Growing Good Mental Health with Choice Theory


Thought Provoker:

How do you define good physical health? Do you know what to do to develop, improve and maintain your physical well-being?

How do you define good oral and dental health? Do you know what to do to develop, improve and maintain oral and dental health?

How do you define good mental health? Do you know what to do to develop, improve and maintain good mental health?

A colorful illustration in blues and greens depicting a figure standing atop a globe, holding an orange ball in their hands.During the psychiatric rotation of my undergraduate nursing program, I read William Glasser’s Reality Therapy: A New Approach to Psychiatry (1965). At that moment I knew this was going to be my area of specialty. All of Glasser’s subsequent books, lectures and especially the work I was fortunate enough to do with him have influenced my entire professional career and personal life.

I worked for decades as a psychiatric nurse in traditional psychiatric settings, using the medical model where diagnosing and medicating people was considered to be “best practice.” This is still true today, despite the lack of evidence to support this protocol. People did experience temporary relief of their symptoms and upsets, but never quite returned to a medication free life, or a vibrant and happy one.

Most of these folks developed “side effects” from the medication they were taking, which were often just as bad and debilitating as the original mental and emotional distress that brought them to treatment to begin with. For some, this led them to seek help from a different health care provider. This often led to a different diagnosis, with new medications prescribed.

Rarely were the previous medications discontinued. It was not unusual for me to see patients with more than one psychiatric diagnosis, taking as many as 25 or more medications, and still complaining of unhappiness and unpleasant symptoms.

This is what was considered best practice. Today this is still what is considered best practice. The noteworthy changes that have occurred in the 48 years of my career in mental health include: new, and different medications, and a change in the terminology from “mental illness” to “mental health,” but still without defining what mental health is. There is no information given or discussion about what a person can do to develop, improve and maintain their own good mental health. It’s worth noting that changing the name from illness to health has had no effect on the negative social stigma associated with mental health. Added to the problem is the pharmaceutical industries’ false advertising that medication can “fix a person’s broken brain,” as if that defines mental illness.

What if we changed the mental health paradigm altogether, making it more consistent with the paradigm shift that has occurred for physical and dental health? What if our best practice taught all people what mental health is, and taught people what to do daily to develop, improve and maintain their mental wellbeing? What if we could start right now Growing Good Mental Health?

In 2005 Glasser wrote a small booklet entitled Defining Mental Health as a Public Health Issue. Today, in 2022, because of the COVID-19 pandemic, the entire world finally understands that personal mental health is also a public health issue.

Yet we still have not defined what mental health is.

Most six-year-old children in the US can tell you what to do to get into better physical shape. The same is true for dental health. I personally know a few elementary teachers who ask their students to brush their teeth after lunch before they go out for recess.

Imagine an eight-year-old, or an eighth grader, or a junior in high school or college knowing what to do to develop, maintain and continue to grow their own good mental health. Imagine them understanding that their negative experiences create a negative change in their mental health. Imagine that they know what steps to take to improve it. Imagine that they know and accept that there may be times when more help is needed, that they know who to reach out to, and that help is available to them, not something to be stigmatized by or hide from.

The worldwide COVID-19 pandemic brought about significant changes in people’s lives, including an awareness of the disruptions, disturbances, and changes in their mental health. Because of my interest in the subject, I set a Google search for “mental health as a public health issue,” and the number of alerts I started receiving increased significantly and continues to this day.

For me, COVID has created an opportunity and a call to action. (More on that later*)

Choice Theory Psychology Explained

William Glasser is the founder of Choice Theory psychology, an internal control psychology. In fact, Glasser, along with Albert Ellis, created the original CBT (cognitive behavioral therapies): Choice Theory by Glasser and Rational Emotive Behavioral Therapy by Ellis.

Choice Theory is a psychology based on internal motivation. as opposed to external motivation which is the model most individuals and organizations operate from. Internal motivation means that the external world provides us with information, but does not make us do anything; behavioral choices are inspired from within and every individual has the power to control only themself. This allows us to take responsibility for our own life, happiness and choices. Knowing this also allows us to stop the exhausting process of attempting to control other people’s decisions, lives and choices. The only person whose behavior we can control or change is our own.

Choice Theory explains that we choose our behaviors in an attempt to meet one or more of our five genetic psychological needs: safety and security; love and belonging; power; freedom; fun. From birth we begin creating internal pictures of what we want, our quality world pictures, because these things, people, relationships, and experiences satisfy one or more of our needs.

Our daily lives are composed of a constant series of self-evaluative cycles, comparing what we want and need with our perception of the world. When there is a difference between what we want and what we perceive we’re getting, we are driven to behave, in an attempt to effect change. Thus, all of our behaviors are purposeful. But all behavior, although purposeful, may not be effective. And even purposeful and effective behaviors may not be responsible. Responsible is defined as a person’s ability to meet their need without interfering with another person’s ability to meet their needs.

Attempting to control another person’s behaviors is almost always irresponsible, leading to damage in the relationship.

In an attempt to better understand Choice Theory psychology, let’s look at the many choices people made during COVID-19. If you were worried about your own health and safety, and the security and survival of others, you probably wore a mask and practiced physical distancing. In fact, these may be things you continue today. You probably quarantined, if possible, for your own protection and the safety of others. Getting vaccinated was never a question for you, you did it to stay safe and healthy even though it was inconvenient and uncomfortable. Because it was important to you, and you chose these things, you never felt your freedom or power were being infringed upon, although you probably felt unhappy about your lack of connection, fun and freedom.

You probably also changed the way you met your needs for love, power, fun and freedom. Suddenly the world was learning and using Zoom for connections, shared holiday dinners, playing new games, going to school and working remotely. It wasn’t the same and yet, because health and safety were your strongest need, alternative methods were found to meet your other needs.

However, if you believed that COVID-19 was not a health and safety issue as reported, you may have done only a few of the above, or none at all. You felt your freedom and power to make autonomous decisions were being imposed upon. No matter what anyone else said to you or threatened you with, you were not going to change your mind or your behavioral choices. Your need for power and freedom were/are more important than your perception of the threat to your health and safety.

Whose position was correct? It depends on what need was most important to you, as well as your quality world pictures, and the way you perceived COVID-19 and the world.

Evaluating the difference between what you want and what you have motivates you to take action, to behave, in order to achieve more of a balance. The practice of Choice Theory involves having an awareness of the choices that will meet your needs, and self-evaluating whether your behaviors are helping you achieve what you want in a way that doesn’t interfere with others doing the same.

Choice Theory involves shifting from an external control psychology, the belief that our behavior (thoughts, feelings, actions and to a certain extent our physiology) is determined by outside forces, such as luck, circumstances and other people, to an internal control psychology, knowing we always have choices and understanding that we direct and are responsible for our choices and resulting consequences.

Definition of Mental Health

My definition is based on Choice Theory psychology. I do not mean to say that this is the only or the best definition, but using this model informs all the work I do with others. I would invite and encourage all practitioners to develop and use their own definition for good mental health, sharing it with their clients so everyone knows and agrees with the goals you are aiming for.

In Glasser’s small booklet, Defining Mental Health as a Public Health Issue, he writes:

As I will now begin to explain, mental health can be accurately described as an entity totally separate from mental illness and I offer the following description: You are mentally healthy if you enjoy being with most of the people you know, especially with the important people in your life such as family, sexual partners and friends. Generally, you are happy and are more than willing to help an unhappy family member, friend, or colleague to feel better. You lead a mostly tension-free life, laugh a lot, and rarely suffer from the aches and pains that so many people accept as an unavoidable part of living. You enjoy life and have no trouble accepting other people who think and act differently from you. It rarely occurs to you to criticize or try to change anyone. If you have differences with someone else you will try to work out the problem; if you can’t you will walk away before you argue and increase the difficulty.

You are creative in what you attempt and may enjoy more of your potential than you ever thought possible. Finally, even in very difficult situations when you are unhappy — no one can be happy all the time — you’ll know why you are unhappy and attempt to do something about it. You may even be physically handicapped and still fit this criteria.

My definition of Mental Health is somewhat simpler: For me to be mentally healthy, my daily objective is to meet my needs for safety, love, power, fun and freedom. When I do, I feel satisfied and content. On those days when I’m experiencing discomfort, anger or frustration, I ask myself: What do I want? What do I need? Which need is not being adequately met and which is driving my discontent? Is what I’m doing now helping me get what I want and need? Can I make better choices about what I’m doing? Do I need to make different choices about what I want?

Sounds simple, doesn’t it? Glasser’s ability to present his ideas in an uncomplicated, straightforward way has always been appealing and it has meant that these ideas can be understood and practiced by anyone, at any age, anywhere. However, putting these simple ideas into practice is very challenging.

There is more to Choice Theory psychology than I have explained here, but this is a good beginning. The more you learn, the more you realize there is to learn and that you want to learn.

COVID-19 presented challenges for all of us, no matter what your circumstances. There are many people in the world who are growing their good mental health and creating a happy life following the tenets of Choice Theory. But has it been working during COVID?

*Growing Good Mental Health: Is It Working?

Several colleagues and I started a project in March of 2022 to find the answer to: Is your knowledge and practice of Choice Theory helpful in grappling with the impact this virus has had on your life?

So far, we have received survey responses from people in more than 11 countries, with the majority of people stating that Choice Theory has been valuable or highly valuable. We are continuing to reach out to our international Choice Theory community to get more survey data. And since Choice Theory is being taught in our many Quality Schools around the world, we have plans to create a survey asking similar questions of that demographic.

Our goal is to share the results of our qualitative grounded research with the largest audience possible, and invite people to start GROWING GOOD MENTAL HEALTH. We hope this will be a giant step forward in changing the mental health paradigm in the world.


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


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      • Nathan M.D. Princeton
        Mad in America, filled with venom disguised as fact, is a general attack on the treatment of severe mental illness. This book is propaganda, not scholarship. Whitaker’s message resembles that of the small but vocal anti-psychiatry movement, which has long opposed medication and involuntary treatment for the mentally ill.

        The book sets out to prove that psychiatry is a morally bankrupt profession, based upon the actions of some misguided and even malicious caretakers of patients.

