On the Mad in America podcast this week we have Robert Whitaker with us to answer questions sent in by readers and listeners. Thank you to all of you who took the time and trouble to get in touch. You sent some great questions and on this and our next podcast, we will be talking with Bob about Mad in America, the biopsychosocial model, the history of psychiatry, pharmaceutical marketing, and issues with psychiatric treatments including psychiatric drugs and electroconvulsive therapy.

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

James Moore: Bob, welcome. Thank you so much for joining me again for the Mad In America podcast, and thanks for spending some time answering reader and listener questions. 

Robert Whitaker: It’s nice to be here again. Thanks for inviting me.

Moore: The first batch of questions are around the theme of Mad in America itself. Carina sent in the first question and she asked, could you tell us how MIA got started and what your role was in getting it underway?

Whitaker: After I published Anatomy of an Epidemic, I began hearing from people who wanted to talk about what it meant for them, both from people with lived experience and from prescribers. At that time, I already had a personal blog based on my first book, Mad in America, and I began running other blogs. Then it became obvious that it would be really helpful to have a website to provide a forum for people with lived experience to talk about their experiences and provide a forum for people, including prescribers, family members, or activists, to write about their thoughts about how we might change psychiatry.

And, of course, Anatomy of an Epidemic is really a story about how we as a society have organized ourselves around a false narrative of science. One of the key things in terms of reforming or rethinking psychiatry is to provide the actual research to the public. What is known about drugs and what is known about the validity of diagnoses, that sort of thing. It became evident that it would be useful to have a website that provided those three things, a forum for personal experiences, a place for blogs, and research news.

I had known Kermit Cole ever since I published Mad in America. Louisa Putnam wrote to me after Anatomy of an Epidemic was published with some questions. The three of us got together and said let’s start a website, and it was founded by us three. It was a joint project and it launched in January of 2012.

Moore: Looking back now, are you surprised with the way that Mad in America has grown over time? When you started out, what was your vision for the website?

Whitaker: I didn’t really see it growing, and there wasn’t a long-range vision. It was sort of a need at the time with those three elements in mind and really nothing more than that.

We started it, by the way, as an all-volunteer organization. Everybody was putting in their time. I don’t think I had any vision of what it might turn into with this number of people contributing and having all the different elements we have today. The only thing I can say is that from the beginning there was a sense that we would be very agile and open-minded to new possibilities precisely because there wasn’t a real vision for how to expand it. It was just, let’s see how this goes and let’s see what we can build.

Moore: So on a similar theme, an anonymous person asks the following: Mad in America has been going for 10 years; can it keep going for another 10? 

Whitaker: Putting this in context, from the beginning there was the sense that we would be an alternative media because the mainstream media is not a reliable narrative of the actual science. And that’s what we’ve become.

You can’t find what’s on Mad in America anywhere else on the web in terms of the information about drugs, research, news, and the variety of opinions and personal stories. We’re now 11 years in and I think we occupy a very important place, not just in the United States but globally, in terms of helping society rethink and consider other possibilities and to do so in an evidence-based manner.

I think it’s important that we continue. However, I will tell you there are challenges and the biggest challenge is financial, frankly. Right now, as you know, we’re hitting a bit of a crisis. We’ve expanded to a place that far outstrips our donations, so we have to rethink how are we going to keep on funding this work.

I can imagine it keeping on going for another 10 years, but we now have this very real challenge. How do we fund an alternative media that can’t tap into any of the usual sources for funding? Even grant sources, because grants, by and large, go to those that are close to the mainstream idea.

Yes, I hope we’ll stay alive for another 10 years, but it’s not easy being an alternative media and finding the funding to do what we do.

One of the things we’re considering now is adopting a subscription model. Under the subscription model what will happen is we’ll have some of our content where, in order to read the complete article, people will have to subscribe. Our thinking is that it will be a minor fee like $5 a month, maybe $40 a year, and we’ll provide some other benefits like free access to all MIA webinar events. And we will include a free option for subscribing. If anyone can’t afford the subscription they can write to us and we’ll set them up as a free subscriber.

