Our guest today is sociologist and author, Doctor Andrew Scull. Andrew is a professor of Sociology and Science Studies at the University of California, San Diego, and recipient of the Roy Porter Medal for lifetime contributions to the history of medicine and the Eric T. Carlson Award for lifetime contributions to the history of psychiatry.

The author of more than a dozen books, his work has been translated into more than fifteen languages and he has received fellowships from, among others, the Guggenheim Foundation, the American Council of Learned Societies and the Shelby Cullom Davis Center for Historical Studies.

In this interview, we discuss his latest book, Desperate Remedies: Psychiatry’s Turbulent Quest to Cure Mental Illness, published by Harvard Press in May 2022.

Dirk Wittenborn, the screenwriter and novelist, described the book as “A riveting chronicle of faulty science, false promises, arrogance, greed, and shocking disregard for the wellbeing of patients suffering from mental disorders. An eloquent, meticulously documented, clear-eyed call for change.”

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

James Moore: You are a distinguished professor of sociology and science studies at the University of California and your many books seem to share a similar theme in exploring the history of psychiatry and the cultural history of insanity. How was it that you became interested in researching madness?

Andrew Scull: I first began working in the field in the early 1970s and at that point, I have to say I did not intend to make this my career. I thought I’d write a single book on the emergence of the asylum and the simultaneous construction of psychiatry as a profession in Victorian England and I suspected that I would then move on in rather different directions.

I was led to that area of research by encountering a couple of books that were receiving quite a lot of attention at the time that I first encountered the field. One was David Rothman’s book called The Discovery Of The Asylum which was about the creation of the asylum system in the United States and offered a very ethnocentric view. It was very much as though it was an American discovery which I already was inclined to doubt. The other book was one that is very famous and is echoed by the title of one of my books, Madness in Civilization, but that was the book by Michel Foucault that was translated in an abbreviated form as Madness and Civilization.

When I first encountered that book, Foucault had not become the huge international cult figure that he became within a few years. He was obviously very important in French intellectual circles, but it’s fairly unusual for a French intellectual to make the kind of impact that Foucault did across a whole array of disciplines. Reading those two books convinced me that this was a subject of considerable intellectual importance, and there was nothing comparable written at that point on the English scene.

That was really the launch of my interest and I then emigrated to America for what I thought was a short-term basis to do my doctoral work. It turned out my career started in the United States and, except for some time in England, has continued there.

When I was trying to get a job, one of the rituals in American academic life is that you go around and present a potted history of your research. In this case, I was trying to get a job in a sociology department talking about Victorian Lunacy Reform, which was a rather odd thing to try to do. But as I went around and gave this talk, my sociological colleagues knew virtually nothing about the substance of what I was talking about, and they would say things like, “well, aren’t you glad they’re shutting these places down now?” or “what’s happening in the current environment? Forget about stuff that’s 100 years old, tell us about now.”

I’d been so buried in the asylum archives and in the medical literature about insanity that I really didn’t know and I thought “that’s a really interesting question.” Is it really the case, because there had been a huge amount of social and intellectual capital invested in creating these institutions, justifying them, defending them, and persuading people, that they were the appropriate response to serious mental illness. I thought that I should investigate this, and I did. 

I went backwards from the 19th century into the 18th century and did a substantial amount of work on how families and patients came to the attention of mad doctors, the predecessors of modern psychiatry. I moved forward into the early 20th century which was a very unexplored territory at that point. A number of other people had jumped in and looked at Victorian asylums, but hardly anybody had really looked at the 20th century.

As I began those researches I encountered things like lobotomy and I encountered focal sepsis and the idea that you could cure mental illness by eviscerating people. I thought that I really ought to write a book called Desperate Remedies and I already had that title in mind. At that point, my focus was on the first three or four decades of the 20th century when these horrors were visited on captive mental patients. I wrote many other things along the way but kept coming back to that topic and doing research whenever I had the chance.

Since psychiatry had taken a turn towards biological reductionism once again in the 1980s and going forward, I needed to talk about that. Why had that happened? What had been the consequences? Part of that story was the collapse of psychoanalysis which dominated American psychiatry in the period immediately after World War II. Part of it was the drugs revolution, the psychopharmacological discoveries that had underpinned this move towards treating mental illness with things that looked like the sorts of things that mainstream medicine was using to treat other kinds of diseases.

The other side of that was the attempt to provide a theoretical underpinning for this biological revolution. That is the move back once again to looking at the genetics of mental illness and the rise of neuroscience which emerged in the late ’60s and the ’70s and had become, in academic psychiatry, the kind of dominant force as opposed to what the people actually in the trenches dealing with mental illness were up to.

That entailed a lot of reading, a lot of thinking about those issues, and ultimately as I read the literature, largely the failure to be able to comprehend the etiology of any of the things psychiatrists have labeled schizophrenia, bipolar disorder, major depression. There are no biological markers for those things. When you look at the genetics, it’s actually tended to undermine the idea that these are separable conditions. As to the neuroscience, there have been advances in the understanding of the enormously complicated thing that is our brain but these had led clinically nowhere as far as I could see.

Moore: Many promises but not much result.

Scull: Psychiatry has offered promissory notes over and over again in its history and it has dishonored every one of them, more or less. That’s not to say there hasn’t been some movement and some progress. I don’t entirely dismiss drugs though I’m highly critical of the ways in which there’s a Panglossian portrait of how much good they do. It’s a very much more mixed picture and indeed for many mentally ill people these drugs simply don’t work and they often have terrible side effects.

One needs a more balanced look at that it seems to me and I always thought this partly because I knew some people who’d become very seriously disturbed and in one case had committed suicide. I wasn’t one to deny the reality of mental illness and the suffering that it causes. As one of my friends and psychiatric historian colleagues, Michael McDonald put it, he said, “Madness is the most solitary of afflictions for the person suffering from it, and the most social maladies for everyone around them. When people become seriously depressed or hallucinate and embrace delusions about the world, the problems that creates are not just problems for the individual sufferer, but most importantly for their family if they have one and for the larger community, it’s impossible to escape that.”

One of the things about mental illness that I think is almost a historical universal, I hesitate to say that but I think having studied everything from ancient Greece and Palestine and ancient China to now I can say that it is enveloped by stigma and rejection. That compounds whatever problems the mental disturbance brings in its wake and is a real problem that seems impossible to escape. More than that, in an odd kind of way, the stigma that accrues to mental illness itself also sticks to the people charged with treating it or the people who have not accidentally come to be treating it. Of all the branches of medicine, psychiatry is among the most despised, the branch about which we’re highly skeptical.

There’s no anti-cardiology but there is an anti-psychiatry. The problem of course is that psychiatric history throws up all too many pieces of evidence that some of that opprobrium is well earned. Some of the things that psychiatrists have done, not just for their patients but to their patients, neglecting them as having any voice in the whole process, really are very disturbing.

When I was researching Desperate Remedies, there’s this odd kind of thing as a historian, you discover remarkable stories that you can tell based on what you discover in the archives. For example, finding that Walter Freeman, America’s leading lobotomist, talked his patients through the operations and recorded them. I reproduce one of these transcripts in the book. On the one hand, you’re saying, “wow, this is fabulous material.” On the other side of the coin you’re going, “my God, what a monster this man was.” 

The way it worked in the early stages of lobotomy before he resorted to the ice pick lobotomies after the war, was that they would do it under local anesthetic. You’d be fully conscious, they drill holes through your skull, like a dentist drilling your tooth only 10 times as bad, and then they slice your brain with a butter knife.

When to stop in this so-called precision lobotomy? Well, when the patient became confused, so you would talk them through it, and when they started to lose track, that was the signal to stop operating. In the case of one patient, Freeman says, apropos of a whole string of questions, “what’s passing through your mind, Mr. Morgan?” There’s a pause and Mr. Morgan answers “a knife.”

I was researching Henry Cotton, who was the Superintendent of New Jersey State Asylum in Trenton, and who conceived the idea that mental illness was the result of your brain being poisoned by lurking infections in various corners of the body. In a pre-antibiotic era, what were you going to do? Well, you had to practice surgical bacteriology. In other words, you had to rip the offending infections out. First, teeth and tonsils and when that didn’t work, you were swallowing the germs, they were going down into the stomach and the spleen and the colon, in the case of women to the uterus for some odd reason. You went in and you discarded these organs one after another sometimes operating two and three times, confessing in print that you were killing 30% of the people you did the serious surgery on to no rebuke. There was no sense that this was improper.

In fact, you were killing 45% of the people you operated on in this way. This went on for nearly two decades. The pulling of teeth and the removal of tonsils at Trenton continued all the way to 1960. I actually interviewed the dentist who had literally pulled hundreds of thousands of teeth in the pursuit of a cure for mental illness and still believed this was correct. Of course, it was utterly bizarre and yet the profession and in particular, its leader Adolf Meyer, at Johns Hopkins didn’t question what was going on, although some people doubted Cotton’s results.

But Meyer knew from the report of one of his assistants, Phyllis Greenacre, that far from curing patients, the more of this treatment people got, the worse the outcome and he suppressed the report. Then when Cotton died unexpectedly from a heart attack, Meyer wrote an obituary saying what a shame it was for psychiatry that such a promising line of inquiry and such a great man had been taken prematurely from our midst.

You encounter these things and they’re great material for a book but they’re also deeply disturbing. When I was doing the Cotton work in the 1980s and early 1990s, I had very little money and I was staying in something that looked a bit like Bates Motel in Psycho. I’d read these patient reports and I turned the page and it would say died, and I’d go back at night and reflect on what I had just seen and it was deeply upsetting. I periodically got contacted by relatives of people who were in Trenton. Somebody got in touch with me and said, “My grandmother was there in 1929. Where can I get the records?” I said, “Well when I was there, they were in the hospital basement.” I lived there with the cockroaches and the vermin while I was researching this with no air conditioning in the New Jersey summer, it was no great fun.

I said, “They’re there, or they may have been transferred to the New Jersey State Archives.” Well, indeed, it turns out some of the hospital records have been. The rest have mysteriously disappeared, no one can now replicate what I did, because it’s pretty clear that the hospital authorities sanitized the whole thing by chucking them out. There were detailed records on every single patient, they no longer exist. What an odd coincidence. If one were inclined to conspiracy, one might think that the profession would determine that it was time to bury those records once and for all.

Moore: I’ve shared the sense of horror in reading Desperate Remedies and reading the history of psychiatry, it’s impossible not to be affected by it. But what comes across for me strongly, the question that entered my mind as I got to the end is, why is it that psychiatry as a discipline seems so vulnerable to fads? New bodily treatments hailed as great advances, yet they never seem to stand the test of time. That was apparent in your writing about the early stages of psychiatry but still seems to be going on today. I wondered what your research had told you about that?

Scull: Well, Desperate Remedies as a title has a kind of ambiguous set of meanings that is pretty obvious when we’re talking about some of the extreme things like injecting horse serum into people’s spines to give them meningitis as a way of curing their mental illness or putting them in prolonged comas with barbiturates and then with insulin. What’s going on here?

I think if we look at the long history when the asylum is born it is an attempt to rescue the mentally ill from the jails and the prisons and the garrets and the pigsties where they’re confined. It launched in a period of extreme optimism when the world is changing dramatically around people. Transportation, canals, railroads, markets opening up, work changing dramatically and people’s day-to-day routines being transformed. Human nature seems to be malleable, the environment seems to matter and seems to be something we can control. The first institutions are labeled retreats after the York Retreat in England, or asylums with a very positive sense of that term.

Moore: A place of refuge, it means.

Scull: Right, it’s a refuge. It later acquires terrible meanings, but at the outset, this is extraordinary optimism and America is bidding up cure rates. Early psychiatry, they don’t yet call themselves psychiatrists, they call themselves medical superintendents, which gives away what their authority derives from. We’re going to cure 60, 70, 80%, or perhaps even more of patients as long as they come quickly.