        Certainly, the days of forced sterilizations and lobotomies as “treatments” for schizophrenia have left a black stain on psychiatry that may never be removed. The antipsychotic-drug revolution of the mid-20th century was overrated. Outcomes didn’t improve as the institutions emptied patients into cities and towns that didn’t provide adequate support for them. Even today, antipsychotic drugs are less effective and more problematic than anyone would like — although they’re still an indispensable part of the lives of millions around the world.

        Unlike Beam, Whitaker doesn’t clearly address how the quality of psychiatric care is proportional to the resources allocated to it, and how our society — not just psychiatry — has often chosen not to care for the mentally ill properly. The anti-psychiatry movement has unsuccessfully lobbied to outlaw involuntary treatment in any circumstance — even when schizophrenia impairs sufferers’ judgment to the point where they reject all help and their illness makes them a threat to themselves or (rarely) others.

        Whitaker makes inflammatory, though subtle, allusions to slavemasters and Nazis. And he judges psychiatry solely by those who have perverted its practice, while ignoring any evidence of progress that is incompatible with his premise. Psychiatry and other medical fields have had their share of quackery, but we must work to improve, not eliminate, mental-health care. Who would seriously suggest that we ban chemotherapeutics and vilify oncologists simply because our treatments for cancer remain dangerous and often ineffective?

        Both books reviewed here include epithets for the psychiatrically ill that carry over into the text and should offend any sensible reader. While “insanity” and “madness” were widely used terms at one time, they now seem as dated and degrading as older terms used to denote race.

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        • Just a couple of comments. First, we have a rule that while we don’t allow venomous attacks on individuals in our comments, there is one exception: we’ll print whatever people want to write about me.

          In my book Mad in America, which was focused on the history of the treatment of the “severely mentally ill,” I told of a history in which psychiatry regularly championed its somatic treatments as very effective (or even curative) when they were first introduced, and how none of them stood the test of time. There was a pattern in that history.

          In regard to antipsychotics, I wrote about how there was a line of research, early on, that told of drugs that could cause changes in the brain that at least some researchers came to understand could make patients more biologically vulnerable to psychosis, which of course was never told to patients or incorporated into any “selective use” model of the drugs. Tardive dyskinesia was another hazard that was long swept under the rug. At the same time, there were experiments and research studies in the 1970s that told of a significant percentage of people diagnosed with psychotic disorders, including schizophrenia, who could do well long term without antipsychotic medication.

          If you care about the “seriously mentally ill,” then you believe in informed consent, and you believe that a profession should adopt prescribing protocols in response to what research is revealing about the merits of their drugs. However, psychiatry as a guild failed in that duty once these problems with antipsychotic drugs became known, and it also became known that many patients could do better over the long term without the drugs. And what has been the result? Long-term outcomes for schizophrenia patients have declined in the past 40 plus years, and recovery rates are now worse than they were before the arrival of the antipsychotics.

          As for the allocation of societal resources, I wrote at length about the Soteria Project and its potential merits, which would require a societal commitment to funding such homes. That project was in essence shut down by the guild.

          I have never made subtle allusions to “slavemasters” and Nazis. What I wrote about in Mad in America is how the Nazi government, with the support of Germany psychiatrists, applied eugenic ideas to the mentally ill, and that it was this “group” that was first targeted and killed in the Holocaust. That is a historical truth.

          As for using terms like “insanity” and “madness”, you can’t write a history of psychiatry without using those terms.

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          • You are an integral part of a movement that uses a wide brush to condemn and to incite hatred for all of psychiatry wholesale, and all psychiatrists, maliciously, unfairly, with repeated venomous attacks, destroying the reputations of millions of good, conscientious, dedicated and caring professionals, who work very hard to bring healing to the suffering. Disparaging comments about groups of people are banned on your website, you say.
            Millions find relief from terrible suffering due to the care of these doctors and the drugs developed by the pharmaceutical industry. As Nathan says, there’s risk in everything. Discuss those tormented souls who perished under the best efforts of therapists who refused drug treatment. Why not mention them, Robert? Why not mention the profits you make from your books? Your speaking engagements, from this your subsidized advertising resource, funded by many who can’t afford it. Oh no! Not you. No trace of of anything impure about you.

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          • Nathan M.D. Princeton has more to say.
            “In contrast, Mad in America, filled with venom disguised as fact, is a general attack on the treatment of severe mental illness. This book is propaganda, not scholarship. Whitaker’s message resembles that of the small but vocal anti-psychiatry movement, which has long opposed medication and involuntary treatment for the mentally ill.

            The book sets out to prove that psychiatry is a morally bankrupt profession, based upon the actions of some misguided and even malicious caretakers of patients.”

            You ain’t kiddin. But, don’t forget, Robert is adamantly opposed to besmirching groups of people, especially his own contributors, those keeping him afloat to spread his indignation at all those greedy slobs over yonder, you know, them, those drug dealing pushers.

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          • Nathan M.D. Princeton

            “Whitaker’s conspiracy does not stop there. He claims that “Eli Lilly and the psychiatric establishment” are responsible for the media’s purported campaign against opposition groups like the Church of Scientology, a religion whose cosmology portrays psychiatrists as an ancient evil race.
            This isn’t to suggest that none of the author’s critiques have merit. As a practicing psychiatrist, I don’t dispute that psychotropics are over prescribed by doctors. Big Pharma’s marketing practices do improperly shape physicians’ prescribing habits and do play down the dearth of long-term data on impact and safety. Even so, it’s a reach to conclude drugs are responsible for rising psychiatric-disability numbers. The author seems more intent on condemning psychiatry than improving it, and this book contains more rant than reason.
            A major contradiction (and cruel twist for the antipsychiatry forces) comes in the book’s final and shortest section, entitled “Solutions.” After hundreds of pages that attempt to show how psychiatric medications are essentially useless and inherently dangerous, the author states that psychotropics “may alleviate symptoms over the short term, and there are some people who may stabilize well over the long term on them, and so clearly there is a place for the drugs in psychiatry’s tool box.”
            But such a reasonable viewpoint comes too late to save this book.”

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          • Thank you Robert Whitaker for your careful patient response.

            There’s this paragraph:
            “Unlike Beam, Whitaker doesn’t clearly address how the quality of psychiatric care is proportional to the resources allocated to it, and how our society — not just psychiatry — has often chosen not to care for the mentally ill properly. The anti-psychiatry movement has unsuccessfully lobbied to outlaw involuntary treatment in any circumstance — even when schizophrenia impairs sufferers’ judgment to the point where they reject all help and their illness makes them a threat to themselves or (rarely) others.”

            I wonder if mentioning that the drug companies had to pay 6 billion dollars because of falsely advertising bipolar medications, hiding side effects, that this addresses the point already. Where does such money fit into where resources are allocated, when there’s even in the “review” talk of how ineffective those medications are. There’s no problem for a person with a diagnosis, and on disability to get 1000 dollars worth of psychiatric medications a month from their insurance, but for them to get the kind of help that’s more effective, or simply is effective, there’s hardly any money when it’s not related to the matrix of psychiatric medication; added to this such help is less costly than the medications which are more in collusion with the spike in mental illness than a lessening. Peaceful housing, activities that help bring comfort to the brain such as yoga, mindfulness training, art lessons, music lessons, acting lessons, resources to get in touch with nature, therapy that isn’t drug based, rehab facilities to help a person get off of psychiatric drugs that have caused a whole array of added on “medications” and diagnosis that logically could be seen to come from side effects of initial medications, and if there was integrity to honoring cause and effect such rehab facilities should at least be tried. And if they worked, which for many many people who have done it on their own it has shown to, then that again saves all of the 1000 dollars a month of supposedly necessary resources for the whole duration of their application (12,000 dollars a year) that the reviewer says aren’t being honored. So, in essence Robert Whitaker directly addresses exactly what the review says he doesn’t. What he doesn’t do is advocate for putting more money into what’s labeled as care while the implementation of such care correlates with the spike in the occurrence of the problem it is said to alleviate. Those are simple logical conclusions that when there is such a spike in mental illness which parallels the use of the chemical imbalance theory, that other methods should be tried, certainly if they are more cost effective. Instead you have the call for more resources allocated towards what statistically hasn’t panned out, while disqualifying funding resources that do correlate with recovery rather than the ideology of the unproven chemical imbalance theory.

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          • Well, Just this note re this comment from Nathan M.D. Princeton:

            “Why not mention the profits you make from your books? Your speaking engagements, from this your subsidized advertising resource, funded by many who can’t afford.”

            I have given hundreds of talks over the past 12 years, and I have no “fee” for a talk. There have been groups that offer a small honorarium, and I accept those honorariums. And if an honorarium isn’t offered, I regularly and happily speak for free, as many advocacy groups can attest. And just fyi, writing books is a lousy way to try to make a living. Writing prescriptions for psychiatric drugs is, I’m sure, a much more profitable endeavor.