What we want to do is make sure that everyone, no matter what their resources, will have full access to all our content.

Now, this year we’re going to have something like six million unique visits to our site. Hopefully, we can convert those visits into a solid subscription base. If we do that, we should have the resources to continue to expand our original journalism, that sort of thing.

Moore: Another anonymous question. Are you ever worried that Mad in America’s reporting and blogs might cause harm? To give a little bit of context here, a few weeks ago Allen Frances on X (previously Twitter) claimed that Mad in America advises people to go off their drugs, which of course is not true. But that’s one example where someone used social media to try and cast aspersions on what Mad in America does. 

Whitaker: This was a claim used to shut us down right from the beginning and it goes back to when I published Anatomy of an Epidemic. That was a book that told of how, when you look at the long-term effects of psychiatric medication, you see a form of treatment that worsens aggregate outcomes. You see that people are more likely to become chronically ill with long-term use and more likely to become functionally impaired. Now the very first review that was published five minutes after midnight on publication day accused me of doing great harm with this book. The reviewer likened me to a South African dictator who by virtue of denying AIDS had caused hundreds of thousands of people to die. This book was positioned as a harmful book right from the beginning.

After that review ran, by the way, in my hometown newspaper, the Boston Globe—that’s a great thing to see in your morning newspaper—I had radio interviews cancelled, and frankly, no other major newspaper reviewed the book.

Now we do know that going off drugs can be very risky. That’s a function of being on the drugs in the first place more than due to the disorder. But what’s our job, and what does society need? Society needs informed consent around the use of these drugs. The harm that has been done is by a profession that doesn’t provide informed consent and a media that doesn’t dig into what the research literature actually says. That’s the harm being done because that has led to a misunderstanding of what the drugs do. That has led to many people being on the drugs long term when clearly short-term use would be much better, or even trying to forego initial use. So you have to go back to the initial source of harm.

By the way, all the data says that with this new disease model of care, the burden of mental disorders has gone up. Outcomes have worsened. That’s a story of great public harm. Unfortunately, what is needed is an alternative media that provides informed consent, and that means providing information about what drugs do and what are short-term effects, what are long-term effects, and that’s what we provide.

Now, I will say we’ve heard from so many people who say this information has given them a new life, a new understanding of what happened to them. That’s a story of great benefit from informed consent.

Do we advise people to go off drugs? Never, ever. In fact, if you read Mad in America, it tells of how perilous and how difficult it can be to go off the drugs, and that you may experience difficult withdrawal effects. We never advocate for any particular mode of therapeutic action. We’re just trying to give people the information they need to make informed decisions.

Anybody like Allen Frances who says we’re harming people, you just have to say to yourself, oh, these people do not believe in informed consent. They believe in information being kept from people so they will keep on taking their drugs.

Moore: Next another anonymous question. Mad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States and abroad. What would need to happen for you to consider that mission fulfilled? 

Whitaker: In a way, I think the mission is happening and the fulfilling of the mission is happening. If you go back 12 years ago and look at the narrative that was spreading throughout the internet and even into mainstream media, it was very different. The chemical imbalance story was still alive then, the disease model was still alive, and there was very little talk in the public media about drug withdrawal effects. There was very little talk about how in essence the whole disease model narrative had fallen apart. Now here we are 12 years later and there’s increasing discussion about withdrawal effects. There’s an acknowledgement even within the profession that the diagnostic categories lack validity. There’s even an admission now that there has been no improvement in outcomes. Now, they don’t want to say that outcomes have worsened in the last 40 years, but there’s that acknowledgement of “no improvement.” Then there are calls for radical change coming from the top, and I’m speaking specifically of when Dainius Pūras was the United Nations Special Rapporteur for Health, he made these calls, and it was a call that was basically consonant with what we have been advocating through our reporting.

Of course, the World Health Organization has twice now issued 300-page documents saying we need a radical change away from the disease model and towards a human rights model, one that recognizes that there are social determinants of health. Disorders don’t just occur inside the individual but in the in-between spaces and in how society organizes itself. These are all themes that tell of a new narrative and these are all themes that we have been advocating for a long time.