But the actual cure rates were more like 30 or 40%. When I say cure, these were people who, with some respite and care, were able to be restored to the community with some semblance of ability to cope with daily life, but that left behind a very large fraction of each year’s intake.

Over time, simple mathematics means a couple of things. First of all, the institutions were compelled to grow and grow massively, so that institutions of 30 or 40 patients became 1,000, 5,000, even 10,000 in the early 20th century. Of course, individual care becomes virtually impossible once you’ve got warehouses of unwanted people of that size. 

That was one outcome and the other is that the image of the asylum became one as a place where you went and you didn’t come out. That was slightly incorrect; of each year’s intake, a certain fraction did indeed emerge within the first 12 months, but if that didn’t happen you went to what Goffman called a lovely euphemism, “continuous treatment wards,” or no treatment wards. That meant psychiatry had this huge problem: how to explain away what appeared to be a tremendous failure of going backwards, not progressing.

The initial response was to blame the victim. It was the mental patient’s fault because they were biologically defective. In an era where evolutionary ideas are becoming increasingly common in the last third of the 19th century, these were a group of people in whom evolution had run in reverse. They were degenerates, they were moral lepers, they were people who’d lost their humanity. The best thing to do was to lock them away because otherwise, they’d breed uncontrollably and we’d have even more mad people in the next generation.

That explained away why it was a good thing that the profession was failing to cure them. You didn’t want them out in the world reproducing their defective kind, so what else might one do? The answer in early 20th century America is to snuff out their ability to reproduce and then you might be able to release them. Compulsory sterilization laws appeared on the scene, and eventually, a case reached the Supreme Court of America in 1927, Buck v. Bell, the case of a young woman who’d been sterilized against her will. The Supreme Court in an 8-1 ruling written by Chief Justice Oliver Wendell Holmes, one of America’s great jurists said, yes, the state had a compelling interest here. Three generations of idiots were enough, they could, in fact, do this.

California became then the leader in actually conducting these things and continued to do it until 1960. The Nazis adopted California’s law; the superintendent of Stockton State Hospital, a woman I might add, boasted that it was her state’s laws that had guided the Nazis to their sterilization. Whereas in liberal democracies there were some checks and balances and there were opponents of sterilization and there were some limits, in Nazi Germany, there were none.

Then, by the end of the 1930s, Hitler and his cronies decided these were, as he put it, “useless eaters.” They were just consuming resources, they weren’t going to get better, so kill them, kill them all. With the active participation of most leading German psychiatrists, they started shooting them and then the gas chamber technology came in. They killed perhaps a quarter of a million patients and then they packed up the apparatus and moved it to the death camps along with the personnel because now they had worked out how to do it. The mentally ill were the first victims of the final solution.

To be boarding housekeepers, to just lodge the mentally ill or to sterilize them, sat uncomfortably with people who wanted to be thought of as engaged in curing people in a therapeutic exercise. The alternative route forward, having decided that mental illness was rooted in the body, was to say “well, perhaps biology could lead us towards a cure.” What then happens is ambitious men—and it’s mostly men in this era—embark on a series of experiments to try to solve this problem and desperation exists on all sides here. Families are desperate for something to be done. Patients, in some cases, if they retain some agency and voice, are also pretty desperate.

When mental patients were shut up in the asylum, they were shut up in a double sense. They were obviously incarcerated, but their voices were shut up. Whatever they said didn’t matter, because it was a product of their madness, and so could be disregarded. This was a kind of perfect storm, it allowed for any number of interventions to be constructed and visited upon helpless people. Often, even when families were asked to give permission, which was not the norm, they readily gave it. After all, the authority figures were telling them that this was their best chance of restoring their loved one to sanity, even if they went elsewhere. For example, John Fulton at Yale was America’s leading brain physiologist and if he’d been consulted he’d have told his rich consultees, “yes you should get a lobotomy.”

Harvard had a very active lobotomy program. Columbia had an active program, Yale had an active program, University of Pennsylvania, Duke—all of these major medical centers into the 1950s, two decades after the operation’s arrival, were still telling people that this was the solution, and indeed were saying we shouldn’t wait, we should operate. If somebody isn’t better within six months or a year, that’s when we should perform a lobotomy, don’t wait till they’ve deteriorated, because then it’s almost too late.

Moore: It got worse, didn’t it? I was shocked to read in the book that not only did they lobotomize people but then if they didn’t see the results from the lobotomy they expected they then gave multiple rounds of ECT to that person to try and elicit a response from the failed lobotomy.

Scull: Absolutely, or Freeman would often operate twice, even three times. He did so within the space of about five or six days after the operation because, as he explained, these noisy mental patients on general wards were really disruptive and besides, they couldn’t afford to keep paying for inpatient care for too long. So if you didn’t get a result, you went back in and did it again. 

Also, one of the things I discovered as I went along was that women were preferentially singled out for many of these desperate remedies. That was true of lobotomy. The statistics are anywhere between 60 and 80% of the cases were female. There was something obviously different about female brains, that was the way things were reasoned about then.

The other thing is that Freeman was willing to operate on children as young as four years of age and indeed said that children’s brains could sustain more damage and the child could become like a pet in the household. 

I did a PBS documentary probably about 15 years ago called The Lobotomist about Freeman, which I thought was a bit of a whitewash of Freeman. I really think of him as a monster. One of the other participants in the program was one of Freeman’s last lobotomy cases. He almost was kicked out at George Washington in 1954 and he moved west to the Bay Area and resumed lobotomizing in private hospitals. This was a young man who at the age of 11 had been lobotomized, a man named Howard Dully, and his parents had divorced, his father had remarried, his stepmother found this 11-year-old a pain in the ass. No surprise, they are resentful of the new situation. Her solution was to take him to Freeman and have him lobotomized. The lobotomy, because it involves a direct assault on the brain, is perhaps the most fearsome and striking of these interventions.

The psychological treatment of mental illness, which these days tends to be some variation of cognitive-behavioral therapy (CBT), is largely outside the ranks of medicine. The emergence after the war of clinical psychology plays a major role in that and thus does managed care. 

In America, we pay for medical and psychiatric care, and people are used to that. But the insurance companies found CBT to be a much cheaper option. Unlike psychoanalysis it was directed at suppressing symptoms rather than treating the symptoms the psychoanalyst claimed were emblematic of an underlying, much more complex, psychological reality. It’s clinical psychologists, by and large, who now offer psychotherapy as a treatment. That’s a heavily feminized profession and as a sociologist, I know when you look at the jobs, those that are female-dominated tend to be paid less. Certainly, clinical psychologists don’t demand the same fees as psychiatrists and if they did, the insurance companies wouldn’t pay them.

The only exception to that is a small group of psychiatrists still clinging in most cases to psychoanalysis, who take patients not covered by insurance, and that of course means it’s a very niche market only for the very wealthy, because who else can pay that cost?

Moore: In the early stages of the book, the asylum period and the somatic “treatments,” cure is mentioned an awful lot. “We can cure mental illness, we’ve got all these new treatments.” But as you then get into the latter part of the book, the modern history of psychiatry, cure disappears from the picture and it becomes much more about symptom management. I wondered what you thought led to that kind of transition? We’re not talking about curing “mental illness” anymore, we’re talking about managing these conditions.

Scull: I think much of that reflects the limitations of what psychiatrists can do for their patients. A new wave of drugs emerges serendipitously in the early 1950s. We’re talking about anti-psychotics like Thorazine and the first generation of antidepressants or we’re talking about the so-called minor tranquilizers, Miltown, Valium, Librium, those sorts of things. Early on there’s talk about cure, but it becomes increasingly apparent that’s not what’s happening. 

These drugs aren’t psychiatric penicillin, very far from it. They are, at best, something that manages some of the symptoms, and I emphasize some, of the symptoms that people are complaining of, are suffering from.

With respect to “schizophrenia,” for example, I put that label in quotations because, as Robin Murray of the Institute of Psychiatry has recently put it, he thinks that within 10 years that diagnosis is going to vanish because the evidence for it as a separate condition is evaporating. But in any event, if we take that, classically, psychiatrists talk about positive and negative symptoms of schizophrenia. This reminds me of when oncologists talk about benign brain tumors. I can’t imagine a brain tumor being benign, but I know what they’re getting at. It’s not cancer.

The positive symptoms of schizophrenia, the delusions and the hallucinations that plague people, do seem for some, by no means all, but some fraction of the patients to be somewhat alleviated, or people stopped caring about them even if they’re experiencing them under the effect of these drugs. But in many ways, far more damaging are the so-called negative effects. We are talking about apathy, blunted social affect, difficulty interacting with people, disorders of thought and language, incapacity to deal with the business of everyday life. None of the drugs really touch those, and so you get a partial relief of symptoms, at best.

Then, of course, the other nasty secret, is that these drugs aren’t a free lunch. When you take them you are courting all kinds of negative effects and iatrogenic illness. Some people develop Parkinson-like symptoms, others become incurably restless and move about constantly, which is very distressing for them and those around them. They suffer from tardive dyskinesia, arguably the real bugbear of the early antipsychotics, uncontrollable movements of the extremities and facial muscles, quacking noises, things that laypeople who are unfamiliar with what’s going on ironically tend to interpret as symptoms of madness. You come across somebody grimacing and shouting coming towards you, you think, oh, there’s somebody who’s mentally ill.

Moore: They don’t realize it’s iatrogenic do they?

Scull: Right, exactly. Then, and this is one of the more striking kinds of things, you look at where modern treatment leaves people. Most of the drug studies have been funded by the drug companies. They operate across national boundaries. The only entity that owns the data and controls the data is the drug company, and they cherry-pick the data. We know that from lawsuits and other studies. 

What purports to be evidence-based medicine is really evidence-biased medicine in a very serious way. Virtually all the major drug companies have been fined billions of dollars and that’s one of the reasons they’re pulling back from research in this area. It’s interesting to see one study, known as the CATIE study, that was funded by NIMH. It was designed to test the comparative efficacy of a first-generation antipsychotic produced in the 1950s. A drug no longer under patent, cheaper, easily prescribed, with newer variants that are variously known as second-generation antipsychotics, or atypical antipsychotics, a very broad class of drugs with different modes of action.

Three of those newer drugs were compared to the original one. Do they work better and what are the effects? I think two striking findings emerged from that research. One is the new drugs were no better than the old drugs. They had a different side effect profile but that included gaining 30, 40, or 50 pounds of weight. It included developing diabetes or heart disease and a whole array of life-threatening side effects. But the other thing that I thought was striking about that study, and it was confirmed independently, was that between 67% and 82% of the patients, depending on which drug they were on, dropped out. They dropped out for two reasons: because the damn things weren’t working in their case, or because the side effects they were experiencing were intolerable. That conforms with what we know from other research.

When people talk about the drug revolution, note that between two-thirds and four-fifths of patients on these drugs don’t find them tolerable or helpful. That’s a very damning finding, I think. That’s not to dismiss the cases where the drugs help, but what it does throw up is a very large caution flag if you’re a patient. There isn’t something better on offer, but what’s on offer can be a poisoned chalice all too easily. And on top of that, the drug companies, starting in about 2010, announced they were pulling out of this business altogether. They’ve made their billions upon billions of dollars. They didn’t see any obvious future targets for new drugs, and there were much more profitable alternatives for research that they could put their research folks to work on. So that’s rather disturbing given that we’re stuck with a bunch of, once again, desperate remedies of very doubtful efficacy. Efficacy for some, but only for a minority.

Moore: Again, something that leapt out reading the book was that you expected to see a big transition from the, frankly, barbarous practices of the past to modern developments in neuroscience and genetics and a greater understanding of the brain. But actually, the vestige of the harm of treatments still comes across in the way that modern psychiatry is done, though much less obvious and less apparent.

