or whatever else might correct the presumed (yet unproven) pathology. And why wouldn’t it be so? To the extent they are even relevant, the role of a behavioral specialist is to support the doctor by teaching the client skills to manage their medical illness. And notably, faith in the presumed pathology is so strong because of this reductionist philosophy that actual evidence of pathology is irrelevant. We KNOW there is stomach pathology because it HAS to exist, philosophically, because why else would people be fussy eaters?

      It’s easy to critique my silly eating/stomach analogy. Yes, a stomach is required to digest food, but that doesn’t necessarily mean a defective stomach is to blame for being a fussy eater. Or that the most helpful solution is to intervene at the level of the stomach instead of eating behavior using established psychological principles. And it’s obvious that there are environmental explanations for being a fussy eater. And being a fussy eater isn’t that unusual, exists on a continuum, changes over time with experience, and is probably best not viewed in medical/illness terms at all. Blaming a broken stomach and using invasive stomach-based interventions to fix a presumed but never demonstrated stomach pathology would obviously be considered idiotic, not just by the medical/scientific community but by common sense.

      What’s the difference?

  2. “For psychiatrists to declare that people in these kinds of circumstances are actually suffering from an illness is essentially a condoning of the real precipitating problems, and serves as a formidable barrier to meaningful social reform.”

    I couldn’t agree more, and my personal concerns are a great example of this “condoning of the real precipitating problems.” In my case, I was psychiatrically drugged because I had concerns of the abuse of my children. An ELCA pastor had denied my innocent child a baptism on the morning of 9/11/2001, a form of spiritual child abuse, IMHO. Likely, according to that pastor’s own confession, and medical records which were eventually handed over to me almost four years later. Because that pastor was “soul mates” with the molester of my other very young child.

    These pastoral / mental health industries’ crimes did aid, abet, and empower the child molester. After the medical evidence of the sexual assault of my child was finally handed over, I was able to scare the school, on which the child molester was a school board member, into closing forever. But I was never able to get police – nor any other government agent – to actually investigate and arrest the child abusing and child abuse covering up criminals.

    And these child abuse covering up crimes are a systemic problem within both the psychological and psychiatric industries, and within the religions that have chosen to “partner” with the “mental health” industries.

    https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
    https://www.madinamerica.com/2016/04/heal-for-life/
    https://books.google.com/books?id=xI01AlxH1uAC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

    And all this systemic child abuse covering up is by DSM design, since no DSM “bible” biller may ever bill for helping any child abuse survivor.

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

    The fact that we have a “mental health” / religious industries’ systemic child abuse covering up “partnership” has resulted in America having very serious pedophilia and child sex trafficking problems.

    https://www.amazon.com/Pedophilia-Empire-Chapter-Introduction-Disorder-ebook/dp/B0773QHGPT
    https://medicalkidnap.com/2018/08/05/america-1-in-child-sex-trafficking-and-pedophilia-cps-and-foster-care-are-the-pipelines/

    Perhaps, given the fact that covering up child abuse and rape is the number one actual societal function of both the psychological and psychiatric industries, and such is illegal behavior. This may be why “Psychiatry [is] So Defensive About Criticism?” Since most of the psychiatrists literally belong in jail for their systemic child abuse covering up crimes.

    Sorry I can not imply as guiltless the majority of psychologists, Philip, since I had the misfortune of dealing with multiple child abuse covering up ELCA psychologists. But I do appreciate the psychologists who are speaking out against the scientific fraud of the psychiatric industry’s “invalid” DSM. Thank you, Philip.

  3. Psychiatrists from my lifetime experience of 50 years , either torture or threaten to torture. They never ever let you go free of them even if you imagine you are . Your history with them is permanently recorded and follows you like a shadow . For example if a person G-d forbid broke every bone in their body in a car accident caused by others , your primary diagnosis would be controlled by a psychiatrist . The rest of the medical profession defer to them . Their power over other people’s lives is frightening and comprehensive . They are a big bunch of sadistic popinjays who would rather kill and torture you slowly over the years for personal profit , then to even talk to you. They are a mortal enemy of humanity and are so dangerous that they must be handled with kid gloves lest they unleash even more torture on humanity which they unleash anyways .
    To end this comment on a relatively positive note . I heard a song by T-Bone Walker that had the lyric in it, ” The blues are just a botheration on the mind ”
    Thanks Phil for being yourself , best wishes all around .