Now the question is, will the mission ever be done? Even as these calls for a new narrative have come forth, and even as they’re gaining a foundation in the general public, the form of care hasn’t changed. Forced treatment is on the increase. It’s still basically drugs, drugs, drugs, drugs. There’s a sense that in order for the mission to be accomplished you’d have to have a new storyteller, not psychiatry, having authority over this domain of medicine. You would have to have a larger group recognized by society as the storytellers for the narrative we should follow.

Is that going to happen? I don’t know. Medical authorities have a lot of established authority in our society. It’s really hard to put them to the side and say these people shouldn’t have authority over this part of our lives. But if we have a new narrative in 10 years, maybe I’ll say mission accomplished and we’ll figure out what to do at that time.

Moore: A couple of other questions on Mad in America and its work before we move on. This next question is about working with others. This is from Mary who says some campaign groups have legislative efforts and track laws and regulations other groups lobby. Are there any ways that MIA could play more of an advocacy and change agent role? Is there any effort to join forces with others? 

Whitaker: This is a good and important question. We are an activist form of journalism because, as you see in our mission statement, we do see a need to change the narrative. But we see our role as serving as a journalistic alternative media to serve that mission best. In order to retain our journalistic sense, we can’t lobby for anything. By the way, as a non-profit now we’re not allowed to lobby for anything, but we also don’t actually join forces with anyone else.

For example, as you know, I had a role in founding IIPDW (the International Institute for Psychiatric Drug Withdrawal). Now I’m no longer one of the board members, and this is part of the reason we can promote what they’re doing. In other words, we can serve as a forum for IIPDW to announce what they’re doing and as a forum for whatever research they come up with. But we don’t join with them in setting forth an agenda.

We need this editorial independence saying, here’s our job, we’re an alternative media, we’re not a lobbyist organization, but we will report on lobbying efforts. We’ll let people talk about their lobbying efforts in blogs but we’re a forum for change within a journalistic context.

Moore: This question is from Tara. Why are readers of Mad in America welcome to share our stories and concerns about psychiatry, but we are shut down if we try to discuss the similar shortcomings of AA-style 12-step programs? 

Whitaker: I’m not sure I know why Tara feels shut down on this issue. In terms of personal stories, we let people talk about what’s been harmful to them and what’s been helpful to them. For example, I’m sure people have talked about help coming from 12 steps, and if people found it harmful and it’s a personal story that’s well written, I don’t believe we wouldn’t include that. There’s nothing saying that criticism of 12 steps is off-limits. In fact, criticism of any type of therapy is not off-limits.

This person can write to me personally, but there’s no sense that Mad in America wouldn’t publish a personal story by someone who’s had an unfortunate experience or a harmful experience with 12 steps.

Moore: This question is from Lynn. I would like to know why you think we’ve not seen a multidisciplinary approach to solving the problem of so-called mental illness. Why is there seemingly little or no interest in the areas of soft psychology, philosophy, sociology, religion, history, and even literature and the arts? 

Whitaker: A great question. I think we need a rethinking that involves all those things, philosophy, an understanding of history, an understanding of literature and arts. That is what happens when you broaden into this multidisciplinary understanding. You get a different vision of what it means to be human than is present in the Diagnostic and Statistical Manual. Of course, the image you get of humans is that we’re very emotional creatures, we have difficult times, we have ups and downs and it’s not like we’re in control of our emotions all the time. Even psychosis can be seen as part of the human condition.

I couldn’t agree more that this is the sort of approach that we need to embrace or incorporate into a new narrative. Under our current disease model put forth by the American Psychiatric Association with its DSM, problems arise within the head, there’s something wrong with your chemistry and something wrong within the individual. When we look into these multidisciplinary approaches and we talk about the social determinants of health, we’re talking about things like food, exercise, shelter, equality, and all the things that we know are important. We’re talking about the environment because we know that human beings are responsive to their environments and we’re talking about creating better environments that help people stay well.