Scull: Yes, it’s not as dramatic as a lobotomy obviously, especially when done with an icepick through their eye socket, but yes those do persist. People sometimes ask me, could this repeat? I don’t know the answer yet, but I’m deeply suspicious when I see things like deep brain stimulation, another brain operation. When that has been put to a controlled trial test run by the manufacturers of the devices who wanted to find they were effective, those trials were aborted because the results were so terrible. Yet, there continue to be both media stories about this magnificent new treatment and publications in things like the American Journal of Psychiatry touting it as a possible remedy for the depression that afflicts 10%, 15%, even 20% of Americans.

I saw about a year ago in the Washington Post a case of one of the great plagues of 21st Century America besides all the gun violence. It is the opioid epidemic fueled by the Sacklers and their minions. This was a patient with drug addiction who is being treated with this brain surgery, seven hours of it. It was a miracle new cure for addiction. My God.

Then there is ketamine, Special K, a party drug. People take it at parties because it changes their mood in the short run. If they are unlucky, it makes them psychotic. If they’re not, it wears off then they do it again and you become habituated. That’s the sovereign new remedy as claimed in some quarters for depression, even though the scientific evidence for it is thin, if not, nonexistent.

The new vogue for psychedelics, magic mushrooms, LSD and so on. Again, a fad is now on offer. You can get ketamine in infusion clinics all around the country, people who have been used to treating cancer patients now have this whole new group from which they can make a profit and people flock to them. Even though, once again, there’s very little evidence in their favor. There’s some but if you do a 30-day study of depression and you’re mucking with somebody’s mental state, they may well interpret that in the short run as an improvement. Come back in a year or two years and let’s look at what the data show, and we have none of that data. Yet, here we go again, another cycle of “breakthrough.”

I’m afraid medical journalists have a lot to answer for in this regard. I mean, when lobotomy was introduced, the Houston Post said it was as easy as removing an abscessed tooth. Well, it was simple but it wasn’t safe, it did terrible things to the person who got the operation. I think being vigilant about these promises of great breakthroughs is really a responsibility that lies with all of us and to expose the fact that there isn’t much in the way of reliable information to support these often very drastic interventions.

The deep brain stimulation, for example, the number of patients who suffer from serious, serious side effects from the surgery is extraordinary. Yet, the enthusiasts continue to peddle this, and I’m just shocked and appalled I have to say.

Moore: The epilogue to your book is entitled “Does Psychiatry Have a Future?” What did your four decades of research leading up to this book tell you on that question?

Scull: It is a very difficult question to answer completely. We haven’t really talked about it but one of the stories that I mentioned at the very beginning of our interview is the collapse of the asylum and what that was fueled by. It was supported by both left and right ends of the political spectrum but for opposite reasons. It led to the abandonment of any pretense of public psychiatry here and the abandonment of people with serious mental illness.

There were no alternatives created, no sheltered accommodation, no attempt to meet the social needs of people who had a hard time competing in the marketplace. It wasn’t driven primarily by psychiatry. It was driven by the concerns of politicians, by budgetary concerns and development of the vestiges of the welfare state that provided some minimal level of survival for people chucked out into the streets. Psychiatry didn’t create that situation but it didn’t protest for the most part as this happened. It preferred to go after milder kinds of mental disturbance and treat those.

The seriously mentally ill were a standing reproach to the profession because they didn’t have good weapons to deal with the problem and they were deeply unattractive patients. They often weren’t grateful. They often opposed what was happening to them, they regarded it as destructive. But as well, they had no money, so in a society dominated by the market those are people who go to the wall.

Our approach to mental illness has veered from a brainless psychiatry after the war when Freudians were dominant and didn’t pay any attention to anything physical to a mindless psychiatry where we pretend, “Oh, there’s nothing here like trauma or other social setbacks that might have some role in somebody becoming depressed or becoming psychotic.” It seems to me that if psychiatry is going to move forward, it has to stop thinking that that’s the answer.

$20 billion spent under Tom Insel when he headed the NIMH led nowhere, as he has confessed. At best, there ought to be continuing basic research, this is a very complicated problem to solve. But in the meantime, we also need research into how best we can make life more tolerable for these patients and their families and how we might be able to help them avoid cycling from the gutter to the flophouse to the jail and back again.

It’s quite remarkable the way in which in some ways we’ve moved back to the situation that existed before the asylum was created. The largest places of treatment for the mentally ill in inpatient settings are the LA County Jail, the Cook County Jail in Chicago and Rikers Island in New York. That’s an indictment of the system, it seems to me.

If psychiatry is going to have a future, it has to start recognizing the social and the psychological dimensions as well as continuing to look to see what, if anything, biology contributes. In some sense, as I argue in those book pages, this whole separation of the biological and the social or the psychological is severely misplaced. One of the things that define us as a species is that our brains aren’t in a fixed state at the time of our birth. Our brains are remarkably plastic and they are enormously complicated things. We don’t even understand the brain of a fruit fly, let alone the brain of a human being.

We know a little bit more, we understand about neurotransmitters and we understand not everything’s electrical as they thought 75 years ago. But our understanding is enormously primitive. Mostly what we’ve learned is how damn complicated this thing is in our head and so, because it’s plastic, it responds to the environment we’re in. What that means is over time your brain absorbs and is transformed by your experiences. That means this whole separation of mind and body is a false one.

Academic psychiatry has to break with that because that’s the group that trains the next generation. The problem there is that if you’re building a career in academia, particularly in the sciences and the medical sciences, it all depends on attracting grant money. If you have lots of grant money you can get away with almost anything. People at the very top of child psychiatry and psychiatry in general took millions of dollars in drug company money and hid it. When that was revealed, the institutions gave them a slap on the wrist and that was that.

Doing social research is politically very dangerous because you might say, “inequality, racism, trauma, these all are vital, and they have to be addressed if we’re going to move forward.” Politicians don’t want to hear that on both sides of the aisle, I’m afraid. There’s no way to build a career that way. You can’t get grant money and if you do get it, it’s very limited. Whereas your colleagues who are in genetics and neuroscience it’s “here, have millions and millions.” You can publish lots of papers because you can parse that stuff in salami slices so that you get lots of publications and you move up the career ladder. You are the people that dominate.

Do I think things could change a bit for the better? They might, I think there are enormous obstacles to that and that’s a distressing end to the book. I don’t have a happy ending to talk about but I do think there are some possibilities. I think politically and given academic politics and academic careers, I’m rather skeptical. I sometimes do grand rounds with psychiatrists in training and at least they start out, in many cases, with the right values. They know if they encounter problems, they’re aware that there isn’t a pill for every ill and that they’re not going to be able to solve things simply with drugs. I suspect they get worn down when they get out in practice.

Again, if they’re going to make a living, they have to prescribe. That’s the only thing that generates income for them so they are also rather trapped. Even if they think underneath they know better, it’s very hard for them to act on those beliefs.

We face a very difficult future. There have been more than 200 years with some halting progress and lots of blind alleys and lots of dreadful mistakes. I’m not sure we’ve finished with those blind alleys and mistakes.

Moore: It sounds like psychiatry should move away from a purely medical view and towards a sociological view.

Scull: I think there’s room for both. I really would be very surprised for the most extreme kinds of mental illness, the sorts of things that lead people to be institutionalized, I’d be surprised if there weren’t some biological component to some of that. I’d also be even more surprised if that were the whole story. I hate to seem like the proverbial liberal who wants a middle course here but it does seem to me that you don’t want to abandon that kind of research entirely. But after 40 years and no therapeutic payoff, no greater understanding of the origins of each of these conditions, whatever they are, maybe it’s time to adopt a more eclectic broad-based approach to trying to do things.

In the meantime, given that you have no cures to offer, you ought to be working out what is the best thing you can do to ameliorate the suffering of individuals and their families because, with the institutionalization, a huge burden fell back on families. 

Organizations like NAMI that were not organizations of patients, they were organizations of patients’ families, they kind of embraced the biological. If you’ve been told you were frozen parents who hated your offspring and had caused them to become mad, then somebody else came along and said, “it’s not your fault at all, it’s the chemical soup in the brain, and here we have a pill that will affect the serotonin levels and then they’ll be fine,” which would you embrace? Of course, you’d embrace the one that said this was nothing to do with you, it’s not your fault, and here’s something modern medical science has done that can alleviate the situation.

It explains why, when budget cuts happen when states have to deal with a fiscal crisis, which they do periodically, resources for the mentally ill are often on the chopping block. They are among the first things to go. Years ago, in 1950, about 30% of New York State’s budget went to mental hospitals. I guarantee you that 30% of New York State’s current budget doesn’t go to mental illness. Then the question is, what substitutes for it? Really, it’s malign neglect. I was going to say benign neglect, but there’s nothing benign about it. It’s malign, it’s malicious, it does terrible things to people’s lives and yet it’s enormously difficult to see how we’re going to move forward successfully from the sort of neoliberal environment we exist in wherein if you’re incapable of competing in the marketplace then you’re so much garbage, so much social rubbish, you almost don’t exist.

Moore: Was there anything else that you felt important to share with the listeners?

Scull: I did talk a little bit about the disproportionate treatment of women, that’s also true along racial lines and that’s something we haven’t mentioned. You can see it across time. In the south, when mental hospitals were built pre-Civil War, black people were kept out. There was no reason to waste money on slaves.

When the hospital system expanded in the late 19th Century, either one of two things happened; black patients were segregated and separated or separate asylums were built for the “colored insane.” Separate but equal, of course, means nothing of the sort. It’s separate, all right, but it’s deeply unequal. If mental hospitals for white patients were often hellhole snake pits, for black patients they were even worse. One can trace this all the way to the present.

We’ve talked about the ejection of patients into a community with no real effort to supply the necessary social support and the cycling of patients into jails. That, again, disproportionately affects blacks and especially black males who are seen as distinctly threatening. In the LA County Jail, for example, in the county, about 11% of the population is African American. In the prisons, it’s about 30%. Of those diagnosed with serious mental health problems, it’s about 45%. You can see that historical trajectory that we’ve talked about being replicated again in the present.

Moore: Thank you, Andrew. I’m sorry we could only just scratch the surface of the book. For people listening, I really urge you to go and read it. It is fascinating. It’s horrifying in parts. It’s forensic. It talks about the characters of the story, so rather than just an overview it talks about the key opinion leaders who set the stage for the changes to come. 

Scull: Thank you. This is very much a book I’d like to think is for everyone, not just for people working in the mental health professions. We all experience mental illness, either ourselves, in our family members, or among those dear and close to us. None of us escapes the social consequences of the existence of this kind of suffering. The book is written very much so as to keep the reader drawn into these things and to assist in understanding them as much as I’m capable of doing in as thorough fashion as I can in the space I have. I appreciate all the kind words and I hope indeed people do read the book.




  1. The amusing thing about this is that these self-appointed “authorities” would go into convulsions at the very thought of nutritional elements having any effect on mental functioning, despite getting a few minutes discussion about pellagra and scurvy with no mention about their psychological “side effects” while they were students (I recall the contorted faces of the professionals who found out I used niacin regularly instead of “meds”).

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    • This so called “new book” has nothing new and is a rehash of his previous books and covers the same historical ground that other books that are critical of psychiatry have covered. Very safe and convenient to go back to the distant past. Only about 35 pages on the current situation. A money grab of $35!

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  2. I think this is a really tragic summary of the world of psychiatry, especially in the US. Of course Bob Whitaker covered a great deal of this ground in Mad in America and subsequent books and articles. It would have been good if Scull had at least referenced that. I wish he had spoken to 2 other things–the rise of the peer movement and the role of alcohol and drugs in the criminal justice system. I’ve recently come across an excellent analysis that shows about 80% of those who end up in jails and prisons with mental health problems also have alcohol and drug problems. We can’t fully resolve this dilemma if we ignore that factor of substance abuse and addiction.

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    • The overall percentage of people in the prison system with drink or drugs problems would be very high anyway.
      The only effective means of recovery from drugs or alcohol that I know of is through the 12 Step Recovery System. When people Recover through this Peer Support System they often remain recovered.