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          • Job job: Your whole argument for the very careful meticulous research Robert Whittaker has done, research whose integrity has been widely honored and even if it hadn’t stands for the total honesty there, your whole argument against it is that it’s a reach. And I’m sorry as much as you’re trying to defend your profession along with your handle as job job, that’s not really a valid debate point. What is this meant to depict that something is a reach? In any society where there is an accepted belief which is challenged, that challenge is going to seem as a reach. that in no way means that the challenge is not valid. Beyond that you can’t dismiss nor have you excused the mounting numbers of disability and complications with people who have acquired a chemical imbalanced from the medications, an imbalance that has not been proven to exist because of a disease although the medications have been proven to cause exactly that; and this parallels the current spike since the implementation of the chemical imbalance theory. The chemical imbalance theory creates exactly what it is said to cure and that is a chemical imbalance because of the medications while the disease itself has not been proven to be caused by chemical imbalance? In fact what is called a chemical imbalance from a biological disease that’s either blamed on environment or genetics or behavior the one instance that there’s concrete proof of any of that coming from a chemical imbalance is from the medications. That is not a reach that is irrational that is based on concrete statistics regarding the currents of what’s labeled us as mental illness as well as concrete science regarding the affect of the medications on the brain. Is ignoring all of that helping psychiatry and if that is the case how does that characterize psychiatry itself which Robert Whittaker is not doing, psychiatry itself is doing that, Robert Whitaker simply lists accurate scientific and statistical data. You also actually in your statements contradict your basic premise because you even have to admit that Robert Whitaker says that for some people the medications can have short-term effect and for some long-term effect. This you state after implying that he doesn’t care about all the people that it has helped. In the meantime the numbers of people who according to his well-grounded research have been hurt is multiple times greater. And I’m sorry again but the way you respond to Robert Whittaker and and imply that you know what is going on with him what his intentions are what is he is hiding when you have stated that you are a professional psychiatrist and thus it is within your means to use diagnosis to actually maintain what is going on with another person someone that could be extremely vulnerable also to everything that the medications could do to them what’s the iotrogenic problems but then there’s the simple fact of the interpretations and presumptions you make. I see that Robert Whitaker has very clearly explained that he gets no money from the speaking engagements and also how that sits with his books. And I can’t really speak for this site but I would assume that the reason it is not allowed for people on this site to be attacked with personal attacks which is what you just displayed against Robert Whittaker, but I can see that for people who have already been damaged by psychiatric treatment, who haven’t been allowed to state how the treatment is affecting them without being accused of being non-compliant, who have had treatment forced on them who have had to deal with interpretations on them that weren’t valid didn’t work for them made everything worse took away their personal freedoms and disabled their life, then yes I can see that for them to suffer further personal attacks could be highly detrimental and it is better that such behavior is not allowed towards the people here on this site. However Steve himself has stated that differences of opinion are allowed and you’re allowed to attack ideas but not people.

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          • Mad In America Foundation

            The creation of author/journalist Robert Whitaker, Mad in America says its mission “is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad). We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, (many of them are paying for the privilege to criticize psychiatry) calls for profound change.” Its Form 990 from 2019 shows gross receipts of $464,471 and a nonprofit net worth of $318,307. It paid Whitaker $40,480.

            You are a multi-multi-millionaire are you not? You own your own publishing company, correct? And you own Mad In America, paid for by many volunteers who were abused by Big Psychiatry, I believe. What are your gross receipts per annum, Doctor, from all your sources of revenue? You’re pulling in a half million right here, again from donations to advertise your books from which you pay yourself nearly $50,000 a year (all from contributions, right?)
            You promote your books everywhere you speak for free, too, no? They pay your expenses, I imagine.

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          • In response to Dr. Angelo, I hope you are a better physician than you are financial analyst. We are a non-profit organization. I don’t own Mad in America . . . no one owns a non-profit organization.

            But this is an opportunity to make known our finances: I am extremely proud of how we operate.

            For the first four years of our existence, those who “staffed” Mad in America worked as volunteers. That included me (and I had put in money to start the webzine in 2012.) Once we began raising enough money to pay people, MIA adopted a socialist policy: I wanted those with lived experience who worked for us to be paid at the same rate as those who didn’t, and that includes me. And yes, I wanted the hourly rate to be a sufficient one that it showed we valued the skills and experience of all who worked for MIA.

            For years, we were operating on the edge of going belly up at a moment’s notice, with barely enough cash on hand to survive another two or three months. All of the guidebooks for running a non-profit tell you to try to get enough “cash on hand” to fund a year’s operations, and thanks to a three-year journalism grant and other generous donations we have come close in the past three years to reaching that goal, so that we know that we can survive another year.

            Our annual budget this year will be around $380k. With that funding, we operate a daily webzine that features science news, in-depth interviews, blogs from an international group of contributors, personal stories, around the web links, and original journalism articles. We have operated a continuing education effort for years, we air about 24 podcasts a year, and we now provide technical support and hosting services for 10 affiliates around the world.

            With this revenue, we pay a team of science writers for their daily contributions, our editors for blogs, personal stories, the family section, and Around the Web contributions, our writers of original journalism articles, the director of MIA Radio, the moderator of our comments section, our arts editor and tech person, and for years, the director of Mad in America Continuing Education. We of course have expenses related to hosting our site and the affiliate sites, software expenses, technical maintenance expenses, general administration expenses (accountants, etc.), and on and on, and we do all this on the annual revenue that what . . . equals the annual earnings of a single psychiatrist who pads his salary with a few talks for Pharma?

            And in terms of our reach, we expect to have about 5 million visitors to MIA and its affiliates in 2022. I would suggest we run a very efficient operation, and yes, that we accomplish a lot with our limited revenues.

            Finally, you seem to think my earning $40,480 in 2019 was exorbitant. I work seven days a week, and probably 60 to 70 hours a week (but pay myself for only 40 hours per week.) And since you apparently know nothing about the book industry, here’s the bottom line: my royalties from all of five of my books come to about $5k per year.

            In short, Dr. Angelo, I don’t own Mad in America. it’s a non-profit and a labor of love, and I am sure nearly everyone could be making more money working in other areas.

            And now, perhaps you can inform our readers about your earnings as a doctor. Are you a psychiatrist? Do you prescribe psychiatric drugs? If so, how much are you paid for a 15-minute visit?

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          • Before expenses paid, and without scientific or statistical data beyond market value publicity:

            Pharmaceutical sales representative salary

            Psychiatrist Salary in the United States

            CEO Salaries for the Top 20 Pharma Companies by Market Cap

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          • He has already made it clear he is not a millionaire, if you read prior posts. It is also completely irrelevant to the questions of science that are posed in his book. Are you implying that rich people have no right to comment on the condition of psychiatry and its impact on society today?

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          • @job job:

            Bit rich to say that Whitaker destroys reputations when it is your fold that has an entire medical book replete with things like “Personality Disorders”. Someone, in some psychiatric setting, is getting categorised with one as we speak. Wonder how people will treat him once they find out about it.

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        • Also, I don’t see any of you running to the defense of patients, the very people you’re supposed to protect, when they get gaslighted by people based on the very “diagnoses” you give them. Get out of MadInAmerica and see how much filth people write about anyone who’s psychiatrically categorised with anything and how badly they get attacked. If anything, you’re the majority and it’s the population that ends up here that’s far more under duress. Places like MIA are the only few places the “othered” have to speak online.

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  1. I think all these old theories are no longer working. Just like you mentioned that physical health – we created gyms and all new world of dealing with it. Same for dental, we created many new ways a person can do their own thing including buying a night guard, flossing, and seeing a hygienist few times a year. All these industries are sharing power. A dentist is a doctor and we cannot do their job but the system gave the individual some autonomy for maintenance.

    Only mental health is the one area, where a person loses autonomy and power to know their bodies and the only acceptable thing is often seeing a therapist or a psychiatrist and when a person gets sick, just locked them up.

    My theory is actually to challenge what is trauma? We need a real definition of trauma without confusion.
    My theory is this back to basics.

    We are born as animals and develop mind. Often trauma happens prior to the mind development, hence why it is very difficult to know what is trauma. So let us do research on what is trauma in the body. Not just repeating the same old tired of survival responses (flight, fight, freeze)…what are they on the body on the corporeal? We should not use words without source of materialism. If a doctor says a person’s response is freezing, they need to teach exactly what is freezing so the person can learn, observe and improve.

    Doctors are keeping knowledge and then wondering why people are not happy with them? People know more about cancer than a functional freeze response…why is that?

    But now, unfortunately mental health is a metaphor – meaning saying something that means something other than what we are saying it is! you see the problem right there!

    What is the source of the metaphor of mental illness? Why animals do not get bipolar but people do? How do animals deal with the source of mental illness? Going back to the body to teach people how to read their bodies. I think the problem of doing this is many but the biggest is cause doctors do not know their bodies as well.

    Let us go back to the board of determining what is mental illness. Otherwise, I feel we are just scratching the surface and discussing about words and lexicons.

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    • Dear Dogworld,

      Thanks for your comments. There presently is a lot of attention on trauma in the mental health world these days. There are a couple of specific and effective new treatments that are very helpful to many folks: EMDR and NeuroFeedback.

      I call your attention to the subject of my blog. I am not stating, nor implying the Growing Good Mental Health is the process to help people who are experiencing debilitating emotional disturbances.

      What I am advocating for is that EVERYONE understands and experiences GOOD MENTAL HEALTH, and that EVERYONE knows what to do to develop, maintain and improve their GOOD MENTAL HEALTH. I envision a world where people know what to do and whose help to seek when they are experiencing and upset or disturbance, the same way we do when we have a tooth ache or nausea and vomiting.

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  2. “Attempting to control another person’s behaviors is almost always irresponsible”

    Attempting to control another person’s behaviors, by force when necessary, is the entire reason for being of the mental health system.

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  3. “knowing we always have choices and understanding that we direct and are responsible for our choices and resulting consequences.”

    We most certainly do not always have choices. A person locked in a psych ward does not have a choice whether to take the medication or not.

    I find this viewpoint extremely simplistic, untrue and demeaning to psychiatric survivors and others who have experienced coercion, suppression and the like.

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    • Katel, I find the whole article simplistic at best and complicated again by comparing dental health to something so very very complex as human emotions. “mental health” is the new advert, making people believe that to feel things is a “health” related issue.

      Our minds and body, and it’s connections, and it’s ability to absorb everything that occurs, to be remembered not just by the mind, but also by the body simply cannot be defined as of yet by any human. Perhaps a dog has a much greater ability to assess a human’s situation and what their needs might be.

      It is just so simple to write an article about choices. I would not write such a thing, because I would offend a ton of people and sound uneducated and priviledged.

      I get it. I get how she thinks if people would just stop “thinking” of themselves as victims, and pursue the elusive “mental health”.

      It is quite the norm for the world to have a ton of suffering people. When we stop pretending that it is “mental illness”, perhaps we would be on the right track to ease some. But it cannot occur since people are selfish and bound up in their own lives….which is quite natural.

      Every single one of us has the potential to look or behave disfunctional to someone else. We are simply animal. Maybe half of us eeks out a sort of comfortable path, and if we look around, many jobs, occupations allow individuals to be in the illusion that they are “mentally healthy”. It is easy to hide behind our jobs or power, usually not even aware just how nutty we are.
      It is simply a crapshoot.