Now, this person is asking why isn’t that story incorporated into the mainstream narrative of the disease model. Because, very simply, the disease model was invented by the American Psychiatric Association because that was a model that gave it authority over this domain of our lives. That was a model that turned them into medical doctors in white coats, and that’s an image of branding that has great value.

The drug companies also love this model. The drug companies can’t sell drugs to provide shelter. They can’t provide a drug that provides food, nutrition, exercise, and socialization. So you have these two strong forces, a medical discipline, medical guild, that wants to maintain this disease model, and pharmaceutical money pouring into it.

It also feeds into this idea there are magic bullets out there that can make us better than well, they can alleviate all sorts of problems. We as the public have been conditioned to think that pills are the answer.

Moore: While you were talking, I couldn’t help but think about the articles that we share from our global partners in the Mad in the World global sites who often write and apply their cultural lens which is very different from the Western-centric lens. They are often talking about these issues in a much less medicalized way and it is fascinating to see how different that can be when a different cultural lens is applied. 

Whitaker: This is one of the things in terms of our growth that has been so important. We now have 15 affiliated websites in 15 other countries. They come from Latin America and Europe, and now we have one in South Asia. Now there are two things to recognize about that.

First of all, you have to say, why are these affiliate sites springing up? It’s because the disease model is failing in every country after globalization of that disease model. The DSM was promoted not just through Europe but to Latin America, to Asia and so on. There is this growing grassroots resistance.

But the other thing goes exactly to what you’re saying. We can learn from each other, we can learn from what they’re doing in India, we can learn from what they’re doing in Norway, and we can learn from what they’re doing in Brazil. The sharing of information across our affiliate sites, across cultures, is a way to give readers insight into the many possibilities for rethinking these things, and seeing how other cultures have done it, taking inspiration from them, and learning from them.

That’s one of the things that Mad in America is now providing, and one of our real initiatives in the coming year is to further this exchange of information among all sites.

One of the things Mad in South Asia is working on right now is looking at the long history of traditional practices for treating psychosis in India. This is of great interest because when the World Health Organization did a study of schizophrenia outcomes, where did they find the best outcomes in the world? In rural India, which was still practicing these traditional practices. That’s an example of what we can learn from this Mad in the World network.

Moore: A question from DB who is asking about the biopsychosocial model. They say psychiatry insists it practices a biopsychosocial model, and so often expects the public to accept that as a given. But do patients report the same? Has there ever been a big study on psychiatric patients ranking the emphasis placed on bio/psycho/social in their experiences of psychiatric treatment? 

Whitaker: The biopsychosocial model is basically a branding message from psychiatry. It’s a way for them to say, oh we’re not just pill prescribers. As much as anything, it’s something they say to themselves to feel good about what they do, because they know that there are psychological aspects and social aspects. But really, going back to the 80s, they started calling themselves psychopharmacologists, they said, we’re going to be prescribers of pills and we’ll leave this other stuff to the psychologists.

If you listen to patient experiences, over and over again they tell about how there’s little interest by psychiatrists in their psychology, little interest in social issues, and little support for even exploring them. Of course, in the United States, you get like 15 minutes with your psychiatrist, so they’re basically pill reviews.

Moore: A question from Larry, who says, has your work resulted in any kind of a vision for what mental health care in America or across the world could become if it were devoted to making people well? How would it finance itself? What range of practitioners would it include? What range of treatments would they use? What benefits to society might accrue? 

Whitaker: Well, if we organized ourselves around a narrative that that did incorporate our understanding of human beings through literature, art, religious tracts, and we also understood that there are social determinants of health, then of course, we would have to do a couple of things to organize ourselves around that narrative. One, if someone was in distress, we’d have to think about how can we improve their environment. In what way can we provide support? But even beyond that, you’d have to say as a society, how do we better organize ourselves as a society to nurture the health of our citizens? It might be in terms of helping them engage socially, find meaning in life, improving equality, better housing, better food, better exercise, and so on.

I think the question is, will we ever have that? I don’t know, James. In terms of society rethinking itself, capitalism is a powerful force. Capitalism is about making money and providing opportunities for funneling money to certain people in positions of economic authority. There is a sense that our economic system is at odds with a society that nurtures mental health. Are we going to get rid of capitalism? I don’t think so.