      The only problem is that 12 Step Recovery ultimately costs nothing.

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          • The AA 3rd Step
            “Made a decision to turn our will and our lives over to the care of God as we understood Him.”

            I believe The 3rd Step Is about Not identifying too much with a troubled mind; and finding peace as a result.

            Practising the 3rd Step can help neutralise Historical Trauma.

            (.. God being a Higher Power of a persons own choosing..).

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      • AA has very low rates of long-term success from what I’ve read (I don’t have any peer-reviewed references on hand, but they’re probably easily found at Google Scholar). The emphasis on total abstinence, public confession, implicit religiosity and potentially re-traumatizing approach (not to mention a reputation for predatory males) don’t make it a great choice for many, although it’s the only thing many people (including judges) have heard of.

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        • Any statistics on AA’s long or short term success might be skethy or questionable as due to the “anonymity factor” “enforced” in the AA meetings and philosophy, etc. I am not sure about the “predatory males” that you mention, so I will not comment on that. However, total abstinence and public confession are very good things. Total Abstinence is very healthy and assists the individual in staying away from alcohol. As far as public confesssion, it seems a lot of MIA posts are the public confession stories of those who unfortunately became involved with psychiatry and are now suffering from it. Implicit religiosity—for many that is truly their “saving grace.” I realize that not everyone is comfortable with religion or spirituality, but for many, it has been the difference between living and dying. Right now, AA might be the only alternative, especially in small town America and other places, other than a residential addiction treatment facility which can be costly, might not be covered by insurance or other and could, depending on the facility, lead to further issues later. The good thing about AA is that it basically costs little to nothing and the AA member does not have to tell anyone, unless they choose or are bound by legal issues. In my opinion, I am not sure why people bash AA when the other alternatives, at present, seem to lead to the psychiatry, etc. of which we are already criticizing, some to most with good reason. I would also suggest that for some “psychiatric survivors”, an AA type “group” or “philosophy” might help them in their recovery from psychiatry, etc. In my opinion, we only fool ourselves if we have been harmed by psychiatry in any way that we are not in some form of recovery from psychiatry. However, as each person is an individual with a unique brain, one’s recovery is always a personal issue. Thank you.

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          • I believe Schizophrenics Anonymous is still going strong in Canada. They’re likely getting grief if they’re in the USA, as they’re fans of orthomolecular medicine (the first organizers were patients of Abram Hoffer).

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          • AA is just another “disease” model that lacks any scientific proof that a true “disease” process exists within the human body.

            Yes, AA and NA does help some people, but unfortunately its model dominates 90% of the rehab industry. This becomes a major “turn off,” and quite often a “turn away” for people who need desperate help for addiction problems.

            There are other alternative self help groups that neither push religion or the the disease model of addiction, such as Smart Recovery and Rational Recovery.


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          • Unfortunately, Twelve Step programs promote circular reasoning type arguments that end up “blaming the victim” for their inability to “get sober.”

            For example, if someone keeps relapsing they are told, “you’re just not working the Steps the right way.” So there can be NO questioning of their “disease concept ” of addiction, or their religious moralizing with slogans like “Just Let Go. and Let God” – “You Haven’t Turned Your Will Over to God Yet” etc…

            This type of moralizing makes people feel like they are “personal failures.” INSTEAD of looking for and developing the actual mental and physical skills needed to break a serious addiction.

            Millions and millions of people have developed the necessary skills to stop self destructive habits without 12 Step groups, religion, or counseling of any kind.


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          • Richard
            To be truthful the AA does work. The AA is not commercial but the Rehab industry is very commercial.

            There are lots of things people object to regarding the AA – but these issues do not present themselves as actual problems within the fellowship.

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    • I agree. Click on my name to see why I do.

      I do feel that drugs and alcohol illuminate desperation. That desperation may be because mental sufffering, like I have with hallucinations, becomes intolerable to live with, or it may be because the desperate are hounded and bullied for being desperate, especially in a tyrannically logical world. Logic does not fathom desperation since desperation is a feeling. And merely being desperate marks you as a loser or quitter or wimp. Someone needing educated out of emotional responses.

      In a previous comment I wrote glowingly of arriving back in psychiatric hospital care. I still feel it is the best option for “me” at this time. But I have been disappointed in how threadbare and scrappy and degraded the institution has become. When I first encountered psychiatric hospital care I was in a ward where community flourished. It was a ward full of poets and dreamers and professors and original thinkers and waifs and orphans and grandmas and rascals and creative humourists. The staff looked at this community and derived healing from it for themselves.

      Jumpcut to where I am now. Same hospital decades on and the ward is eerily quiet. Everyone stays in their room. There is zero community, zero poetry, zero humour, zero intellectual philosophy, zero creatives, the list is long of what is NOT here. So the staff are imbalanced and one or two are time served bullies. Those instigators and button pushers like to worry the desperate by withholding comfort, comfort in the basics, like ass wipe or shampoo or soap. Their jealous despising of patients, who get to loll around in bed all day, is to them am injustice. Injustice is how they experience their work, a job that has stopped being about community and has become a skull numbing exercise in form filling and computer data. The computer age has destroyed communuty. The main bully in staff may have risen to that spot by being intimidating yet impressively logical. Logic can make barbaric acts seem sensible and necessary. Order can be got up to look quite beautiful, like uniforms do. Like “consensus opinion” can.

      I have said that if there is only one bullying nurse on a ward then all the rest must be forgiven for having to follow the bully’s ever neurotic orders. But one thing a bully can do is spread “stories” about you to the other staff. It does not take much to build a story. A muddy towel, a broken window lock, a failure to eat an uncooked rasher of bacon, a smile that conveys some other feeling, being a bit of a mystery. These are all it takes to have your story. The story of how “you” are sneaky
      too sociable
      attention seeking
      ALL the worst characteristics get plunked at your hospital room door because stories are powerful attempts by the imbalanced to heal themselves by calling some stranger a “THEM”.

      I do not like to use the term narcissist anymore. I think it is the cuddly toy brandishment OF narcissists. I prefer to just say “bully”. No doctorial expertize is needed to call someone a bully. Probably that is why the overly logical bully does not like to use that easy word. But I do like the notion of flying monkeys. I do think a bullying member of staff becomes impressive at marshalling supporters for scapegoating a patient. This wonton act of betrayal is often the most astonishing collective insanity that a bully puts effort into. Millions of Jews were not so much murdered by bullies but by underlings who did not have a clue about why they “had to” carry out logical orders to prise shoes off philosophers. The story or fairy tale is evil’s best school book. The story that gets told about you has you pinned as a “them”. And so the moral of the story, the lessons, get centred more than the emotions within the story. Lies get cooked up to make you the villain.
      Humans pay ticket money to go to cinemas to spectate the punishing of the villain. Everyone’s life is not dramatic enough and stress can be swapped for the drama of seeing you get made even more desperate in your desperation. Flying monkeys can remorselessly corner you in powerlessness. Like velocerapters ganging up in three dizzying coordinated directions and coming at your plaintive request for a sticking plaster.
      ALL humans behave this way. So it is no surprise that it inches into nunnery cloisters and charities and activist campaigns and theatres and hospitals. It is just that in hospitals it is teeming with such gossipy story telling at a time when you are already suffering your own private unravelling, that hell. You do not need to be visited upon by some bully nurse’s inner hell.

      There ought to be in every hospital a BULLY department. Where anyone can safely whistleblow without having to drink alcohol or take drugs to steel their non existent wiped out courage.

      I am for loads of free choices and the choice to have hospital care is among that.

      But where is the care in withholding a bar of soap?

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      • I do feel the institution of anything can be made better. And I do think there needs to be alternatives to institutions. Both of these are true.

        I often seem irked at the logical or the bullying. I am not undermining the healthy love of logic. And I am not wanting to “them” the bully. All humans bully. Most humans do not know they are coming accross that way. They think they are doggedly asserting a human right. For the protection of the planet.

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      • Update…

        A few weeks later and whilst I still stand by my impression earlier of imbalance amist staff, at the ward I am in, I do have this to say even louder….

        A number of patients treat the nurses like dog dirt. They shout at them. They curse at them. They yell at nurses to fetch this fetch that. They barge into one to one conversations. They hurl dishes across the communal spaces. They kick the nurses. They do this sort of thing ALL DAY long. These are patients who came here of their own choice. Nobody is forcing them to take medication. Such patients are free to leave. They enjoy treating the nurses like scum. The nurses are NEVER raising their voices. The nurses are not given a minute’s peace. The nurses are demanded of to “fix everything” every minute of the day. The nurses ARE short staffed. Several times I have seen some on the verge of tears. The nurses are blamed for everything. The nurses are treated like vermin. I do not think it is good for the environment anywhere for human dignity and compassion to be denied anyone and everyone. It disgusts me when people give themselves permission to bully people.

        ALL ARE EQUAL.

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    • I bought this book on Amazon and paid nearly $35 to find that this really covers no new ground at all. Everything in here is old news and like 95% of his book deals with the distant past that he and others have covered over and over again.

      Prior to the biological revolution of widespread use and promotion of psychiatric drugs in the 70’s the population in the USA that was impacted was rather tiny. These days a large segment of the population is negatively impacted by these toxic drugs. The elderly in nursing homes, those deemed developmentally impeded, children, teens, prisoners are prime targets of this complex psychopharmacology that lead misery and premature death.

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  3. Psychiatry’s Turbulent Quest to Cure Mental Illness

    This is a good one – because my Cure was leaving Psychiatry.

    My (1980) notes from the Maudsley hospital contain a letter from a Dr D C Mawson stating that he feared I had come under the influence of (street) drugs in London – but the only place I could have – would have been in the Maudsley Hospital/Kings College itself – through my normal eating and drinking habits.

    I attempted suicide twice in a state of Acute AKATHISIA while consuming strong Psychiatric drugs (1980 – 1984) – but never before taking these drugs, and never after stopping these drugs (1984 – 2022).

    I came off the strong Psychiatric drugs through acceptable Psychological means.

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    • Exposure to strong Psychiatric drugs can cause “Schizophrenia”.

      Fluphenazine Decanoate consumption over a period of time – can on its removal – result in MADNESS.
      ….As can be seen in the (below) Paper:-


      “..In total, 71.4% (n=10) of our participants had relapse significant of noting since fluphenazine decanoate withdrawal…” (- with the availability of replacement “neuroleptics”).

      The Irish Researchers have CONFUSED “Psychiatric Drug Withdrawal Syndrome” with RELAPSE.
      (“Withdrawal Syndrome” happens automatically – RELAPSE happens further down the line).

      I was capable of surviving inside my own head prior to consuming Psychiatric drugs, but after attempting to stop taking these drugs my ANXIETY was such that I was in danger of Breaking Down.

      I learnt how to cope with my Psychiatric Drug Withdrawal High Anxiety through trial and error – but it could have gone the other way.

      I believe that If a person can learn to cope with Neuroleptic Withdrawal Syndrome they can probably learn to cope with so called “Schizophrenia”.

      I was described (as per my records) as a sick individual while I co operated with Psychiatric treatment – but I recovered as a result of stopping Psychiatric treatment.

      This drug is notorious for causing Akathisia, Suicide and Physical Disability. This drug has killed many People, their deaths masked as Mental Illness.

      Psychiatric Times June 18, 2014
      “..For example, a study published in 1982 reported that when a group of patients with schizophrenia were each given 20 mg of fluphenazine, the difference between the highest and lowest blood level of the drug was 40-fold. ..”

      Journal of Clinical Psychophrmacology – August 1983 – Volume 3 – Issue 4 p235
      Suicide Associated with Akathisia and Depot Fluphenazine Treatment 1983

      Study Work Status “…92.9% unemployed..” :-
      I remained physically disabled, not unemployed while I consumed Fluphenazine Decanoate.