  4. I’d include PTSD and CPTSD on the list of real mental “illness”. They can probably be seen on physical markers like stress hormon level. The D needs to be dropped, tho. They are normal reactions to extreme stress.

    I.e. when I was locked up in a psych ward, I had a “resting” heartrate of 114 on day one. That’s a real marker for the immense stress arbitrary deprivation of liberty causes. Stress level never normalized after that, even though it is somewhat better now.

  5. Article: Note that Dr. Aftab concedes that some psychiatric “patients” have been harmed by psychiatric care, but doesn’t offer any estimates of the numbers involved.

    Filling this lack seems like a possible inroad to change.

    States and the feds should track involuntary detainment and patient views of treatment, both hospitalized and otherwise, so mental health codes can be updated, and biggie, some federal laws can be established to protect patients.

    Big fight I know. Like Catholics don’t want laws to protect victims of church sexual abuse, APA and Big Pharma don’t want their victims to be able to sue.

  6. There are some definite things in this article that I disagree with. The main point is that psychiatrists are defensive because they know that psychiatry is a lie as are their diagnoses. If there is such a thing as a “mental illness” which may really be an “oxymoron.” Actually, the psychiatric drugs, the ECT treatments, the DBT, CBT, and other treatments alone or in combination with various forms of therapy do cause brain damage or injury, which might resemble the mythical, illusory “mental illness.” I would like to think that traditional medicine may not have these issues; but tragically much of the lies of psychiatry is infiltrating traditional medicine, too. In fact, I would suffice it to say that it is infiltrating so many areas of our lives now that it might very well eclipse any pandemic that we have been living through in the past few years. Thank you.

  7. Hi Philip

    I thought Psychiatry was ridiculous, at the beginning. The original doctor couldn’t get a Diagnosis – so he game played my symptoms.

    But I believed in it after some years, because of how I felt when I tried to stop taking psychiatric drugs. I eventually found a way out though – and I don’t believe in it now.

    About 20% of Normal Americans take Tranquilizers and Antidepressants. Psychiatric drugs can be used to control “Normal People” as well as the so called “Mentally Ill”. But the Originally “Normal People” can easily become Genuinely “Mentally ILL” as a result of cooperating with Psychiatry.

    My own experience was that there was enough within the “Community” to resolve the problems I had as a result of consuming psychiatric drugs – and get on with my life.

    (12 Step, Counselling, Buddhism. Spirituality, Sharing, Human Connection, Independence).

  8. Contemporary psychiatry is not a wrong turn, it follows the road laid out by Benjamin Rush, M.D. (1749-1813), the “father of modern psychiatry”. Rush thought “mental illness” was biological, a circulatory problem leading to an inflammation of the brain, and treated it with bloodletting, purging, alternating warm and cold baths, confinement to a “tranquilizing chair”, and a a gyrator board upon which patients were strapped and spun around — he invented the latter two therapies.

    For psychiatry, it only took short hops from the trepanation of the Middle Ages to the phrenology of the 19th century (the foundation of neuropsychiatry) to prefrontal leucotomy and then lobotomy (1930s) or, after the electric chair was invented in the late 1880s, from Rush’s “tranquilizing chair” or gyrator to electroconvulsive therapy (ECT) (1930s).

    After an early antibiotic, isoniazid, was observed to cause mood elevation in 1951, it was easy for psychiatry to envision invasive treatment of the brain using drugs rather than piercing instruments.

    It was the psychoanalytic era that was a departure for psychiatry. Otherwise, psychiatry has been bouncing biological treatments off people for centuries based on bizarre theories with no scientific evidence, and without any effort to understand what experiences might be causing their emotional distress.

      • Good point..but “mental illnesses” are not contagious, or are they? Just a little push, and whaddayaknow, we’re in “the twilight zone”, “the twilight zone” of “mental illness”. We can’t shed any light on that, it would be the end of “mental illness” and “the twilight zone” both. When it’s a matter of horses wearing blinders, of course consciousness, deliberate decision making, must wait on further evolution.

        I have always felt that “mental illness” was an abstraction. “Illnesses” are either bodily, organic, or they are not. “Illnesses” are physical. A non-physical “illness” is a form of deception, either of oneself, or of another, or even of oneself and others. Fictive illnesses have their own set of rules that cease to apply as soon as one shuts the book. Fictive illness discoverers, their authors, of course, have a lot to do with the stubbornness of those rules.