That also goes to this question of financing. Our current psychiatric system generates huge profits. It is, though, largely funded by the government. For example, in the United States, if you look at spending on psychiatric drugs, about 60% is funded by the American government through Medicaid and Medicare. The rest is mostly funded through private health insurance that people are paying for. The problem is how do you finance a form of care where you’re not making a profit from it?

Now, if you could have a government that said, okay, let’s fund respite houses, or let’s fund medication-free care and let’s do so because it will save us money in the long term, that would be great because then you can make an economic argument for such change. So for example, if you can have this sort of good care right from the beginning that focuses on psychological and social determinants of health, and helps people get back on track and not become chronic mental patients, that’s a great savings, right?

Moore: This question from Laurie is along similar lines. Laurie says do you honestly think psychiatry could ever change to become an industry that truly helps people in society as a whole? 

Whitaker: Here’s the problem in psychiatry today. To become a psychiatrist you go through medical school so you adopt medical thinking, and you adopt a medical identity and you’re invested in that. Now, you can want to help people, you can be a very caring person and go through that process and you can choose psychiatry for that reason, because you want to help people, and you want to help them get their lives back. The problem is, and again, I keep going back to this narrative, it’s not just a medical problem. It’s sort of a whole living problem.

What psychiatry would have to do is rethink itself. Rather than have authority over this domain of our lives, they’d have to give up their position as the leader of this whole story. Because right now, as the medical specialty, they’re on top of this whole pyramid we talked about of psychologists, sociologists, and so forth. They are the ones that, when the media calls up someone, they call up psychiatrists. Will they give up that power, that domain, that authority, that sense of self? That’s really tough. It’s tough for people who go through medical training not to see themselves at the top of that perch.

You know, we have a younger generation coming through that is more humble about being a doctor than before. More aware of a need for humility. There are more women doctors now in the United States so that old image of the male doctor that we all know is diminishing. I hope I don’t get in trouble with this, but I think the younger generation, and also women professionals, are more willing to share power. Could we move to a place where psychiatry sees itself as a part of a power-sharing arrangement? That’s the hope.

The thing that we’ve learned about mental disorders is that the brain, of course, is so complex and mysterious, and of course, the brain is attached to the body. You have to have humility about that to ask what’s going on with people who are depressed. What’s going on with them when they’re mad? What’s going on when they’re psychotic? That humility so often says we don’t know what’s going on, and therefore we have to be open to saying there might be a lot of different approaches. Remember, medical training is about saying “we know.” Psychiatry needs to adopt this position of humility saying “we don’t know, and how can we join with others in creating this sort of holistic system?” It’s a big ask. But that’s the hope.


  1. Question:
    What are we doing, at home, in the community and at large to prevent our own governments from creating home grown terrorists?

    And what is America doing to guarantee it’s citizens, living abroad, have access to their mental health needs in their own language?

    I ask because right now, my 16yr old son and I are legally trapped in France and everyone involved, including the courts are being abusive to the point of gross negligence and pushing my son … Who is in the middle of an existential crisis from his dark tetrad presenting father and is suffering from suicidal and homicidal ideation with no help from the local community and is on the edge of putting his ideation into action

    The French are abusing their positions of power, causing PTSD, refusing to allow us to leave and if my son loses control over himself, he is a danger to the hospital and staff (including his father, a “fine upstanding citizen” and member of the hospital faculty)

    We are region blocked and unable to seek help outside of France, the American embassy has abandoned us and no one replies to emails, the very few who do (including the Maryland Board of professional therapists and counsellors) have been rejections that lack any sort of humanity

    It is my observations that every school shooting in America (or similar with adults and other mass shootings/acts of terror) or revenge boy Reed W in the uk who was arrested for plotting large acts of violence and all other similar acts are due to local communities lacking support, the various governments instigating segregation and abuse while claiming they support and care for all of their people/humanity

    What are we doing, at home, in our communities and up to a global government level, what are we doing to better care for the needs of those who are suffering so they do not feel the need to take the law into their own hands and have access to a better quality of life and access to any help they need… Including therapy

    Because right this minute
    I genuinely do not know how my son and I will survive the next 4 months without an incident (which I am being set up /entrapment as the scapegoat) let alone until 2025 when he will be 18 and far too emotionally and psychologically damaged to function in society

    We need help
    Where do we get it
    Who is stepping up to offer it!?!