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      • Thanks, Sam. Yes, I found this article pretty triggering. I spent a lot of time in DBT (after decades of psych drugging without informed consent, or rather with mis-informed consent, led to a diagnosis of treatment resistant depression, which led to ECT, which led to a diagnosis of borderline personality). I heard a lot about choice and only being able to control my own behavior on a daily basis in DBT. Ultimately, I found it to be very damaging, as it ignored the iatrogenic harm I’d experienced and the almost complete loss of power I experienced as a patient. This idea about personal choice and responsibility would make more sense to me if the mental health system did not exist. But the mental health system does exist and it leads people into very dangerous places from which it is hard if not impossible to return, and many people do it without any support and surrounded by risk. Can I risk going to a doctor with a physical complaint, can I risk opening up to an acquaintance about my life, my history, my struggles without worrying that they might decide I need more treatment? I don’t think people who haven’t been through it can understand what a dark place psychiatry can lead people to. I’ve been disabled for 15 years and the idea that my current situation is due to my own poor choices and that I am solely responsible for the loss of health and a place in the world that resulted from my interaction with the mental health system feels unfair. There is also no mention of trauma or the impact of trauma on a person’s ability to make good choices and meet their own needs. Personally, I never feel exactly safe in the world. The best I can manage is to feel less unsafe. Often that comes down to staying in my apartment, not communicating with the outside world.

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      • Sam,

        What is it you want that you’re trying to get by making the comments you have about my article?
        Do you believe your comments and criticisms are adding to the discourse? Are your comments helping you feel better?

        I sincerely look forward to you answering my questions so that we might enter into a productive conversation.


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    • Thanks for sharing your thoughts about this Kate. It’s pretty clear from your words that you have had your share of negative experiences within the traditional psychiatric system.
      I do believe we almost always have choices, although that does not mean the choices are good ones or easy. If you haven’t already, I would strongly encourage you to read “Man’s Search For Meaning” by Viktor Frankl. He speaks of being in control of his thinking, even in a concentration camp. When you are on psychotropic medications this is much harder, but still something over which you have control.

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      • Nancy, thanks for your reply.

        I know that what I want is justice, recognition, or even acknowledgement of the abuse I was subjected to for 3 and a half decades of my life by a system/by people who say they are there to help and who get paid, often quite handsomely, to help. I want acknowledgment of the lies, the fraud, the ways they punished me for trying to advocate for myself.
        I want palliative care since the decades of drugging left me unable to do the things a healthy 56 year old is able to do, and I’m completely alone. I want guarantees that I will never be force drugged or forced to undergo ECT for the remainder of my life. If that can’t be promised, I want legal euthanasia.
        I would like help for my adult son, who is extremely suicidal. I don’t know where he is and haven’t seen him in over a decade, but he texts me often and tells me he plans to kill himself.
        Yes, I have read Frankl’s book.

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        • Thanks for sharing what you want by writing all that you have with me. I sincerely hope you are able to get some, or all of what you want. I’m guessing that won’t be from me however. My ultimate goal is to be another voice adding to the chorus of many to change the status quo of the system that contributed to your abuse, as it did, and still does, for so many.

          Presently the work I am doing is to introduce another, and I believe more effective and helpful notion of dealing with emotional disturbances. As I wrote in my blog, I spent years in a system I knew was doing more harm than good. To the extent that I could, I practice Choice Theory with my clients, patients, parents I was coaching then and now. This included people who were on medications (not proscribed by me). With those folks, I encouraged them to educate themselves about the medication they were on, the short and log term effects of these medications, while simultaneously offering alternative therapy that was more helpful and effective.

          My goal in working toward a paradigm shift is to change the unhelpful, unhealthy, and in some cases abusive standard treatment that you and several others on this thread experienced. I know this is a long and challenge mountain to climb, with so many who are practicing in the traditional methods because of the financial gain or actual belief that this is the way to go.

          I am sincerely sorry about your isolation and your worry about your son. Here’s some advice that you can take or leave. The next time he texts you simply say, “I love you. I miss you”

          With respect,

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      • “It’s pretty clear from your words that you have had your share of negative experiences within the traditional psychiatric system.”

        Yes, I experienced decades of abuse and coercive control in the system. I tried to kill myself at 19 — took an overdose of elavil that had been prescribed by a psychiatrist who dumped me the day the Board of Ed stopped paying. Why did they send me to her? Was I sick? Did I need “medication”? If so, the doctor should have lost her license for malpractice since she dumped me with no notice out of pure self interest without telling me what to do with the elavil or referring me elsewhere for treatment (it was the ’80s, there was no internet. Were there help lines? not that I knew of.). I called her multiple times begging for help but she knew she wouldn’t get paid, so, tough luck for me. When I overdosed my stomach was pumped and my mother insisted to the ER doctor that I was “not depressed and there are no problems in the family.”
        He didn’t question why I had a prescription for elavil, which was commonly prescribed for depression back then. I would think an ER doctor would have known that. I was sent away with no help, without even speaking with a doctor. Then I was kicked out of my house, sent out of state to a place where I couldn’t even find my way around, didn’t exactly have my wits about me, and was completely alone. I had housing but no money for food, no transportation. I was sick and alone. One person spoke to me: a guy who said he would marry me if I got pregnant. I got pregnant. Then he broke up with me, I lost my housing and wound up in a locked psych ward for the entire pregnancy.
        4 decades later I think I made a good choice — my choice — with that elavil but it wasn’t honored. And all the system has done from that point on is torture me more. Tell me that I don’t deserve to live, that I’m inherently defective (borderline!) but not allow me the solution. The system and what they did to me are the height of irresponsibility as far as I’m concerned.
        I wish everyone did have a choice. The fact that a professional would make the claim that everyone has a choice shows that only survivors understand the reality of this brutal system.

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        • My mother has never even acknowledged what she did and the impact her behavior had on me and her grandson. The most she’s ever said about why she lied to the ER doctor (I was most certainly depressed and traumatized and already had been made to understand that there was no help available — hence my solution. There were enormous problems in the family. Both of my older brothers had already been diagnosed with SMI and hospitalized many times. My parents were both abusive.) the most she’s ever said is, “I guess I couldn’t handle having another mentally ill child”. My parents were smart enough to drive me – unconscious – to the smaller hospital instead of call an ambulance and risk the authorities make a connection to my brothers at the “real” hospital. Her “partnership” with the ER doctor in denying my most basic needs and punishing me for being in pain (I still remember the sadistic look on his face when he ripped the tubes out of my nose) taught me, once again, that there was no help and I would be punished for needing it/seeking it.
          Years later, when I was able to pay for my own treatment, I spent hours and hours in IOPs, locked wards, therapist appointments, psychiatrist appointments, paying paying paying for them to tell me that I had borderline and I needed more ECT or another drug added or I needed to learn more coping skills. None of them knew my history. It was deemed irrelevant.

          Why not focus on the choices made by the ones with all of the power instead of trying to correct the choices of people who have no power and whose only choice is how to survive a life of pain?

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  4. I’m sorry, but I truly wonder whether such an analytical method truly helps regarding responses that are subconscious or unconscious responses. Feelings are subconscious, and trying by any means to first analyze them, then decide which ones are good and which ones are bad, and where they come from, this could be like taking a fish out of the water to see what it is, and you’ve killed the fish.

    Emotions are made to be felt, deciding this isn’t a good emotion, and I want it to go away, and using the left side of the brain to develop strategy, even when you’ve accomplished this you might be worse off. Because the natural intelligence that comes with the emotion when felt, intelligence that’s also so subtle you can’t fit it into the calculations of the conscious mind, it’s more intertwined with life than that. Simply not pushing an emotion away, but allowing it can get rid of the discomfort that came from pushing it away, not the emotion itself.

    I’ve had thoughts that would be labeled as schizophrenic happen, simple thoughts regarding themes in life that for one day bled into my conscious mind, like the kind of eidetic memory that say Tesla had. Visceral depictions of something inner, potential and symbolic of interactions that are impelling. The next day I realized that stuff I needed to be able to consciously relate to had superimposed in a way that could be seen as non-reality based, and even though I was COMPLETELY non-violent in contrast to those deciding I was some danger, it made no difference when I had the next day realized I was a bit off. Those thoughts then 13 years later pointed out so clearly things regarding life, and time, and what life is about, and how a miracle resonates with themes in life and touches upon others I hadn’t even met yet, that the whole idea that those thoughts needed to be seen as crazy, or stuff that comes from bad decisions on my part, or any of what “psychiatry” would come up with, such that even any analyses regarding whether they are reality based or not falls short.

    And I’m sorry again, but the example of what mentally healthy is you list above can be seen as quite non reality based to anyone who every day has to deal with what you have even listed as going on in the asylum, and then further more outside of the asylum, which might have forced them into one. I’ve never been committed to an asylum during the incarnation this body has had so far, I’ve never been forced on or taken psychiatric drugs, but yet EVERY DAY I have to deal with SEVERE discrimination because of alarmist paranoia in society regarding how my mind works, when my brain is HEALTHY. I can only imagine what it’s like for those whose civil liberties were taken away from them who are surrounded by those who only see them as broken, diseased and flawed when they have logical and understandable reactions to trauma in life that they either can’t or don’t know how to respond to or express. And then have to deal with the chemical imbalance the MEDICATIONS have caused in their brain disabling it from natural functions, the whole while being told the untruth that the meds are necessary to treat exactly what they are causing instead, and even if they know these truths aren’t allowed to express them because they’d be seen as non compliant to treatment and forced on more. Somehow somebody with such a life isn’t going to fit into your analyses of whether they are mentally healthy or not, as little as those in a war zone, suffering extreme poverty, living in an autocratic regime or worse. Maybe they just need someone to listen to them so that they feel it’s OK to even feel any emotion, let alone analyze it as good or bad, what to do this about or not? Maybe the emotions THEMSELVES when allowed and simply given some legroom have an intelligence all their own and then solutions are found, rather than they already are analyzed before they are even given the space to be felt.