  9. Mainstream psychiatry’s position on this sort of thing is a pristine example of the motte-and-bailey argument.

    For those who aren’t familiar with this term, in medieval times, the bailey was the fortified castle – dark, dank, cramped, smelly, but highly defensible. The motte comprised the surrounding lands where the people actually made a living and lived their lives.

    So the serfs would spend their days on the motte, tending his lordship’s fields and pastures and orchards, while the nobility would go foxhunting or whatever they did to fill their days. Then, when the invaders came, all would retreat to the bailey and remain until there, hoping the attackers would eventually run out of supplies and/or lose interest and go home.

    Biological psychiatry is the motte where the psychiatrists earn a handsome living doing fifteen-minute med checks, at the expense of the peasants – oops, I mean the patients – who swallow the drugs – and justify all this by pointing to the petabytes of data generated in the course of neuroimaging studies and genetics studies.

    Then, when some troublemaker comes along and points out that all the billions and billions of taxpayer dollars spent on these studies have not produced a single cure, or treatment, or even a new diagnostic test for so-called “mental illness,” psychiatrists retreat to their bailey of semantic obfuscation until the barbarians go away and it is safe to come out into the light again.

  10. Some associates and I are working on a study of NIMH grants. Some of these researchers propose to terrorize rats or mice in some unspecified fashion and then use all sorts of gee-whiz neuroimaging technology to study the effects on the rodents’ brains. I have a better idea. Why don’t just assume that being terrorized is bad for you, and if rats or mice or people are being systematically terrorized, put a stop to it?

    • Although, I definitely want to be treated with dignity and respect by anyone I come in contact with for any reason, whether we agree or not or on the same “wavelength” etc. or not, I do not ever need to rejoin the ranks of the living. This is because no matter how I am treated and there are many times I do not like the way I am treated; past, present and future, I am alive! No matter what happened to me in the past, I absolutely never ever ever left the ranks of the living. At times, I was asleep to myself and the psych drugs, etc. actually made me asleep to myself and otherwise, but I was still alive. At times, I just forgot. Yes, we all deserve to be treated with dignity and respect always from everyone, but we do not need to wait to join the ranks of the living until we are. If we wait to rejoin the ranks of the living based on whether or not others treat us with dignity and respect, we will be freely giving away our power rather than keeping lawfully to ourselves, that is, they will retain the power and second, why do that? Why torture ourselves? In all due respect, this is the most absurd thing I have heard to date. I may have been asleep at times, but I have always been alive and in the ranks of the living no matter what people have and have done to me. I could go on, but I won’t. Thank you.

  11. rebel,
    Human dignity is indeed innate and inviolable, and I, in no way, meant to suggest that anyone wait to be treated with dignity. However, when people are not treated with dignity, as is often the case in the mental health system, disaster can ensue – and the overwhelmingly destructive influence of the mental health industry can render one unable to live the life they otherwise would and could have chosen.

  12. Great news that more professional people, in many different areas, are starting to speak out against psychiatry. Awesome! Fact is, I doubt us current or former psych patients will ever be believed. The media, drug companies psychiatrists, etc have brainwashed the public, gps, police, teachers, clergy, friends, family, everyone.

    I began questioning medications slowly. Found out that questions are not allowed. Told I was in denial and overthinking, all part of my illnesses. Mind you, I was told this by lay people and professionals alike. Refusing to get well. I’ve had many regular people find out I am “severely mentally ill”, and if they know I don’t take meds anymore, I am further shunned. So I stay myself where I live. Only out for groceries. This was even way before covid!!

    Any time I have a legit, normal human problem. Nope, go get some meds. Any physical illness, nope, be quiet about it and if you’re upset, take some meds.

    I’ve had people stuck in the psych system who get VERY offended themselves about the fact that I myself don’t take meds. They get legit mad, even though it has no bearing on thrm. Probably jealous they are on 10 different meds, also tons of health problems they didn’t have before. Thing is, I was on and off meds for over 20years. I know what I’m talking about.

    I told a staff once. So, are just supposed to spend life taking tons of meds, sick, still mentally unwell, shuffled to tons of drs, whole life going to Drs and appointments etc. I was considered rude for asking. And told that since I have mental illness that is my responsibility in society, to take care of it, which to them means: be quiet, take pills, ignore your body and mind, be grateful, and remember that if you had diabetes you’d take insulin.

    Do you know how many regular people have bleated that fixed trope of: if you had insulin….

    So, if you do not take tons of meds, go to endless appointments, you aren’t being responsible. I’ve been threatened in the past with being locked up for life because I must follow Dr orders.