      “…When thioridazine, another FGA, was withdrawn from the market in 2005, high rates of relapses for many patients with psychotic disorders including those who had maintained mental health stability for many years was noted (Purhonenetal.,2012)…”

      Thioradazine and Fluphenazine as older drugs target different parts of the brain to the newer drugs.

      Thioradazine can also have strong Withdrawal Effects.

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    • Dr. Scull’s latest book is aptly tilted “Desperate Remedies: Psychiatry’s Turbulent Quest to Cure Mental Illness”. It shows mainstream psychiatry for what it is – a dirty, but no longer desperate, business, ever since it fell into bed with the pharmaceutical industry, that is. But it’s more realistic to say it still hides under a rock.

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  4. “More than that, in an odd kind of way, the stigma that accrues to mental illness itself also sticks to the people charged with treating it or the people who have not accidentally come to be treating it. Of all the branches of medicine, psychiatry is among the most despised, the branch about which we’re highly skeptical.”

    Please stop blaming patients for the way that Psychiatry is viewed. The way Psychiatry is viewed is completely psychiatry’s responsibility. Patients have been scapegoated enough!

    Why is Psychiatry the most despised branch of medicine? Why is it the branch about which we’re most highly skeptical? Why is it necessary to even ask that question? Psychiatry is despised, people are skeptical about psychiatry, because of what it does. Its desperate treatments are not so much desperate but barbaric and completely void of science, completely dismissive of the Hippocratic oath, then and still. The treatments are only desperate in that they make the patients more desperate…that is if they survive.

    If Psychiatry wants to be respected it should change its own behavior (as psychiatrists tell patients every day while scribbling prescriptions).

    Imagine saying that people hate oncologists because people hate cancer or because they hate people with cancer. Completely bogus.

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    • KateL says, “Why is psychiatry the most despised form of medicine?”

      Because psychiatrists have too much power and misrepresent what they do.

      Psychiatry: A Branch of the Law” by Thomas S. Szasz, fee.org/articles/psychiatry-a-branch-of-the-law/

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      • KateL asks, “Why is psychiatry the most despised branch of medicine”?

        Because mainstream psychiatrists have too much power and misrepresent what they do.

        “Psychiatry: A Branch of the Law”, by Thomas S. Szasz, fee.org/articles/psychiatry-a-branch-of-the-law/

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      • Psychiatry is not a branch of “medicine” it is opinion based “medicine” if you can say that. If it was a business it would long out of business, exposed in the media, tons of lawsuits, bankruptcy etc. Since its inception it puts the cart before the horse and proposes theories and pushes services and “treatment” only to find out every sayy 40 years that opps we were “misguided”.

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    • “Please stop blaming patients for the way that Psychiatry is viewed. The way Psychiatry is viewed is completely psychiatry’s responsibility. Patients have been scapegoated enough!”

      He’s not blaming patients, he’s saying that stigma that gets attached to people with psychiatric diagnoses (by the general public) also “infects” those who treat them. The patients aren’t doing anything whatsoever in this process, but you’re right that psychiatry’s image is psychiatry’s responsibility.

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      • The comment makes it sound as if stigma “rubs off” on the providers, when in actual point of fact, the providers themselves create the stigma they are complaining of. The main reason psychiatry is viewed as a sketchy, unscientific, unprofessional branch of medicine is because psychiatry IS sketchy, unscientific, and generally unprofessional. Psychiatry has earned and deserved the reputation is has. Its patients have not earned or deserved the prejudice and discrimination that the psychiatric “profession” has brought upon them by their own unscientific and unprofessional behavior.

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      • In the case of the borderline personality diagnosis, the stigma originates within the profession and then is amplified by society. A quick perusal of the psychiatry subreddit, or any place, real or online, where psychiatrists feel like they are in safe company and can speak freely, demonstrates how the profession views “borderline patients” (as lying, drug seeking, hypochondriac, malingering losers). The med school students who are in training to be shrinks are the worst — they haven’t yet learned how to disguise their hatred, and are probably trying to impress their superiors/mentors and show that they’re “in on the joke”.

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      • The psychiatrist’s job in a clinical setting is to dismiss, ignore and diminish the patient “presenting” as they say in ground rounds. Label, Drug and next patient. What matters is what the psychiatrist feels about the patient and not what the patient feels. It is all opinion based dispensing of medicine ( drugs).

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  5. A depressing read/listen and an accurate summation of psychiatries miserable and destructive history. What Scull misses is the way capitalism and psychiatry are entwined. Psychiatry started out as do goody doctors taking charge of the extremely mentally distressed and became a business opportunity which they ruthlessly exploited as asylums fitted in with the development of industrial capitalism, it provided a way to remove disruptive non criminals from the bussiness dominated society. From that logic sterilisation, lobotomy and ultimately death camps evolved. Scull also misses the emiseration that capitalism causes and the way the rhetoric of Mental Health individualises distress and distracts from its social causes. The mental health industry is a core way capitalism continues, it’s ideology is part of the way modern capitalism is maintained, we are all sick in the head now, not miserable because of the poverty of everyday life.

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    • John Hoggett says, “….capitalism and psychiatry are entwined…”

      Yes, very true. Capitalism and psychiatry reinforce each other, because psychiatry’s a form of eugenics, and modern psychology’s not much better. And it stays this way because those with degrees can charge large fees.

      MIA’s “Psychiatric Eugenics Then and Now – You Betcha It’s Still Happening” by Bonnie Burstow Ph.D

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    • John Hoggett says, “…capitalism and psychiatry are entwined….”

      Yes, very true. Capitalism and psychiatry reinforce each other, because mainstream psychiatry’s a form of eugenics and modern psychology’s not much better. And it stays this way because those with degrees can charge large fees.

      MIA’s “Psychiatric Eugenics Then and Now – You Betcha It’s Still Happening”, by Bonnie Burstow PhD

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    • John Hoggett says, “The mental health industry is a core way capitalism continues, it’s ideology is part of the way modern capitalism is maintained, we are all sick in the head now, not miserable because of the poverty of everyday life.”

      Most psych professionals let themselves be lulled into a diagnostic trance from reading and believing the DSM’s innumerable diagnostic fairy tales, that, btw, ALWAYS have a happy ending – FOR THEM – because after every diagnosis is a code that means one thing: $$$……

      MIA’s “Capitalism and the Biomedical Model of Mental Health”, by Micah Ingle, MA

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  6. https://youtu.be/zBrwaCjJIFU

    Music for my earlier comment.

    What half the world are fleeing from are the institutions. They are fleeing to the garden of nature paradise, the communal small tribe.

    What the other half of the world are fleeing from are the tribes. They are fleeng to the dreaming spires and cathedrals and better living and institutions.

    When tourists a hundred years from now go touring it will be to do nostalgia trips to what they each fled from.

    In retrospect the symbol of institutions outlive all the people who made them and bitterly resented them.

    It is interesting to ask why humans need institutions. I mean ballet is an institution, opera is an institution, motherhood is an institution. Some may say that capitalism is an institution. But institutions go way back to Gobeli Tepe and the Walls of Jerico.

    People are still looking for archaelogical substrata evidence of them walls. As to establish its “realness”, and as if “realness” exonerates it of being a bad realness. As if realness is a cause for amnesty because stone realness is more valuable than the unrealness of feelings.

    Until humans figure out why they need institutions more and more of them will throw landmark shadows across the ant people streaming into them.

    I like institutions because they are absurd. Like Knossos and the Giza pyramids are full of enjoyable theatrical puff and pomp and ceremony. Humans like a bit of a party or festival. And so they get busy building needed weatherproofed awnings and edifaces to house those feelings. But then other humans get worried about the growing dominance of the institution.

    Institutions have internal battles to assert power and this causes “us and them”. That is the ugly side if institutions. The Colosseum was built first for acrobatics then for gladiators. Institutions begin as a utopia vision then become machines of conquest IF they are infilrated by too many “us and them” argy bargy bullies.

    I dont care if there are institutions or not. I just believe bullying is to be banned where ever it occurs, whether in a stone palace or a garden.

    I only believe free choice is healthy.

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    • THE HOOVER DAM is going to explode.
      I have been hearing from the angels that something is coming that is on the theme of THE WALLS OF JERICO. A modern take on that might see armies surrounding a city with trumpeting sound waves. A bully likes to demean one person. A tyrannical leader likes to bully a city.

      This article is very clear and knowledgeable. It is not my own knowledge for me but I have no wish to put a ripple on this pond.

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  7. “The seriously mentally ill were a standing reproach to the profession because they didn’t have good weapons to deal with the problem and they were deeply unattractive patients.”

    No, I don’t think this book is for everyone. Would a person who has been diagnosed with SMI, as I have, want to read, yet again, that I am deeply unattractive and that “good weapons ” are required to deal with the problem….the problem being me?

    Once again, people who have experienced the most grievous harm are blamed and left out of the conversation. Talked about, not to. No thanks.

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    • That is pretty damned offensive – makes “the seriously mentally ill” (who of course could be anyone “the authorities” so deem, given there is no objective way to assign such a label) sound like the enemy and psychiatry frustrated to be unable to defeat them and their “unattractiveness.” This kind of comment reveals a lot about the contempt in which such people are commonly held by those running “the system” that is supposed to be there to help them.

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      • Fair point.

        I had therapy with a woman who was wonderful but she a book on her shelf called “Hateful Clients” or something like that. It was on Borderline Personality Disorder. I rembember feeling glad I was not.

        However, on my ward a very florid young man hurled a bowl of hot soup at a trainee nurse. He may not have been aware of her feelings as a human being but I do think his act was hateful.

        There is a need for love to flow, to both bruised miserable clients and bruised miserable nurses.

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        • The Mayor of San Diego flew up to Sacramento recently to support the forced drugging effort. He has tied his role to reducing homelessness, yet he is also a Good Friend of developers – so affordable housing is pretty unobtainable here.

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          • There is a lot of support for Newsom and Eggman’s psychiatric policing plan coming from city and county governments.

            There is not much opposition, except from civil rights groups. The civil rights groups are vociferous in opposing it.


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  8. This is a very interesting expose of psychiatry. Actually, it is a tragic expose and it shows psychiatry, at times, as a monster, but more so as that ugly stepsister who only wished it could be Cinderella. In my opinion, this article reflects that psychiatry itself is more to be pitied than anything else. We have spent way too much time in a enraging anger against such this institution when it really needs our condolences. In this way, I slightly disagree with the author of this well-researched expose. I, personally, see a dying profession grasping at its last straw as in the infinite drugging of its patients. It has gotten so awful, that it now resorts to ketamine, a date-rape drug, and the psychadelics, the “counter-culture drugs” of the bygone hippie era. Psychiatry does need to be “replaced” in some manner, but what we need to do is pay more attention to the unique differences in how we both learn and are unable to learn. One of the issues of psychiatry is that it runs itself into the overblown effects of a “system” that has disregarded the unique gifts and challenges of the person and the very brain that runs it. Their solution has always been to neutralize the “problem” with lobotomies, ect, and especially drugs. The question may be does cbt and dbt do similar things. We can no longer live in a world where brains can be neutralized and also falsely blame it on capitalism. If our country was instead a country of socialism or communism, psychiatry would have gone to bed with them. The same is true for Big Pharma. Changing the political/economic system will not change psychiatry. If we think that we are only fooling ourselves. Actually, in a way, psychiatry will eventually die of its own accord, but what we must look out for with vigilance is what will replace it. Right now, one thing of hope on the horizon the continued availability of the Alcoholics Anonymous Model. One of the good things about this model is it does allow alcoholics to get together and talk and share their experiences. A variation of this occurs when Military Veterans get together and share their experiences. That seems to be one of the most productive ways in their healing and recovery. There are more than a million and one variations to a theme, as many variations as there are people with brains. In my opinion, psychiatry, like many other institutions, has totally forgotten that each person’s brain may share some “traits” with other person’s brains, but in the end it is individually created. Raging anger against psychiatry will not fix these problems. Raging anger against psychiatry will only make it grow stronger and more tragic. LOVE and FORGIVENESS, really are the ONLY answers. Thank you.