    Emotions are meant to be felt. To once again be offered a whole school of how to make one “mentally well” can be like these drugs you say “People did experience temporary relief of their symptoms and upsets” when in reality you have to admit there was no true relief. And it’s simply discrimination in society in general. Women lack the ability to make rational decisions because they are emotional was even put forth as the reason they weren’t allowed to vote or have positions in government or religion. There’s this untrue concept that emotions are irrational. It’s simply wrong, and it could be that someone having an observably “happy” life with “emotional well being” in reality is maybe too sterile to feel the emotions of someone that’s actually experienced what’s going on in a society not quite as functional as its made out to be, and those emotions themselves when allowed have answers rather than deciding one is to find a means to turn them off, and then one is mentally healthy. Maybe such inhibiting isn’t mentally healthy, no matter how uncomfortable that may seem to the fantasy people have that they shouldn’t be feeling what they make strategies to avoid. No matter how disruptive or inappropriate it might seem to others when those emotions aren’t avoided and express themselves in whatever way is left for them to find an outlet.

    Emotions exist to be felt, that’s why they exist, that’s what their purpose is, and they involve all manner of natural instincts with perspective and insights that one isn’t going to find deciding how to censor which ones one should be feeling and which ones one shouldn’t.

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    • Thanks for your extensive and thoughtful reply.
      I agree, emotions are feelings, whether they are meant to be felt or not.
      Choice Theory explains that ALL behavior is total. That means every emotion/feeling has simultaneous acting, thinking and physiology (internal body response)occurring at the same time. And all behaviors are purposeful That is, when I’m feeling angry, or sad, or happy, that is my internal attempt to help me get what I want and need. For me, an emotion is a signal, letting me know that the world is out of or in good order. Emotions ARE felt — driving me to take action, or change my thinking to get what I want and more effective meet my need.

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      • The idea that “all behaviors are purposeful” has been central to all of my work as a counselor and/or social worker, but it seems an utterly foreign concept to those steeped in the DSM/psychiatric worldview. If all “mental illness” is a result of “brain dysfunction,” then NO behavior has any meaning or purpose at all. Could not be a more opposite approach to what I know to work!

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        • Thank you Steve. I was beginning to feel quite lonely.
          Clearly there are many, many people still steeped in the DSM/psychiatric view despite the research indicating that this is unhelpful and harmful!
          Clearly, working toward a paradigm shift is an uphill journey. Luckily, I see signs that you and I are not alone in this mission.

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  5. My point actually was that a child that is going to end up diagnosed with a mental illness, although it may be completely true that being able to see how you’re in control of your own emotions, and that you can’t change the stuff around you, and as is stated here: “Choice Theory involves shifting from an external control psychology, the belief that our behavior (thoughts, feelings, actions and to a certain extent our physiology) is determined by outside forces, such as luck, circumstances and other people, to an internal control psychology, knowing we always have choices and understanding that we direct and are responsible for our choices and resulting consequences.” when you are dealing with people who never have been given the legroom to know how they feel, to start telling them they are responsible for what happens in their life this could be missing a whole step. I think you have to be able to know how you feel, I think you need to have the matrix of reflexes to engage with your own feelings before you can start knowing how to make decisions for yourself. Imagine telling a person who has never been allowed to express how they feel, that their very feelings of distress, anger, anxiety, sadness, all the rest, that they are there because of choices they’ve made, and that they are in control. In the meantime they may not even know why they feel that way, they may not have the reflexes to identify what it is that causes those feelings because every time they tried to express those feelings they were met with such a response that they disassociated, and so their whole response to begin with is to subconsciously push those feelings away to such an extent there’s no bridge to where they came from, or why they were there. What is it going to do to such a person to tell them they are in control of feelings, that depends on the choices they make, while that might yet again be another occurrence of those feelings being seen as something to avoid, to judge, to want to get rid of?

    Just as forgiveness in a complete form can be getting out of a situation and then not judging the people you needed to get away from, trusting the Universe, enjoying life rather than looking to get badges for staying in the situation and being “forgiving,” feelings that are “bad” or that you don’t want could simply be feelings that you need to allow, because they’re there for a reason. Having a formula to make someone happy and have good mental wellness when that becomes yet another example of “this feeling is there because of my own choices, it’s my fault etc.” when in reality someone may not even know why they feel that feeling, they have had to disassociate from making such connections their whole life, and telling them it’s their own choices that they have such feelings, when the real choices that they never have been allowed to make remain beyond their matrix of understanding, this could only cause more stress in their life. They don’t know why they feel that way, they don’t know why the feeling is there, they need to feel that feeling just to gain insight into what they have been disassociating from their whole life, and the feeling is once again analyzed in a way to isolate it as on object to want or not to want rather than it’s just allowed, which would make room for the perspective that’s needed.

    I’m sure that: Choice Theory Psychology has helped many people, and that it does wonderful things. But sometimes a feeling just has to be felt, and sometimes it’s better not to talk at all about good or bad mental wellness, because saying a person has bad mental wellness implies that they need to change or gives them a formula to change rather than being allowed to feel and express what’s just waiting to give them some insights that only such feelings can. Without looking to avoid them, to change them, to judge them as good or bad.

    You don’t push happiness away. Why would someone judge other feelings before knowing what they express?

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  6. Readers, I encourage and invite you to define Mental Health for yourselves. I defined it from my point of view, not to represent it as the ONLY, or the BEST definition.
    I do believe that professionals within the “Mental Health” field have a professional obligation to define Mental Health, and that this definition should include more that the absence of symptoms. When working with a client, I believe that professionals should share their definition, ask clients to define it for themselves. Then together you work as a team for the same target and goal.

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    • It’s a bit peculiar that mental health professionals come from more of an academic environment (usually), and I’m generalizing, but those who have been through what’s labeled as a “mental illness” or who have been labeled as lacking in Mental Health, or even themselves felt there was something wrong with them, would they have gained insight that doesn’t judge anymore responses that they didn’t understand, and gives them insight, this rather turns around the definitions of what’s Mentally Healthy or what isn’t.

      That’s quite predominant in many fields concerning lived experience and academics, but in the mental health field it’s quite predominant.

      It sounds like you really have helped people, that’s great, I’m sure you’ve helped people that otherwise might have been lost. Along with you there are those in the Mental Health field that have, you certainly state viewpoints that would help many if most people, although in general they may not be voiced at all. Just for someone to be able to state the medications aren’t working for them, and have a cogent response is quite progressive. But what if we are in a society that you get more points for being “immune” to the stuff that causes the symptoms of those that are labeled as not being mentally well, what if many of those symptoms if looked at differently come from people who simply can’t push away the feelings that something just isn’t right, that they are supposed to be happy with this society but it’s not working this way and they just can’t be happy anymore, what if fitting in and being “happy” just doesn’t work for them? And then you have the people that do know it’s not working for them, and instead of the trauma being acknowledged they are told their very human and vulnerable response to it is a disease?

      Just to point out how the very terms involving judging a person’s mental state can become contradictory. Of course a person who is a good therapist will recognize when a person simply is out of the norm, and give room for that, or that they have experienced legitimate stuff that needs attention, and when acknowledged gives another viewpoint regarding society or themselves, a viewpoint that’s actually needed in society, would it survive? When an organism evolves to adapt to its environment it isn’t the whole general population that mutates, it’s only a few and they allow the organism or species to survive through evolution. It seems that what’s called the mental health system so often judges the very people that might have the perspective to be able to bring in the change that’s necessary for the whole population to actually gain insight into what’s really going on, and what’s healthy and what isn’t. Being “happy” to have adapted to the mob that isn’t flexible to change because that would otherwise cause problems,are those feelings a sign of mental problems or are they actually the germinal elements of insights that are actually needed in the society?

      And it’s quite strange that so many people who have moved away from the standard mental health treatments, and who have gained such insight, that they aren’t acknowledged because they don’t promote the chemical imbalance theory. It’s in a way having people who have changed their diet from experience, changed their health or weight or any number of things, but if they aren’t going along with the academic teachings, they aren’t even considered as authorities that would help in mainstream nutritional counseling. When their problem is what encouraged them to look with open eyes, not censored by academics or accepted mainstream economic trends.

      And in mental health the “symptoms” used to define illness or not aren’t even concrete, there is no real test for them in the sense that those doing the diagnosing even agree on them. Someone having difficulty fitting into a society, and the consequent symptoms, isn’t really a disease, nor is it a comment just on them.

      Anyhow, thanks for your input Nancy, I just don’t want people to think they are “sick” because I know all of the extreme distress that goes with that, even trying to find a way to not feel that way, or behave that way, and in the end it was not judging the feelings or behaviors. Certainly when they were totally non violent. And then gaining insight in how I had reflexes towards escape I didn’t know existed, such as drinking too much coffee, and even when I stopped that it was the anxiety of slowing down my mind, simply out of insecurity; that stopped the “symptoms” but in reality even those “symptoms” allowed for a dis-inhibition where thoughts could come freely into my mind, or I wouldn’t judge things that I actually saw happen or experienced as impossible [and this is a WHOLE other conversation], and those thoughts were even in line with what might be called miracles (explained themes from other lifetimes when miracles happened, or one specific lifetime), and I experienced metaphysical things. Maybe I just had to allow my left brain to accept those things. If life has themes, and if it has meaning, that meaning and those themes express themselves in ways that are germinal elements for what we experience, not the other way around, and so such understanding remains a bit “non-reality-based” because it’s more objective than physical reality, which has remained the means used to judge what’s real and what isn’t. But thoughts are real. And art is real. And you might lose all of the symbolism going on with the emotions, and thoughts of the most severe “mental illnesses” such as “Schizophrenia,” would you call even those “symptoms” signs of a sick person. Maybe life has more mystery to it than to dismiss things not understood as non-reality-based? And I know from my own experiences that as soon as you go beyond certain boundaries of what’s considered reality based, or are just a bit different and weird, even actually interested in what it is to be human rather than what others think of you, that people are going to make up the most alarmist paranoia about you, and then think that that’s valid. That, along with fear of and alarmist judgements on the supposedly non-reality-based stuff that’s labeled as psychosis actually can be seen as very unhealthy mental behavior, but it’s pretty much standard for many mental health workers. “Psychosis” might be a way of escaping fitting in with a prevalent alarmist paranoia in society that’s considered “sane” or a consensual reality deportment, or a statistical based norm. Evolution hasn’t come from statistical based norms or consensual reality deportment, it comes from the few organisms that mutate away from that, I think.