    I was taken to a psych hospital very upset crying. Depressed cuz all I did in the group home was sit, watch tv, and had something upsetting happen. The Drs bleated on about helping etc, but that meant more meds. This new med. I said do I have to take it? At first they said no. I was gonna discharge. Was told the day of that since I won’t take the med, I am not allowed to keave. I cried and cried. Took the med just to get out. Eventually got out of other help house. Stopped that med. Coercive control.

    I have so many bad experiences with psychiatry and mental health system. A few good experiences with a few therapists. Constantly passed around as they don’t have expertise in trauma. Therapists by and large don’t know much. In cahoots with psychiatry. Go Drs too.

    I no longer go to Drs for even physical problems unless super severe. Even then its not often a good experience. No matter the reason I’m there, its always cuz I’m crazy. I also get fearful that any Dr at any time can say you are crazy and lock you up. If you are blocked up, you end up having to pretend that just cuz you sat doing nothing but maybe a fee cooing skills classes, and took a few pills, that you are mostly better and super happy now. If you dont, you will be put on more meds or not allowed to leave. If you say something isn’t helping, it’s always your fault and they are MAD at YOU for it.

    Seems mental illness will be society’s next scapegoat, if it isn’t already.

    Public mostly considers Drs gods.

    There was a patient sick in a psych ward once. They were told that you have to wait to deal with physical problems unless its fatal til you are out, this is a PSYCH ward. I’ve had Drs tell me that food does not affect your mood or body. I complained that we all are supposed to eat 3 meals and maybe a snack,just sit here doing nothing, takingnmeds, and most gain weight. I ssid, I don’t need that much food to sit and do nothing, it makes no sense. Nope, eating disorder behavior. Tho I had a staff told me she agreed, so I was allowed to not eat all the food. This wasn’t even an eating disorder hospitsl. Oh god, dont get me started on those either. Abysmal. Yet the patients are deemed incurable. No one will ever blame drs, they are god remember.

    I have just met A professional and they will say in a very irritated voice, you have too many boring MS I don’t know where to start with you. I have had professionals say the hat people like me never get better, so expect to be like thus and on meds and hospitals for life. Yet you are worthless, hopeless, yet can’t die. Nooe, can’t die cuz then THEY would feel bad. So we are meant to subsist as prisoners of psychiatry and Ford d to be alive in this hell, all so the Drs and public can sleep at night, safe that they are “helping” those worthless people and safe and smug that they are not mentally ill.

    Psychiatry created us worthless ones. I was z13, put on meds against my will. Told was born broken. I any many meds later. And drs. No career, no relationships. Shunned. On disability. Had the trauma and abuse that happened nd and going on been dealt with, I could v been a regular member of society. Is impossible now cuz everyone will always believe you are ill. The public does NOT want to help LP mentallybill. If hey dont want them in work, family, or for nds. They are resentful that the media tries to destigmatize illness. They don’t WANT to interact with or know you. Even if you are “cured”, you never will be. I believe he I was a normal girl reacting sanely to bad circumstances. But, I was a submissive kid, and believed I was born broken. Stil do actually. Tho psychiatry made me that way. Nobody believes s that, if you say it, it is your illness blaming others.

    So, yes, please, recruit ” normal” professionals to tear this devil of psychiatry down.

    I know many people in their teens 20s 30s who their life, like mine was and is, is either going to endless appointments, or if nit, shunned and sitting home all day like lock down. Most of us are on permanent disability. Paid to be on my d’s and keep quiet. Paid to keep quiet. Shoved out of the workforce. Many like me never having a relationship, and in fact I’ve usually been shipped encouraged to NOT seek friendshios or relationships, as people can’t handle mental illness. Gone years s talking to nobody but a therapist as a “friend”. Was told the only n people who would love would be those trying to hurt me. Grsnted, they were right, only abusers want anything to do with me. So I have up wanting friends or s relationships, either they want to hurt me, or I’m so much seed up I will upset them, which is a fear made 100x worse by Drs and therapists telling me to his. If hen that hey act like you have no right to be lonely, you are mentally ill.

    Really, I just pray for a quick heart attack. Life looks bleak. Is no return or way out. I’ve accepted it. Just very sad and hesrtboken. I can’t even get proper help or talking cuz it all ends n up being about labels and must get meds and half don’t want to hear your life. I had numerous times just needed to talk. If old if I’m not taking I d’s for life I am refusing to be well, and then you are further shunned cuz you are crazy but not fixing it. And by fixing it hey mean take meds and never cry, be sad, lonely, upset etc.