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    • rebel says, “We can no longer live in a world where brains can be neutralized and also falsely blame it in capitalism. If our country was instead a country of socialism or communism, psychiatry would have gone to bed with them. The same is truth for Big Pharma. Changing the political/economic system will not change psychiatry.”

      This is absolutely true. But mainstream psychiatry and capitalism sustain each other, with Big Pharma right alongside. But you’re right – it doesn’t matter what governmental system is in place, and it’s already being used by other systems, often in an even more authoritarian way.

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    • A nice balanced review, Rebel.

      I find it slightly suspect when an appeal to the past (misdemeanours) is put forth as if that past is here and now. Lobotomies are no longer done. And before anyone says that chemical compounds do a version of lobotomy, i say read ANY side effects and warning list that comes with ANY prescription and you will struggle to find even a vitamin pill that does not damage neurology if taken at top doses. People on menopause patches and people on contraception and people reaffirming their gender by having hormones are ALL affecting the brain, it is inevitable as the chemicals whirl through brain circulation. In one country over the pond there was a furore about salmonella in hens eggs. Adverts showed up on television that zoomed in on a million eggs being confiscated as if the robotics in factory farming had decided to make a mass omelette. Nobody dared enter a store selling an egg lest they need a medic. Every frozen or ready meal got sent to the bin because egg was therein. But the moral panic evaporated a few weeks later and nowadays we enjoy eggs with salad and so on. The public blaze of fear around ingestibles probably goes back to the cave times. But the public’s pendulum swing back to nonchalance is just as interesting and less studied. What or how or why do humans get over moral panic with, and relax into “balance”?

      I know the answer.

      But the angels want me to leave.

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      • Daiphanous Weeping, Thank you for your comment. We have issues in the States, like your “egg issue.” Sometimes, it’s a brand of peanut butter or even dog food. Each week, it is usually something, we must check our pantry, refrigerator or freezer for and either throw out or take back to the store and get a refund. And I heard on tv, they are worried now that they say about 40% of the food becomes waste. I think they are just probably trying to “mess with our minds.” On all those points about the drugs, etc. you are correct. Actually, everything we do or don’t do affects our brain from what we eat, to what we read, watch on tv, the movies, etc, how we use our skills, etc. The list is endless. I will say that much of modern psychiatry ignores this, but so also does education, traditional health care, the government, etc. I am not necessarily for psychiatry, but utilizing the system is a person’s choice. Children, yes, are in many respects a different manner, altogether. But, it is the parents’ responsibility, legally, still to raise the child appropriately. But, in my opinion, there is the “anti” thing that bothers me, because being “anti” anything without a corresponding “pro” will have a tendency to boomerang on a person in a negative way. I definitely understand the “anti-psychiatry movement” as I have my own issues regarding psychiatry. However, each day, I realize that one can not seriously and substantially be “anti-psychiatry” unless one is also, not only against “capitalism” but also, “socialism” “communism” “feminism” (all the “isms”) and much of the current and popular thinking about many subjects that were “hush-hush” years ago. Psychiatry is part of all that too. But, still, in my opinion, it is far better to live one’s life “pro” something good, rather than “anti” anything. And like Robert Louis Stevenson said in his poem, “Happy Thought.” “The world is so full of a number of things,/I’m sure we should all be as happy as kings.” In my opinion, that is the only way to win against anything, including psychiatry. Thank you.

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    • Some say capitalism is flawed, while others say socialism and communism are flawed as well. But all three use mainstream psychiatry in the same way, which means psychiatry isn’t about health or science or medicine – it’s about who holds power. On a small scale, it’s drug dealing, and on a large scale, it’s used as a tool for social control.

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      • Birdsong

        There are NO genuine socialist or communist countries in the world today, so your comment above equating systemic flaws regarding psychiatry and these two types of systems, does not make complete sense.

        Theoretically, there is NO contradiction between capitalism and psychiatry. Capitalism is a class based system that, by its very nature, has built in mechanisms of exploitation and oppression – it was NEVER intended to be fair or egalitarian by its own design.

        Theoretically, genuine socialism is, by design,, meant to gradually eliminate classes and all forms of human exploitation. So psychiatry (by its true nature) is in total contradiction to these goals and systemic aims.

        Yes, it is possible in a newly emerging socialist society for there to still be leftover forms of psychiatric type abuses. After all, the medical model (and all its pseudoscience) has a deep hold in the thinking of most people in the world today.

        The struggle against the medical model will be an important struggle within the newly emerging socialist societies. HOWEVER, it will be FAR EASIER to argue against psychiatry and the medical model under a socialist system, because it DIRECTLY contradicts the fundamental aims and goals of socialist theory and practice.

        In contrast, psychiatry and the medical model, has become an ESSENTIAL FEATURE for the future existence of capitalism. It serves the profit motives of Big Pharma, along with the power motives behind expanding the guild interests of psychiatry. AND IMPORTANTLY, it shifts people’s attention away from the inherent exploitation, alienation, and trauma within a class based profit system to make people focus on “bad genes” and “personal flaws.” AND of course, it drugs and anesthetizes potentially rebellious sections of society.


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        • With all due respect, “theoreticality is not practicality.” The comments made speak almost of “genuine socialism” as a “utopia.” Sadly, “utopias” are just that “utopias” and exist only in fiction and fantasy. In my opinion, there is no “ism” that can save us from anything, including psychiatry, etc. In my way of thinking, it seems almost delusional to even consider that “socialism” can do it either. Yes, our society has millions of problems and psychiatry, as it is now, is a definite contributing cause. However, until we see less of what is wrong with a person and more of what is right with a person, which has been epidemic in our educational system and of course, psychiatry, we will have nothing but pain. The answer always resides in each individual and his or her relationship to Spirit. Thank you.

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          • Rebel says:
            “With all due respect, “theoreticality is not practicality.” The comments made speak almost of “genuine socialism” as a “utopia.” Sadly, “utopias” are just that “utopias” and exist only in fiction and fantasy.”

            Nowhere have I EVER referred to socialism as any kind of “utopia.” These are your words, and a “straw man” argument about the nature of socialism.

            I spoke above about the GRADUAL elimination of exploitation under socialism. Socialism as a TRANSITIONAL SOCIETY (on a long journey to a truly classless society) will take many generations of education and transformation of both the young and the old.

            This period of “transformation” will require continuous struggle within all political and social structures. The “birthmarks” from the past history of capitalist divisions and exploitative thinking within society will require continuous debate and wrangling over new ideas and a total “breaking with the past.”

            This will be a dynamic and exciting process of political change – never boring – with the the constant risk of some people in society trying to take things back to past forms of exploitation and domination.

            Rebel says:
            “The answer always resides in each individual and his or her relationship to Spirit. …In my way of thinking, it seems almost delusional to even consider that “socialism” can do it either.”

            Unless “individuals” become part of an actual political movement for major systemic change against all the oppressive institutions within a profit based capitalist society – NOTHING will change.

            The “spirit” we need is that which is can only be derived from the collective struggle of humanity for a better and more egalitarian world. This kind of struggle (creating a new and fertile environment) is what has the potential to bring out the very best in the human spirit, and an evolving human nature.

            In fact we are now in real danger of losing what little democracy actually exists in the U.S., and descending into full blown fascism.

            What would truly be “delusional” in these circumstances, is to expect the current status quo of a profit based capitalist system to solve the very problems it has inherently created itself. Psychiatry and the medical model are an essential feature of this status quo.

            To Rebel and others:
            it is time we begin to explore brand new political and social options in the world. Climate destruction, world war, and the developing second “civil war,” demands we think “big” and “outside the box.”


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          • Hi Richard,

            glad you said this;

            “In fact we are now in real danger of losing what little democracy actually exists in the U.S., and descending into full blown fascism.”

            Reading the comments about ‘capitalism’ I can’t help but feel that people are failing to connect the dots on our regression into a state of fascism. Where ‘regulatory capture’ is the means of opening up ‘markets’ for these ‘products’ that are being sold under the disguise of ‘medicine’. Not unlike the way that Zyklon B, a delousing agent with some serious side effects, was used by the National Socialist’s in Germany.

            I know in my State (and possibly as a direct result of my personal experience) the Police are looking more like the Shutzstaffel every day.


            This reminiscent of the way that those who were stigmatised by the NSDP were ‘treated’.

            I am now increasingly aware of why I found myself nearly ‘outcomed’ in an Emergency Dept for daring to complain about the misconduct of public officers who have been given virtual carte blanche to resolve any complaints via the use of the Mental Health Act (and the newly introduced Euthanasia Act). This is precisely what one would expect in a fascist State.

            Private clinic uses the resources of the State (ie Police snatch them from their beds with no “reasonable grounds” and deliver them to ‘hospitals’ for ‘treatments’ including chemical kosh and electricity) to have someone ‘treated’ against their will? Private company has employees who are potential whistleblowers referred to Private clinics for ‘assessment’? And the ‘marriage’ of Police and Mental Health ‘professionals’ providing ample opportunity for people to be ‘coercively interrogated’ and the traumatised victim then labelled for the ‘treatment’ they have received. The documents being “edited” to ensure that legal representatives can not effectively represent, and fraud and slander completing the “fuking destruction” of the victims.

            I Never thought I’d see the day where a hospital Operations Manager was speaking like she was Al Capone….. but, there you have it. That’s how open and brazen they are about who they think they are in my State.

            What do you think about this gradual regression into a state of fascism? I mean it obviously has to occur, given the fact that the people who represent us, must recognise the position they find themselves in where they can turn the screws and enrich themselves with their unrestrained corruption? It used to be that politicians would be people of honor who spent years in office and did great things. These days it’s a get in and do your best to grab as much as you can before your forced to ‘resign your position’ and take everything you have basically stolen with you. The claim that we can’t start holding public officers accountable because no one would do the job the justification for not acting and putting these people in prison.

            And I have said before, this is Australia, not the U.S. We bug the offices of third world nations (calling them our ‘friends’) under the guise of proving them ‘humanitarian aid’, to gain an advantage over them in negotiations about Oil and Gas, and lock the whislteblowers up if they tell the public. Jobs for the politicians at the Oil and Gas company when they leave the government? Looks a lot like Hermann Goering walking through the collections of art seized by the Shutzstaffel and selecting pieces for his own home lol. Not that they ever see it that way.

            I just don’t see a ‘leader’ on the horizon who would be prepared to take back from these corporations what they have stolen from us by corrupting our political system. But then did anyone really see the storming of the Bastille as anything more than another riot that needed to be put down? “Let them eat cake” not a lot of good to a mob that wants blood, and who have nothing to lose but the misery they find themselves living in.

            Anyway, i’d be interested in your thoughts about the ‘stage of fascism’ (as opposed to the stage of capitalism/socilaism) the world now finds itself in.

            Also, what do you think of the situation with ‘journalism’? Antonio Gramsci was ‘dealt with’ by a fascist. Are we about to see the removal of the ability to practice ‘journalism’ (or at least the few who are actually left that are not agents of propaganda. I must look back at the footage of the way the Warsaw Ghettos were presented as holiday camps by the ‘media’. The ‘magic bullet’ presented as the way to ‘utopia’ via our media these days. Breakthrough in mental health…. if this program has caused you any concerns call Lifeline…… Don’t suspect a friend, report them.)

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        • Richard D. Lewis, Thank you for your reply. I did expect a rebuttal and a deconstruction of my comments. As for the “utopia”, I will say, in my opinion, it was implied by your statements, as in your description of “socialism” it appeared that “socialism” would be the answer to most all problems. If I read it incorrectly, I am sorry. I still think it does all begin with the individual, not some alleged “collective society.” I, also think, that each person has the right to decide whether or not they wish to “become political” in regards to the issues we face. In my experience, what is “political” can be as “addictive” as any other “mind-altering drug.” With all due respect, any kind of politics is as risky as any kind of psychiatry, etc. Thank you.