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      • I’ll share with you Dr William Glasser, the founder of choice theory psychology, description of the DSM: “It’s a good describing all of the many creative behaviors unhappy people have come up with in an attempt pt to feel happy and meet their needs.”

        There is NO scientific evidence that any of the traditional approaches to psychiatry works!

        Thanks for continuing the dialogue

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    • I guess I’m trying to elucidate this point you made. And the point is completely valid, because that means a client is part of the process, not that they have been labeled a certain way, and the mental health worker is the one deciding how they should change. It’s the clients place to decide what’s going on with them: “When working with a client, I believe that professionals should share their definition, ask clients to define it for themselves. Then together you work as a team for the same target and goal.”

      I have to state that in my experience, I knew I was having episodes in my life where I myself didn’t even understand the “psychosis.” The very desire to get that to stop in a way could get in the way of understanding. I never would have said that I saw it as a disease, and I needed to eradicate it, but still there was that extreme push to WANT it to stop, even to think that support from a therapist would get me to feel good about myself enough to get it to stop, but I had no idea really that I lacked insight into what I thought was interfering with my life, and that experience to gain insight only came from not judging it beyond what I already myself wasn’t doing. I wasn’t judging it already, but even analyzing it, even as trauma where it came from that didn’t give me insight into the the stuff of it that was involved with life itself completely, and that involved impossible things like a miracle healing, which became quite normal rather than impossible. I’m not saying you have to experience a miracle healing to understand psychosis at all, or even that you should be interested in that. That’s my experience, I’m just trying to share part of it. There were of course behaviors involved/ I didn’t know how much drinking too much coffee was contributing, and having stopped that I didn’t know that a dis-inhibiting spurt to just do things more impulsively that that also was an escape from what you might call left brained activity, the part of the mind maybe setting up these goals and targets. What actually surprised me, was that in the end how sane the “psychosis” actually was in areas incredibly sane. There was the dis-inhibition of being petty at times, buying in social values and exaggerating them to such a degree that one could in the end only see to get away from such desires. Akin to when something (a belief) starts to loosen and and before detaching it actually shows how warped it was or indoctrinated from peer pressure and insecurity taking on social norms or needing to be critical. But then there were also truly spiritual insights cloaked in symbolism, or thoughts that just popped into my mind out of nowhere that contained information regarding actual themes in life going on, actual germinal elements that with the help of a healer I could clearly see weren’t “crazy” at all. In fact they were from beyond time, or beyond linear time because they contained connections and a theme regarding someone I hadn’t run into yet, and this was involved with what might be called a physical miracle. Without “psychosis” that theme might not have acquired the freedom to express itself, even thought it wasn’t worked out and I expressed a few things that were symbolic, which I knew the next day were, but that was too late. I was already labeled as someone non-reality-based and could be a danger, even insinuating I could become violent, and a whole list of other things which were only paranoid suspicions of a social worker (thankfully only teaching yoga at a parks and recreation class and not in control of whether I was committed or not) the whole list of other things which weren’t going on at all, but were alarmist paranoid discriminatory suspicions akin to what school children make up about someone who is just “weird” all of that [the paranoia] was considered to be going on, just because I expressed some stuff that wasn’t understood. Label a person “psychotic” and you can add on a whole list of stuff. That’s of course quite traumatizing although I had seen this happen to so many of my friends. In fact to be REAL clear regarding how UNTRUE the whole evaluation of “symptoms” is. During me simply trying to take a yoga class a very clear voice told me to stay away from this “teacher” to not even ask questions after class (I really was interested in yoga) and to just go there and leave. I knew I wasn’t doing anything that should be of concern, I had had it enough how people react just because they think you are weird, and didn’t follow that advice. But it WAS a very clear voice, as clear as one you hear on the outside from sound waves in the air. And so when this whole alarmist paranoia was in process, this “yoga teacher-social worker” said to a judge: “I know” and she sat up in her chair bobbing her head a bit: “I know, he doesn’t hear voices, he see things that aren’t there, it’s non-reality-based” I didn’t say anything regarding hearing voices or not, in fact she pretty much PROVED that hearing voices can be enlightening, and give extremely accurate information, although she just used it to denote symptoms of a mental illness. And over the years (quite a few 13 or so) I have come to learn that what I tried to express that she called “non-reality-based” was involved with leading towards a physical healing, which might be called a miracle, gave insights into past lifetimes and themes going on with another I hadn’t even met yet that also touched in with a miracle energy and the place of no time, or another dimension where time comes together to give meaning to life, and our belief system could be the germinal elements bringing such experience together, rather than it’s on the outside. I’m not even saying that should be anyone else’s experience, it was MINE. And it’s valid. Other people could have any number of other experiences having nothing to do with mine in content, but still pointing out perspective they simply didn’t know their behavior contained in it. So I did finally shed the fear of what I didn’t know was going on, and what was labeled as a disease, this was that after simply finding a couple of good therapists also, and beyond that a healer lady who is a true healer (was tested in a hospital when she noticed she could facilitate healing, tested because she wanted to know if she truly could help these vulnerable people that might be looking for metaphysical healing, and if she didn’t test to be able to she wouldn’t have started healing, she then in a hospital in Japan with thermal imagery and electrodes attached to her skull to see what kind of brain activity was going on got a cancerous tumor to disappear in ten minutes. Her brain activity also was that the left side of her brain actually was inactive And also was tested other times with the same manner of results). The healer lady has a sanctuary in virtual space where she simply says one should meditate twice a day for 20 minutes or once for 40. After the initial period of a couple of months the physical healing I was looking for got so much better it wasn’t bothering me, and I had to laugh with joy at things I could do I wasn’t able to before that.

      That’s just ONE crazy things one can encounter. But trying not to be crazy rob you of an experience that will change your life. And life is meant to be LIVED. ALL OF IT! The stuff you loved and wanted to experience, and even the stuff you hated but impelled you into amazing things you didn’t know were there….. just because it went beyond your sanity filter…..

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      • Thanks for all you’ve shared Nijinsky.

        I’ll share with you a question I ask children and adults AFTER I’ve actively listened and understood all of their feelings and distress.

        “What is it you want that you’re trying to get by crying-depressing-feeling anxious -fearing?” Fill in the last part with whatever the doing, feeling or thinking is? “If we could figure our a way to help you get what you want are you interested in learning?” Understanding that all behavior is purposeful is understanding that people, young and old, behave the way they do to get something that they want. (That includes all of the angry and abusive comments made by many in this comment section.)
        I learned these “Magical Questions” as I called them while I was raising my identical twin sons who ofter were so emotional they acted out or displayed their emotions before the had words to describe these feelings. What surprised me is no matter how upset my child was, he would answer the question! Then together we could figure out another way to help him get what he wanted, or figure out a reasonable substitute.

        Hope this helps.
        Thanks again for sharing you experiences and thoughts with me.

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        • Kate, in response to your question. I have had to recently take a step with such feelings, also with anger, that certain situations, when they make me feel that way, that there’s no loss in simply staying away from them. This actually regarding a rather fundamentalist approach that I’m causing those feelings not the situation. But this way if I see the situation as causing the feelings, then I end up not seeing the situation as causing the feelings, because I stay away from it. A different brand of forgiveness than staying in the situation. Life itself when you take yourself out of danger, the enjoyment of it teaches forgiveness. That’s also how it’s designed I think and why we have such amazing things to enjoy. Even the slightest thing that we might overlook thinking we have to have some fight that has to be won or it’s necessary for us to label ourselves as victim and see ourselves as hurt. But then there’s the other side of that as well, if you acknowledge that then maybe you allow yourself to see that you can and want to get out of such a situation. the mind also disassociates for such reasons. And you have the whole array of stuff as in multiple personalities and other escapes that can be seen as diseases. But forgiving and getting out of a situation are the same and go along with seeing you’re responsible for how you feel. And you give room for the change that can take place on “both” sides. There’s also the other side of it, when I read your remarks towards jobjob and the situations you have encountered, what people have had to deal with that makes me want to cry. My cheeks get pushed down and start puffing out, my eyes water. Then I might have a different reaction, and try to stick up for such people. (this is just a quick response)

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          • I guess I just took the borderline label off and replaced it with the victim label. It’s difficult to forgive when one is not forgiven and the torment is ongoing. If it’s true that we make a choice how to feel, then I choose to be angry, scared and sad. I’ve been “doing it wrong” my whole life. I guess I’m just one of those people.

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          • Kate L I’m sorry if I confused you, because I notice now that I said I was answering your question, but really was responding to Nancy. I had gotten your names confused. And sorry I hadn’t even read your posts in this thread, although I have in others and completely empathize with what you have to go through with this horrible diagnosis. It can be like the other diagnosis, mean spirited criticism or down right hate speech. Kate, I wish I could hug you, be there for you every day so you didn’t feel abandoned in expressing that you’re human, and this SH@#$@(*)T goes on regarding the mental health system. We are supposed to be diseased, but what I’ve noticed with all my friends in the mental health system, the ones I spent time with, who have been disenfranchised and disabled is that they don’t judge you for all your “weird” supposedly dysfunctional behavior, and the interactions instead are human. I think it maybe even becomes dangerous do I think I need friends who are “functional,” because really this society isn’t. We aren’t little androids walking around programmed by society giving us rewards when we follow the patterns of you are a good boy or girl and deserve to walk around in the machinery of image arrogance that you have been assimilated and there’s something wrong with those who haven’t. Is not being assimilated really a loss? Is it a loss to let go of wanting such “functional” friends or such a life? Here’s something, years ago, I composed and performed, I was on facebook at that time (am again, but have taken a break in between) and a group of us within the alternative movement regarding mental health practice were trying to help a girl with BPD, and I found this music playing through my mind, consequently, and this piece came of it.

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        • And seriously Nancy what Same was maybe trying to say. With emotions you touch into a whole other world, a world that one might even argue remains intangible to another part of the self wanting to define things, and wanting to have answers, and wanting to be in control.

          I’m a musician-artist, have written a few novels, even indulged in studying nutrition to such a degree I could contradict your statement that we know how to take care of our teeth. You’ve also contradicted it yourself below, so we’re in the same ball park, and you were just using that as an example regarding where effort is put. Adding to what you stated, I don’t know why it isn’t basic care for one’s teeth to know about phytic acid, and how it affects the health of teeth, as well as that of your guts. What Weston A. Price discovered in his investigations of indigenous cultures.