    Thanks to those with the power and social clout for speaking out. We haven’t been rendered voiceless.

    • One thing I don’t get is this: if they think you’re a hopeless case, why do they keep accepting payment for “helping” you, and indeed forcing you to be “helped” even though they themselves have admitted they don’t know anything that will help?

      I’m glad you got away from such irrationality!

      • Wow, I’ve never thought of that. Good point! I think I assumed that if/because I’m so mentally broken, that I am not able nor allowed to be amongst society without help, and that it’s the dr’s/therapists/police’s jobs to keep sick people either out or closely watch them. That even if you are hopeless, you are not allowed to die, but they can’t let you amongst society unwatched, as the public would be upset. So they are forced to keep you in line, but they know you are hopeless but have to monitor. And that’s also why I thought, in part, that the attitudes towards hopeless cases like me was one of anger, resentment, disgust: they are duty-bound to keep you as “well” as possible yet mad cuz they know you are hopeless, waste of time, just gonna die like this anywY. But jump on a moral high horse if anyone mentions euthanasia. It is bonkers when I think of it. They are resentmentful that you are there and untreatable but they are forced to do whatever they think to make sure you don’t die nor bother/upset the public, yet in their minds they know it won’t help. Babysitting with pills and psycho babble and probably some secretly hoping you die naturally to rid the world of having to waste time, money, food, meds etc.

        Or they just like taking anyone’s money and it’s as simple as that.

        I really think many working in psychiatry and therapy literally hate most the clients. That it’s their job to society to keep us in a small niche, usually medicated. It’s been my experience that a huge chunk of us patients are living in a bubble of meds, therapy, groups etc where most psych patients are only around or kinda interact with other psych patients and drs/staff. And the public mostly avoids us, so our whole world, mentality is based on that, and “normal” people don’t want anything to do with it. And the public loves pushing you back in that bubble. Normal upset? First response is find meds, your dr, therapist, A psych group, etc. If I am not talking to a therapist or similar, I am isolated. And who wants to make new friends with the girl the whole town knows is crazy. Let the Drs deal with it. Happens to others, I’ve seen it. I’ve gone back in the system purely cuz I have nobody hardly to even just talk to., they don’t want to, or I get people warning people to stay away, which is how I lost a brand new friend, she said people told her I was hopeless, crazy, beyond help. I’ve gone months, A year, by myself, and end up running back to system out of sheer desperation. Had a therapist who would talk to me about movies, books, etc, cuz I just need to talk, much less any issues. Most my social life in life has been vague pseudo friends while in group, but not after, and therapists etc. And I’m shy anyway. I got very depressed in past thinking that. Pseudo friend of a therapist. Then they dump you, or move, or you do. Bam, no friends. Only human I talked to for long while was a therapist. Angway, I digress. I think the system sets ppl up to have to depend on it for literally all your needs–medical, mental, social. I had a worker once whose job purely was to do stuff with me–walks, cards, etc. But it’ll never be a true friendship (we are exempt from friendship/relationships, we are the unwanted specimens after all). I believe this is a core problem with psychology. But the public doesn’t want us, they want Drs to fix us or deal with us, so I’m sure the Drs don’t know what to do.

        You can manage symptoms but you’ll always be a very bad case and that’s all you should expect but not whine about it. Was my understanding.

        The public expects the Drs and pills to fix you or keep you out of society either physically or socially.

        However, I feel if they declare you hopeless and are resentful, they should offer euthanasia. But they need to be on moral high ground, so as to sleep at night, or feed ego.

        Which brings me to the point that we are society’s scapegoat– those damn hopeless crazies, causing stress and problems for us and everyone, I’m so overwhelmed having to deal with them and they are ruining society.

        However, I do wish they had therapy robots or something one could buy to be your friend, cuz many of us are just lonely I feel. Very isolated for much of life. The system benefits off our pain and loneliness though, that’s for sure.

        • Loneliness is chronic in our weird society and is of course causal in many “mental disorders” as described in the DSM. But if they admitted that, they might have to DO something about the situation! Instead, it’s easier to assume that everyone should love our society just the way it is, and that anyone who doesn’t is deviant, oops, I mean “mentally ill” and must be “helped” to stop those “bad feelings” that are making the so-called “normal” people feel bad, because it reminds them that THEY are lonely and confused and hopeless as well.

          It’s quite a conundrum!

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