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          • Rebel

            We are ALL political – whether we want to be or not.

            We are either “political activists” – trying move society toward certain political aims and goals.

            OR we are “political fodder” – people being moved by OTHER forces in society who MAY NOT necessarily be doing so in our best interests.

            If someone chooses to go off by themselves (as an “individual”) and just meditate or pray for change, then I would argue that they will be subject to the “political” whims of those in society who are actually engaged in political activities affecting the very institutions we must live under.

            Yes, “politics” can be risky, but I would argue that it is FAR MORE risky to let others do it for you.

            BTW, “politics” does not necessarily mean “running for office,” but can involve ANY TYPE of effort we make to influence how people think and act in the world around us, especially as it pertains to certain established institutions in society.


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  9. It’s absolutely hilarious how people can go on and on about personal responsibility and taking responsibility and ownership of one’s actions, but oh poor psychiatry, poor little Psychiatry they didn’t know any better. They wanted to be real doctors but they’re not real doctors so they just started experimenting on people’s brains and pretended they knew what they were doing. It was a good setup though in a way because they could always say it was the patient’s incurable mental illness when things went south. And they still got paid and no one could sue them. But we should feel sorry for them. Maybe if we feel enough sorry for them they’ll stop killing people. But all these former mental patients who survived what Psychiatry did to them and didn’t have the sense to die well they will be blamed eternally and told that they’re not allowed to be angry about what happened to them. What a joke.

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    • Katel says “It’s absolutely hilarious…” and “no joke…” Yes, psychiatry has hurt people. I would say some thought, maybe mistakenly, they were doing good. Others had probably evil plans from the start. Some were actually involved in the “eugenics” movement. All of this is true. But, in my own, obviously stupid opinion, as some seem to consider it as such and by God, I must get more stupid every day by some of the comments, I will tell anyone that anger will get anyone nowhere. If we want to get somewhere, we will need to practice love and forgiveness and that includes loving and forgiving ourselves for our involvement in psychiatry. We will, also, need to be open to the fact that some think psychiatry has helped them, whether true or not. We can not solve the world’s problem through being angry. As difficult as it is at times, we must learn to practice peace. Space is no longer the final frontier, except for some, peace is. Each one of us needs to work on peace within ourselves, before we can even think of confronting psychiatry for all its ills and evils. Otherwise, we run the risk of turning into the monster that psychiatry is now. Thank you.

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      • I don’t think it’s okay to preach personal responsibility and to claim that Psychiatry takes advantage of those who refuse to take responsibility and then go on and say that Psychiatry deserves our condolences.
        I’ll find my own way out or not. I don’t need more people telling me, “you’re doing it wrong” like I’ve heard my entire life. If I’m angry from right now till the rest of my life till my dying breath that’s my business. Anyone who doesn’t like it can skip my comments.
        If I fail it at being a psychiatric survivor or fail at recovering from what Psychiatry did to me that’s my own business. It’s not like I’ve had any help from anywhere.

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        • And the harm that Psychiatry inflicted on me isn’t over by any means. I still get attacked on a daily basis, even here, even on the antipsychiatry subreddit I get told I don’t know what the hell I’m talking about, that I’m a stupid crazy person, here I get told that I’m too angry. What does it matter I’ve been alone for years practically bedridden for years there’s no help anywhere and I’m just waiting to die. Go on with your lectures. Did you lose 35 years of your life? Did you lose your entire family? Did you lose your physical health? Did you have your brain shocked and then threatened with more?
          There’s No Love in telling someone on the internet that if they don’t do it your way they’re going to become a monster. Give me a break.

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          • Katel, Please forgive me. I will not comment any more about your situation. It does sound awful. Each person does have the right to respond to what life has dealt them in their own way. But I do hope things improve for you at some point. Thank you.

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      • https://youtu.be/EGzlNPPkW0M

        This channel is like Lee Haris’s channel. It is not for everyone. But for some these ways of seeing the increase in intolerance going on it world today is useful.

        When wounded there is a necessary relex outrage that is healthy. It is good to accept a feeling of anger because by accepting it the feeling soon disipates or disolves. Like a boxer biffing a punch bag. The angry energy weakens. But what can occur instead is the person does not experience a feeling of anger, because feelings are chronically blocked instead of healthily flowing. When humans accept blends of their many feelings they calm down and cease ranting. A person who is out of contact with their feelings experiences unsatisfying levels of agitation and stress. They live in their critical mind and overthinking and outward behaviour rather than leaning back comfortingly into their many felt feelings. Because they never allow themselves to actually feel the emotion of anger they only allow themselves to be outraged at not getting to feel. As if some external person has forbidden them to feel. The upset one could simply choose to allow themselves to feel all their backlog of feelings in one brilliantly liberating moment but what deters them is the way they have become frightened of that backlog of feeling erupting uncontrollably. So instead of finding calm in allowing all feelings to become befriended and flowing again, as children are skilled at, the upset one keeps a lid on such feelings and retreats ever higher into the mind, not the heart. It is THIS cramped discomfort and being bereft of feelings that THEN gets BLAMED on outward people. As if those people insisted the upset person stay only perfectly logical and live only in their mind. It is as if the other person has stolen the upset one’s whole exuberant medley of fine feelings.

        No human can steal another person’s feelings. A human chooses to put that divorce from feelings on themselves. Another person may logically teach them not to be so emotional but ultimately nobody can control the interior life of the human. Nobody can get inside the human’s psyche and manage it or order it all neat and tidy. Try as they might, with drink or drugs or propaganda or skewed false man made religious tennets.

        If a human is uncomfortable through never feeling and never arriving at the calm from that flow, which is like the calm from crying, then the become a bottled up powder keg of explosive backlog of emotions, emotions that are from the past and have nothing to do with whom ever the human has on their list, their blame card.

        What I am saying is that if a human feels wounded it is healthy to let that anger flow. But there should come a point where calm follows and from calm often comes a moving on kind of forgiveness. However, if the anger is blocked, then a different sort of anger manifests, as an anger at not being allowed to FEEL the anger that is there. Or the different anger is from ever having dangerously pesky feelings at all in the first place. As if a psychiatrist either “stole” the feelings that are hidden under the lid, or that the psychiatrist is to blame for “giving” the feelings. The mind is often at war with the messiness of feelings and likes to call feelings TRAUMA that somehow should not be there. As if calm and happiness are emotions that come from the non-feeling safety of the mind and its manufacturing of cold “reason”.

        Every imbalanced stressed out human likes to get rid of feelings and when they cannot they often blame outside people for giving them the feelings, normal every day feelings like sadness and anger.

        That then makes going from accepting anger and letting it flow harmlessly away as an inner holding become impossible, and that is why calm is not reached, and without calm there can be no possibility of forgiveness.

        The anger needs to flow within for the next stage of forgiveness to come. BUT in a world with leaders all itching to make people into puppets on strings, propaganda gets done to tell people to stay enraged at the way others have either “caused” feelings…or disallowed “feelings”. Both of these are discomforts. Discomfort then gets marshalled en masse into “consensus opinion” as to who caused the problem of feelings. Who is to blame.

        Psychiatrists are caught in the cross hairs of such human difficulty over just letting feelings be. But the main thing to realise is we are captains of our own ship. If we want to allow a feeling like sadness or anger to well up….no one can stop us. The idea that other people have the power to do so is almost wishful thinking. Our feelings are our own responsibility. That said….none should tolerate actual abuse or bullying or cruel. But those are actions not feelings. Feelinga are not outward behaviour. Feelings are harmless to just feel. Not feeling causes bullying to erupt.

        I must go..
        Heh….the HOOVER DAM exploded today. There may be more to come. Like the Twin towers had a van explosion before the finale.

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  10. at a personal level, I benefit from Orthomolecular psychiatry. Orthomolecular psychiatry seems to have helped mitigate, possible un-do, damage done to me by standard issue (read: chemical warfare on “patient” and “illness”) psychiatry. Would I need the mega-dose vitamins if I hadn’t existed as a psychiatric casualty for years? I kind of doubt it. And yet…I do rather enjoy my vitamins’ side -benefits-, so…there’s that.

    at a larger, macro-level…what is needed is -not- yet another “new, exciting” approach to “(severe) mental illness,” but rather a less toxic, more viable approach to life and society and the economy. dare I say…socialism with a side dish of utilitarianism? at the very least…an end to the -especially- draconian and merciless neoliberalism of today’s USA. To me, it seems that things have gone from “trickle down economics” to “stomp ’em down economics,” and the growing numbers of “mentally ill” on disability, in jails and prisons, on the streets, and the suicides and other “deaths of despair” demand change…but who will listen?

    and to return to the personal end of things…I think of my own vitamin popping, Bible thumping approach as a sort of…meaningful life, -after- psychiatry, despite the labels. Other have their own “formulas” for making a live-able life, post-psychiatrization. 🙂

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  11. Serious mental illness?! Seriously?

    Attempting to cure mental illness is like attempting to exterminate unicorns. I won’t even go so far as to wish the social control authorities luck in the matter.

    Our antipsychiatry movement has experienced a great die off in recent years, but I intend to go against the grain. I’m going to shrug off the lack of support antipsychiatry receives these days, and become the lone antipsychiatry clown hold out stepping out. I don’t care who wants to buy BS galore, it’s not for me. You can be psychiatrized to the gills, just leave me out of it. I’m done with all mental health what-cha-ma-call-it. You can manufacture that “need” for somebody else, not me. I will make do without such contrived and magnified misfortunes.

    Actually, I’m trying to make up for my lame positive take on your book Madness In Civilization. In it, you were highly critical of two of my heroes, Michel Foucault and Thomas Szasz, and by doing so, offering a friendly pat on the back to those who thought they knew what was best for those who theoretically didn’t know what was best for themselves. If I recall, once we had a psychiatric survivor movement. This differs a great deal from a mental patients movement, serious or comedic, and that’s where the movement remains for me.

    The psychiatric drugs developed to have fewer ill effects than the first generation of psychiatric drugs have been killing people off at a younger age than their predecessors. Does this make death a good trade off for what Thomas Szasz referred to as “problems in living”. I think not. As you pointed out, “solutions” don’t pay unless they are chemical, and keep the “troubled” returning for more.

    I heard a slogan that I think might apply here. “Less is more.” In particular, “less” treatment “is more” health, quite literally. Continuing, “none” being “least” must be “most”. Right, when it comes to psychiatry, all for it. I’m all for none of it, that is, for me anyway. Anybody who wants psychiatry can have it, but children don’t have rights, and neither do psychiatric patients. I’d rather hang onto mine, thus I can do without right depriving “treatments”, thank you kindly.

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    • This “new book” by Andrew Scull has nothing new in it! He and other authors critical of psychiatry have exposed the past and few want to focus on the horrific damaging effects that psychiatry and those who are involved in dispensing these toxic drugs. The population in the USA that is being exposed to these drugs is exponentially greater than the relatively small group the was victimized forty years ago.

      Like 25 pages toward the end deal with the current situation. This is a $35 money grab. Sad.

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  12. I would like to see a professional (psychiatrist, sociologist, therapist…) write a book addressing the current carnage and what steps psychiatric survivors can take to either recover from their Psychiatry-induced injuries and/or what steps the system should take in the way of reparations/palliative care for those who have been injured by these criminal practices, many of whom (myself included) have been ABANDONED by family, society and institutions. I struggle to feed, clothe and house myself, and there is no help. None.
    I have tried to recover on my own, through diet, etc. I have been off the psych drugs for over a year. But after 35 years of psych drugs, trauma, ECT, etc, maybe my brain/spirit cannot recover. I’m extremely isolated. I don’t even have anyone to go to in an emergency, which is terrifying. Maybe my body can’t heal because I never feel safe. As a middle aged woman alone who has trouble looking presentable, I have to fight for things that, for another person, would simply be seen as a basic right.
    It’s unbearably painful to get the message that I’m failing, once again, this time as a psychiatric survivor. After a long life of failure, as a daughter sister mother employee patient, the list goes on, now I get the message every day that I am feeling again.