          Anyhow, past that digression, emotions are things that in art defy logic in a way, and what a society thinks gives form to it. And in music for example, what’s called Jazz theory has a resonance with the overtone series that allows just a bit more room for emotions than traditional Western theory. And it’s the “poor” black slaves who started such science, actually. It’s like the conservatories of the planet still have to catch up. I just yesterday, before my “therapy” session was playing around with a melody that comes out in a Mozart Cadenza to a concerto he wrote when he was 17. But in transposing it to play around with it I found I was giving it that resonance. Harmonizing it so it resonated with the overtone series just a bit more (Western harmony does this but not as exactly). I first just thought that would make a nice song, and have a beginning for that. But I was just laying in the bath retransposing it to where it is in the cadenza, that whole beginning and it fits perfectly in the cadenza, first the more scientific resonant, and then the same melody back into the custom of the time then. I’ve actually written cadenza’s for a couple of Mozart concertos and done that, but haven’t fit an extra place in the any of the ones in existence till now. It really just feels like a portal for angels amongst us, which I’ve encountered as told in Hebrews, also. It’s simply an incredible spiritual matrix, from another dimension, more germinal to how we create life, just by letting it happen. And art does that, all art forms, they open us up to how everything in life is beautiful, and it’s simply that feeling that became a melody, but it didn’t even have to be because something was consciously felt it simply gives room for that dimension where feelings do stuff our conscious mind would dismiss, for it perhaps remains intangible to it.

          I’m not saying you shouldn’t do what you do. To ask the magical questions, that’s just part of it. But there’s another gear, maybe. It’s like what I’ve experienced regarding angels amongst us, they just are there from a whole other matrix of interactions. Thinking you have control of that is sort of like thinking you can move a mountain. Now, some people might argue with me, but I don’t think if man with all of his machinery started deciding where mountains should be (or the oceans or forests, or plateaus, or what color the sky should be or whether fish should have fins or not) I don’t think they’d get it right. I think the mountain is going to be there for another reason that our mind deciding why it should, and that expands potential, maybe.

          That’s all, it’s just another gear. If I’m writing a piece of music I don’t usually have a connection with the emotions beforehand, it’s more giving room for the ability. It’s only once this happened that I can think of, or twice come to think now. There was a friend of Mozart, the one soft point in his last years (and this WASN’T his wife), a piano student. And I came upon someone who I thought was this friend, and I think it was when it dawned on me, and out of nowhere a friend of mine (a lady that was ALSO supposed to be “crazy” and this has happened with another “crazy” friend as well), she called me up because I wanted to ask her, which I had been thinking to do, whether she picked up that this was a soul connection, and she knew the color of his hair, and she had called with I think more than serendipity. Then I must have hung up the phone, and started hearing a melody in my mind and in working this melody out on the piano I sat there finding myself weeping so hard that my FACE hurt. Just WEEPING! And it was nothing perhaps but the music letting that out, nothing more, not even thinking about what it meant. It’s even like with trauma, to feel it and trust the Universe to heal it. Not judging others, not even trying to figure out what went wrong in the life of the person who could be listed as the abuser, but simply feeling it, and trusting the Universe. Perhaps what Lao-Tzu called non-attachment.

          I wanted to say it’s like a time warp at first (but I was told I would loose you, who ever is trying to figure out what I’m going on about), like in the cadenza phrase I added from this time, to the concerto that when I talked with Mozart’s mother through a medium and mentioned it she said she remembered me playing it, and it was like a dream. Can spirits dream, what is the unconscious, can they manifest in our dimension say as why might in their while we dream?

          That’s “Crazy” but maybe emotions and the sub or unconscious have that connection with the Universe, and can resonate with stuff we would think is impossible did we decided we knew what they feelings were for.

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  7. To Nathan MD, Princeton
    Dear Anonymous “job jog”

    I sincerely hope that I am an integral part of a movement that uses my 50+ years of experience in the field to condemn, (not meant to incite hatred) of the present and lob existing field of Mental Health, Behavioral Health and psychiatry. Did you know that when a dentist from South Dakota suggested to dentists that they could do more than fill cavities there was and large and unhappy push back among dentist! They feared they would lose their livelihood!

    Shall I tell you about the young adult I met in an Intensive Outpatient Treatment center (who had been to several “Therapeutic Wilderness Programs” as well as inpatient hospitals and was being home schooled? He was prescribed Prozac and aged 8-years old and was still on it at age 20! Do you know what effects Prozac has on an adolescent going through puberty? I bet you don’t because there is no information documented by the drug company. However, we both know that it had some effect. How about the 70-year old woman I worked with who was diagnosed with “clinical depression” because of her flat affect. She still walked 5 miles a day as she had before she went to see her primary doc who diagnosed her with this and put her on an antidepressant. Because she was not getting any “better” and instead was getting worse, (medication?) she too came to an intensive outpatient setting FINALLY, upon my nursing instincts she was seen by another medical doctor and was diagnosed with Parkinson’s disease. Do you know what one of the symptoms of Parkinson’s disease is? Flat affect, low energy and change in general disposition and outlook. Or shall I tell you about the man in his 40s who was feeling less energetic, less able to perform sexually, with the usual symptoms of anxiety and depression. No surprise, he was put on antidepressants, and when the first batch didn’t work the dosage was increased and when that didn’t work he was put on an additional antidepressant without the original antidepressant being discontinued. Eventually, this man chose to stop seeing this pyshciatrist and went do a counselor in private practice. He also decided to discontinue taking the antidepressants. But it took him 3 years to do it. And this same antidepressant now has the research indicating that this medication causes harm not help.

    JobJob, Please help me understand what is it that YOU want from defaming my blog with your comments and defammin Robert Whitaker who is a well respected health reporter?
    I’m asking sincerely. I would be interested in engaging in a productive conversation and discourse.

    (Princeton, NJ? Just curious, but do you work for on of the drug companies in Jersey? I understand that perhaps you, and certainly the drug companies have a lot to lose by changing the mental illness paradigm!)

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    • Let me propose an answer I believe will address your concerns. Let me ask you a question. Are you trying to prove that psychiatrists are no good? I ask because you list several people harmed by them. You implicate the entire industry based on some bad experiences. That isn’t logical. That’s what I believe Whitaker does.
      Do you know how much a top orthopedic surgeon cost me by botching the surgery on my ankle? A professional career in football. Do you know how many orthopedic surgeons botched my care along the way? Do you know what that felt like? Or, my mother whose breast cancer was caught only after several doctors told her there was nothing wrong with her? M.D.s. Almost died.
      I believe in doctors.
      I, personally, I can’t speak for others but your question insinuates I must have a lousy but hidden agenda, which is an insult in itself. I have nothing to do with this industry Except one thing: I know a number of people who are alive today and doing well because of excellent psychiatric care and the meds they take.

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      • If you would actually read Whitaker’s work, he was originally fully supportive of the status quo system. He only reduced his support as he observed SCIENTIFIC STUDIES showing that people AS A WHOLE were getting worse, not better. As far as I know, Bob Whitaker has never said that psychiatric drugs are worthless, that all psychiatrists are evil, or that no one has benefitted from psychiatric drugs. In fact, he has spoken out in favor of a targeted use protocol for psychiatric drugs, to use them for what scientific study says they are useful for, primarily for short-term symptom reduction, while seeking to look at other approaches which COULD be used by psychiatrists or anyone else to try to get past “symptom management” and create some viable long-term change. He even gives a couple of examples of how this mixed-use protocol would work, including real world examples of where it has been effective. Given the disastrous “recidivism” rate among users of psychiatric drugs and repeated studies showing that long-term use can make things worse for many users, indeed perhaps the majority, this seems a VERY rational viewpoint to take.

        You seem to be making this a personal thing, as if critiquing psychiatry as a SYSTEM is the same as saying psychiatrists AS INDIVIDUALS are no good. This is simply not the case. You are arguing for a chance to have a civil exchange about these questions. It seems to me that would start with you as an individual dropping the assumption that people at MIA are out to destroy people’s “mental health,” which VERY clearly seemed to be your assumption from the first words you put down in your first comment. If you come into a web community and start off insulting everyone here, it should hardly be surprising if you don’t get a warm welcome. If, perhaps, you REALLY want to have a meaningful discussion as you claim, it would seem to me the most sensible thing would be to start by saying, “Wow, I have a really different experience of psychiatry from y’all. Can you help me understand how you came to these conclusions, and maybe I can tell you how I reached mine?” But I don’t hear you expressing any interest whatsoever in the people who have experienced psychiatry as something unhelpful, insulting, demeaning, or downright dangerous in a very physiological way. I am hearing in you a desire to tell such people their experiences are wrong, or their conclusions are wrong, but wanting them to listen to YOUR viewpoint “nonjudgmentally.” I don’t think that is a realistic plan.

        Have you actually read “Anatomy of an Epidemic?” That might be a really good starting point before you start forming conclusions about Bob Whitaker and the entire community simply because they see things differently from you.

        And I absolutely respect your right to have your opinion, and you are welcome to post it here. But others are also welcome to theirs, and I kinda want to see you find the same respect for them you are asking for yourself.

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      • Tom Shapiro: When you had your problems with your ankle, and the doctor didn’t fix it, did he tell you that the reason your ankle didn’t get better was because you were non compliant to treatment, even when you noticed it wasn’t getting better? Because that IS the case with MANY people who have had to deal with a psychiatrist and their chemical imbalance theories. Further more, in psychiatry if you don’t want any more treatment, and you have told them that it’s getting worse, they can force you on more, and say that the reason the problem is getting worse is that you need more treatment. Did this happen with your ankle? Were you forced on more of the treatment that you say botched your ankle so badly you couldn’t play pro football, and not allowed any other choice? I’m just mentioning choice also, not whether you chose to continue with whatever treatment. Were you arrested from your home and imprisoned in a hospital when you showed signs that the treatment didn’t work, after having gotten away from it? Was this continued even when it disabled your life, even when you weren’t able to function at work, even when multiple other medical issues started cropping up that scientific data shows is from the treatment? And when you tried to point out with clear evidence that statistically the treatment you were forced on correlates with an extreme spike in the problem, were you told that you were a danger to yourself or others because you were non compliant with treatment? Because that is the case with many people who have been forced on psychiatric treatment (read Whitaker’s books, and others such as Moncrieff).

        What YOU are saying is that people who actually feel they should have the right to say no, this isn’t working; or I’m interested in other treatments that correlate (read Whitaker’s works) with more recovery: you are saying that those people are speaking against doctors, and insult you because why?

        You speak of people doing well because of psychiatry. I’m not aware that they aren’t allowed to tell their story in mainstream media. Do you think this site is mainstream media? Is there something wrong with a group of people who are doing well because they got away from psychiatry and its controls on their life who have the temerity to point out how when they stopped doing what psychiatry said was necessary they could function again? Is there something wrong with the fact that when they got away from controls psychiatry wanted on their life that they could function again? How is that insulting to you for them to tell their story? This is insulting to you because they survived, have a life, and want to speak freely how that happened?

        If there’s clear statistical evidence that other methods work, or simply that the one that’s being forced on anyone isn’t, people advocating for the right to make their own choice are insulting you? And why is this? Because you lost your ability to play pro football because of a doctor but didn’t lose faith in the medical profession?

        Whitaker doesn’t at all speak against people that say they have been helped by psychiatry. He doesn’t do what you are doing, and say that when they tell their story they are speaking against the clear evidence he puts forth regarding those that haven’t been helped by psychiatry, and who aren’t allowed to tell their story.

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        • Dear Tom Shapiro,

          Of course I would not condemn all psychiatrists. I actually know more than a few, some good, some not so good. I do condemn the profession as a whole in their lack of considering other alternative treatment methods for mental illness, as they define it, through their medical model paradigm.
          Of late there have been some amazing alternative treatments being used. However, I know very few psychiatrist who are recommending these kinds of treatment alternatives. These newer methods include: Neurofeedback, eye movement desensitization and reprocessing (EMDR) and Emotional Freedom Technique (EFT) to mention the most recent. Neurofeeback addresses electrical targeted brain connections. This practice is having remarkable positive effects for children, teens and adults. Compare this with psychiatric medications that make chemical changes in the brain that are indiscriminate, not targeted, making changes in the entire brain. We call these changes “side effects.” One of the well known and reported long term side effects of some of these drugs is Tardive dyskinesia. This IS brain damage, and gets worse when the psychiatric medication is discontinued. Now big pharma has created a new medication to deal with this debilitating disease (an iatrogenic disease). In my almost 50 years of working in the traditional psychiatric field, I never knew of a doctor who warned their patients of the potential of this long term effect.
          I’m surprised that doctors who are still willing to consider ECT are not considering neurofeedback. My guess is they don’t know about it!

          My research is asking the worldwide Choice Theory community if what we are doing is working? Boy I wish psychiatrist would do the same.

          If you know of doctors who are working with patients to grow their good mental health, I would love you to share that news with me, and everyone else reading here. As far as I know, the psychiatric field, that includes psychiatrists and others, continues their same old traditional psychiatric practices that are helping some and failing most. The news has spread that the pandemic did not only increase physical illness, it also increased mental health/illness. It’s also clear that the traditional practices to deal with this present crisis is not up to the task.

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  8. Hi Nancy,
    Yes strange why this vile attack on Robert Whitaker is on your blog. Mr. Whitaker is a well-respected investigative health reporter, a humanitarian and person of integrity. However it’s coming from a psychiatrist who is obviously desperate to protect his fragile ego, relevance and lucrative turf so it should not be a surprise.

    I appreciate much of what you have written and your good intentions but for this to be helpful it has to be available BEFORE a person tangles with psychiatry and is harmed by the spurious DSM labels and drugs.

    “that they know who to reach out to” – that’s the most critical component for someone to improve their state of mind and situation in life. Psychiatry is NOT the place to reach out to for ‘help’. There are some psychiatrists with good intentions, but psychiatry has proven to be a most detrimental place one could reach out to.

    My brother was an electrical engineer, athletic, talented musician and father of two little boys when he saw a psychiatrist for ‘help’ with divorce depression. I foolishly believed (at that time) he was getting knowledgeable/specialized ‘help’ to sort out his emotions and a path forward. Instead I was worried to see his physical health and cognition decline until he could no longer work. It was a shock to realize the only ‘help’ he got was drugs and also subjected to ECT. One night he died in his sleep at the age of 40 and his autopsy concludes his body was not properly metabolizing the drugs and a fatal level built up in his liver and caused his death. Yet the psychiatrist watched his health go downhill without questioning anything, just kept prescribing. So many have been harmed or killed yet the status quo remains.

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  9. “Big Pharma’s marketing practices do improperly shape physicians’ prescribing habits and do play down the dearth of long-term data on impact and safety.”

    So, physicians are not able to look past the “marketing practices” of big pharma when making decisions about prescribing? Big pharma is tricking them?

    Well, that doesn’t surprise me. I’ll always remember the good-looking sales reps who showed up in psychiatry waiting rooms in the 90s. Well dressed, smiling, and armed with plenty of swag emblazoned with names like Prozac and Wellbutrin and Abilify, and often bearing free samples of whatever new drug they were hawking.

    I would like to have been a fly on the wall in those meetings. Did the sales reps coach the physicians on what to say to patients when recommending a new drug? It was so casual back then, the salad days of SSRIs and atypical antipsychotics — no talk of withdrawals, brain damage or akathisia. No black box warnings. I remember this one psychiatrist who I saw for 6 years until he sent me on to an ECT Dr. He used to say, “I’ve had good luck with ______,” whenever prescribing a new drug. So pleasantly vague and comforting and yet unscientific, maybe even illogical. Is it luck we need, doctor? I dared not ask. I just filled the prescriptions, swallowed the pills and kept hoping for good luck as I lost any grip on functioning and my “biologically based mental illness” got more severe.

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    • There is more than a “dearth of long-term data on impact and safety.” There is PLENTY of long-term data saying that the impact and safety profile of these drugs is questionable at the VERY most optimistic. I’m not OK buying into this “more long-term studies are needed.” The studies we have are more than sufficient to call the use of these agents into question, particularly the blithe way they are prescribed so broadly with little to no standards of care. It is the job of the doctors and the medical community to prove they ARE safe, and they have failed to do so. No one should have to prove “beyond a reasonable doubt” that they are dangerous!

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      • Agreed, there is no dearth of long term data. There is plenty of long term data including what to me is the most relevant and accurate data: Self-reported experiences of individuals who were prescribed the drugs in various doses and combinations ever since the drugs came on the market in the 80s. Those experiences are shared everywhere across the internet, from this website to websites like surviving antidepressants and inner compass. The drugs were tested on the population for the last 40 years, so there is a very large sample size. Pro psychiatry people will dismiss these narratives as anecdotal, but the people who have been prescribed the drugs, who have taken them in various combinations over years or decades, these are the people with the first hand knowledge. Not something they read about in a drugmakers’ pamphlet or an APA conference. Not something that a psychiatrist “observes” during a 15 minute medication check and writes about in his notes, if he even keeps notes because not all of them do, and probably chalks up to the patient’s inherent mental illness anyway.

        Honestly, I think you can’t win a debate with most people who advocate for psychiatry because it’s a group that has already demonstrated an allergy to logical thinking. I just took a look at the depression screening quiz that used to be put in front of me every few weeks when I was in and out of the psych ward and IOP. It makes me laugh because there are questions about feeling guilty, feeling like I’m “less than” other people, feeling like I might be punished or I am being punished, feeling that I am not interested in things and I don’t look as good as I used to. All of these things were made worse by the treatment I was enduring. Unfortunately no one noticed. They just kept writing in my records that I was non-compliant and non-responsive.

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        • It sounds like literal torture! I have also noticed that whatever “treatment” is being provided, there is no requirement that it actually improve the client’s condition, either by the client’s report or any of their subjective “screenings” that are supposed to be objective. If things get worse, it’s raise the dosage or try a new “treatment.” And then they say you are “treatment resistant” if their shit doesn’t work, rather than saying, “Well, I guess our shit didn’t work this time.” And if you somehow get better in some way despite all of this nonsense, they are the first to step up and give their wonderful drugs all the credit. No, logical reasoning doesn’t seem to be in much supply.

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    • KateL,
      Drugs reps are some of the most highly-trained salespeople out there. They actually go out of their way to ‘research’ the personalities and lifestyles of the doctors on their drop-in list. They scout out their vulnerabilities and where to complement them, because the seduction of doctors is a drug rep’s specialty. And it’s no accident that the sales reps are good looking. It’s a real schmooze city.

      I once read a book on subliminal seduction. And according to the authors, physicians are the most susceptible, because physicians are typically the most cut off from their feelings, due to both the doctor’s inborn personality (big ego), and the unsympathetic training (med school) they subject themselves to.

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  10. One of the worst things about the “mental health system” is it that people don’t have a choice as to whether or not they’re labeled. And being labeled means being stigmatized. No choice there.

    And these harmful, stigmatizing, bullshit “labels”, which are “chosen” by some asshole “professional”, stay on people’s medical records for life, which can create all kinds of havoc and injustice. No choice there, either.

    I personally have never liked labels, diagnostic or otherwise. To me they’re all a huge pain in the ass, even ones like ‘victim’ or ‘survivor’, because even these are too connected to the crap I didn’t ‘choose’ to endure — and ‘choose’ to forget.

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    • And for those people who ‘choose’ to make living off blithely labeling others, (psychiatrists, psychologists, etc.) I’ve got plenty of labels FOR THEM, the only difference being my labels, however crude, are entirely accurate —

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      • Define ‘blithely’:

        – Lacking or showing a lack of due concern, casual, ‘spoke with blithe indifference to the true situation’

        – Heedless, lacking due thought and consideration

        – A disregard for the rights of others

        – Ignorance and indifference

        I can’t think of a better word to describe the mental health industry.

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      • And for those people who ‘choose’ to make a living off blithely labeling others (psychologists, psychiatrists, etc.), I’ve got plenty of ‘choice’ labels FOR THEM, the only difference being my labels for them, however crude, are ENTIRELY ACCURATE —

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