    With the dozens of books that have come out now including this one making very clear what Psychiatry has done, why has nothing changed? Why do I still get looked at like a crazy person when I go to the doctor and try to explain my situation? If the books and the articles don’t change anything, what/who are they for?

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    • Steve McCrea is right, “there is no way to be a failure at being a psychiatric survivor.” Also, sdaly, it does take more than a year to go through the withdrawal period from these drugs and at times it can be a little rocky. But there are good times, too. During most of the worst of it, I chose to isolate myself for my own protection. In many cases, traditional medical doctors and other health related professionals lack the understanding and knowledge to help you. This is basically uncharted territory. In many ways, you are a pioneer, but many have gone before you and survived and thrived to a better life. I can not tell you exactly what happens when you get to the other side. Each person’s experience is a little different. Luckily, I had my mother and still have my mother and despite some occassional issues between us, she has helped me greatly. I did have to explain things to help her understand, but when she saw that I was thinking and acting a little “clearer” and more like myself, she began to understand completely. All I can tell you is stick with it, it will get better. Thank you.

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    • Sadly everyone profits for the misery of others. Not just psychiatrists and big Pharma are at fault, but it is the main stream media, PR firms, Internists that prescribe like 90% of psych meds, NP’s, Psych RN’s, Hospital staff, Unions, Administrators, Advertising firms, drug salesmen, Nursing homes, Jails, Generic Drug companies, Lawyer who sue Drug Companies, Patent lawyers, Psychotherapists, psychologists who can prescribe in some states, shareholders in drug companies, Private Mental Health hospitals, politicians, historians, book publishers, non-profits, lawyers who specialize in Mental Health Hygiene law, Judges, social workers, psychologists, researchers, counselors, Medical device companies, ECT & Brain stimulation practitioners and manufacturers etc.

      There is a large segment of the US population that sadly believe a that a cure or salvation comes in pills that you pop each day. Poor outcomes and endless “treatment” is the business plan as it keeps lots of people employed and brings in tens of billions a year.

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  13. Richard D. Lewis, With all due respect, you think what you think and I will think what I think. There are those who have actually studied history and have come to the determination that there are different ages of humans and the political is only one of them. The Indian Chakra system actually places the political aspect of humans on a lower level than say the spiritual, intuitive, or creative. I just see it a different way and yes I do consider the political more of an addiction than anything else. This doesn’t make me better or worse than anyone else. It is just how I look at the world. In my personal experience, politics is like a dead end street and as both society and culture, we will never progress until we basically leave the political and embrace SPIRIT to a much greater degree. In my opinion, politics of all human affairs is the one most subject to greed and other of the so-called seven sins. I don’t know. Politics is a dirty affair and I would hope we would not sink that low in our desire to either reform, conquer or abolish psychiatry. Thank you.

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  14. There are few observations I made:

    The culture say we are responsible for our feelings and thoughts because we are responsible for ourselves and everything that happens to us.

    The culture also says “share your feelings and thoughts” with a psychiatrist who makes a “judgement call” and gives you a label based on your thoughts and feelings not on your behaviour or the serious situation you found yourself in the culture – capitalism.

    because your “behaviour” may be you are working, living, struggling but still paying the person who is telling you that you are sick or buying extreme expensive medications when in fact, you are experiencing oppression at home or in the society.

    Quite conundrum!

    This is called double-bind: You are an individual responsible for everything that happens to you and when you share your inner thoughts and feelings and that person says you are mental, that is your doing. No winning here!

    It is almost as if the cure is: do not give a person access to your thoughts and feelings but your behaviours (which is what others see and what you might be judged by). Example, you say there is structural racism and you cannot get a job. No one should ask you what is your inner thoughts and feelings and then say, ooh you are the problem! This is crazy making. A more humane way would have been tell me what is happening in these places where you are applying jobs and let us talk about how to maneuver in this system! but that may get the psychiatrist not an income!

    What happens is the person is obviously pissed off about the situation and the psychiatrist says well the problem is you are pissed off (my LOL here because that piss may be labeled an ambiguous scientific sounding name to make it interesting) and until you stop being pissed off, the problem remains. I mean talk about gaslighting!

    This is a nutshell of psychiatry.

    Feelings and thoughts do not need medications! behaviours do not need medications. Medications should be saved for an inflammation that is also obvious to the owner of the body….

    But we cannot give that sort of power to the individual! oopsie but we can convince them they are individual until we say otherwise!

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  15. Richard D Lewis,

    I like your zeal to make the world sympathetic in the way you want it to be.

    You say…

    “BTW, “politics” does not necessarily mean “running for office,” but can involve ANY TYPE of effort we make to influence how people think and act in the world around us, especially as it pertains to certain established institutions in society.”

    I am looking at the word “influence”.

    Everyone is trying to “influence” everyone. Nobody seems eager to be influenced. It is as if everyone thinks they have the winning formula for a better world. Their world. But it is also my world and your world and we are hopelessly different in myriad ways. The difference is delightful. And so long as the difference is not directly harming another person then it is good to allow for it. But this word “influence” gets in the way of “acceptance”.

    A person ought not accept violence or cruelty or abuse. Those are not differences but more like sicknesses that spread all over the world. But confusingly some people may encompass justifying cruelty AS an influence added to an influence. This is perhaps what makes me reluctant to want influences that may be fine on paper. I see nothing wrong with your vision of a better world. I feel you hide a deeply loving heart in it.

    All kinds of different influences run simultaneously in the world and seldom is there any one that wins over all the rest. Rather the tension between them all forms a kind of spider’s web. A silk of socialism begin separately, anchored in a particular part of a shrub but ultimately it merges with other approaches as it gets nearer the centre. All strands do this. Any influence has to play footsie with difference sooner or later, to be a “balanced” influence and not an extremist influence. It is a source of sorrow to have a vision infiltrated by those who only partly like it and see its merit, but the choice is either go it alone or yeild to the preferences of the different.

    I see the intricate spider’s web needs all the influences to come together in a harmonious balance or its just a tight rope.

    But I am interested in why humans want to influence each other at all.

    Animals don’t.

    Animals are compassionate and do not cause wars. Animals have no interest in influencing anyone, beyond the odd dog fetching a leash or a soggy slipper.

    Animals leave each other alone.

    It is not animals who cause climate change.

    Much of the things that wreck the environment are due to the human urge to influence other humans. A city of tower blocks towers over all else in an attempt to influence. But what can occur is bullying can seep into the attempt to influence. Bullying is caused by fear of being overwhelmed by emotion. Bullying protects against breakdown by numbing away emotionality and swapping it for mind and analytical thinking. Politics can be a place such bullying gains cover in. Religion can be that safe house for bullying also.

    I think influence is wonderful when it is, as Rebel says, more “pro” than “anti”.

    One does not have to hate to do the art of being love. When influence sweeps up a noise that seems to be about hate I tend to shut down my listening. I just don’t want hate’s diatribe to be in my life. I believe a human does not have to hate to effect the same visionary change or build their version of a better world that they want to. When bullying infiltrates a vision of a better world it can cause that vision to seem tolerant of a necessity to bully. And this makes the beautiful vision look like an unwelcome of difference.

    But Richard, I like how you are free to be different and passionate and rousing and clear talking and suffering no fools gladly.

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      • That means a lot to me. Thankyou.

        I know you do not have much interest in angels but it is a model I am using as a convenience to do this comment.

        I think I may have said that I once nearly fell off my chair when my angels told me they love the arch atheist Dawkins. He, the very same, who derides angels and heaven and deities and Father Christmas. When I asked the angels why they love someone who doesn’t want to believe angels exist, the angels told me that free choice is the best. Even the choice to call angels absurdities. The angels cheer when someone chooses to be atheist or devoutly religious. And the angels cheer when someone chooses to be capitalist or socialist.

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  16. Scull’s book is largely a retread of old information that has in well known. The first 19 chapters go over history and ground he and others critical of psychiatry have gone over. Pages 321 to 379 cover newer ground but nothing worth forking over $35.

    Scull is critical and yet somewhat supportive of psychiatry and its overreliance on toxic drugs and destabilizing patients- making them forever patients. The real horror is that even after a long well documented history of harm, abuse and poor outcomes psychiatry still continues to exist!

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    • Thank you for the synopsis! It’s so unfortunate that people who have studied psychiatry’s history still support it to even the slightest degree. I did suspect, after reading the interview and hearing the author speak of the need for “better weapons,” that the book would be more of the same.

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      • Hopefully when Scull gets old and foggy in the mind he will experience first hand how the most vulnerable are treated like in out prisons and nursing homes plied with “complex psycho-pharmacology” to manage and control their symptoms. I guess Scull will have to wait another 20 years so he can write a critical book about the period from 1995-2022. It is always safe to be critical of the distance past. This book is a money grab and about 95% of it is based in the distant past.

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  17. Richard D. Lewis, Yes, there are those who do break out of their addictions without Twelve Step Programs, but there are those who need them and feel comfortable with them. So, I ask, why not let them be available to the people who do feel comfortable with them? Why do we just have to one or two options available? Also, the phrase, “Let Go and Let God” is NOT moralizing. It is a gentle statement that can release tension and anxiety in people. Not only that, the concept of “surrendering to God” can be quite freeing and healing for many. Please don’t take this type of help away from those who need it. In my opinion, that too, is a form of moralizing. Thank you.

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  18. In addition to the history given above, it is important to know the DSM-III committee in 1980 split Manic-Depressive Illness-MDI (for which bipolar is a smaller category) into two categories of MDD and Bipolar based on six years of family studies. Subsequent research over the past 40 yrs. has disproven that decision but the current DSM committee decided they did not want to put Humpty-Dumpty back together, an unscientific decision. The full MDI disease syndrome is severe recurrent depression with or without mania whether a person is sad or not.

    I cover these issues in depth at https://medicalmodelredux.com/

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    • “the current DSM committee decided they did not want to put Humpty-Dumpty back together”

      They can’t, not now that all the Kings horses and all the Kings men have been eating scrambled eggs for years. Shoving that egg head off that wall was the best thing that could have happened ….. for some anyway lol

      Aside; I note that Rich Rivera of West NY PD was aware of the uses of psychiatry for police officers who complain about corruption. See Betraying the Badge episode 1 @ 30 minutes onwards. But what choice does one have when your employer orders you to attend such an ‘assessment’? Only to be ‘mugged’ on the way out the door by a State sanctioned predator aware that you have a wallet full of money.

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        • Without a doubt KateL.

          I realised when it was too late how a rogue psychologist had warned me about the ‘FREE’ counselling service provided by my employer (is anything ever really free? lol). The reprimands he received for not documenting my ‘case’ should have been warning enough……. how was his superior to inform my employer if he wasn’t documenting? And as many are aware, the idea of ‘confidentiality’ is a farce. Who is paying the bill again???

          Any issues, referral from psychologist to ‘friendly’ psychiatrist for the kosh or electricity.

          I suppose many police would ‘resign thier position’ rather than be taken down the dark alley of psychiatry. Note Rivera only slipping through the net because he didn’t attend the appointment, despite this being a sackable offense.

          So while police may be making arbitrary referrals to ‘mental health services’ of citizens who have proof of their corruption ( a telephone call made to mental health about the person “hallucinating” in their station based on zero evidence or no “reasonable grounds” [forget the “Criteria” set out as a legal protection for the community, this is mental health were talking about. Fabrication city] enough to snare the victim in my State), they are by no means exempt from finding themselves on the wrong end of ‘treatments’.

          Most police would know the point at which to ‘bail out’, ….. which can be advantageous to a well placed psychologist/psychiatrist team. Think your walking away with your pension? Think again.

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