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  2. A lot of news agencies on the internet try to come up with with some kind of paywall scheme. When I see that sooner or later I will have to pay to get information from a site, I start losing interest in the site. Quite often another site has the same information for free but it may be a challenge digging for it. Needing funds to keep an organization going or growing, puts that organization in a tricky position. Temptations start to arise to do things that normally would not be done if everything was done on a voluntary basis. When money starts creeping into an organization, there is a subtle tug in the hearts of those in the organization to get closer and closer to managing the money. Greed is like the plant in the little shop of horrors. It just cries out “feed me, feed me”. It never has enough and the more you feed it the bigger it gets. If Peter Gøtzsche knew what the Cochrane Institute would become, he probably would have had second thoughts on whether or not to get it off the ground. I don’t know for sure though, it might be good for someone to ask him. Maybe someone has. This is a problem I run into all the time. How does one separate money from corruption? It’s like separating a person’s fingers from their hand. What is a person’s hand without its fingers? So many want to separate money from corruption. It sounds good in theory but I have never really seen it done, at least not for long. There is a poem I came up with a couple of years ago. Sometimes I say it to myself to remind me of the reality of things.

    There is a ship called Tyranny.
    Her hull is made of tar-baby.
    Her flag will say, “My way is fair.”
    And port to port she ships her ware.
    Men do fight her, and do fail.
    For as they win, her flag will sail.

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    • The paywall is already there: many of the reviewed articles at MIA are behind a paywall, and MIA provides a free, even from adds, review of many of them. And that costs money…

      And I don’t think it’s accurate to somehow equate money and corruption. Not all money leads to greed, and I seriously doubt it’s the case of MIA. And having that many readers, interviews, reviews, “just” the website, tax fillings, etc., so a lot of money.

      I can’t speak for PG, can’t say his thoughts on alternate history.

      But it’s not always the case that even if one knew something one took part in starting up ended up corrupt, one would not have participated from the begining: from start to finish a lot of good might have came up of that one, which otherwise, although transient would not have existed.

      Someone else might have built it anyway.

      And if the Cochrane turned a nefarious behemot, well, there are other social forces than now will have to deal with it, particularly because the founders had not much role in not protecting it from the corrupting influence of Big Pharma. That probably was for the State, society at larger, I don’t think it’s the case that only the Cochraners were responsible for that.

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  3. The body needs things that money can buy. The soul needs things that money can’t buy. How do the people with physical resources get the needs of their soul met? How do those who spend their time dealing with the soul get the resources to live? Something tells me that things over time work themselves out. It is a common theme in a culture to have a few people dealing with the issues of the soul and the larger majority dealing with the needs of the body living in a symbiosis. Quite often the majorities are switched however in a nuclear family. It reminds me of a story from the gospels in the Bible. In the story Jesus had a close relationship with a woman named Mary. Mary liked to sit and listen to Jesus. Mary lived with a woman named Martha who basically did the cooking and the chores. Martha started complaining to Jesus that Mary was basically being lazy and should be helping her out. The response from Jesus was that Mary had chosen the better part. To some this may look like a cryptic part of the Bible. The Bible is a pretty cryptic book. I don’t read the Bible much anymore but I remember parts of it from time to time. In Asia there are yogis and Buddhist monks that fill the role as soul masters. They provide wisdom and knowledge about the matters of the soul. In return the populace who have resources provide them with basic living needs to keep them alive and healthy. The west is obsessed with materialism. There does however seem to be a growing movement of young people with individualized spirituality. Evangelical Christianity could easily find itself in a heavy battle with paganism if it hasn’t already. There are a lot of variables in trying to predict the future. The big challenge for me is listening to my soul and finding value and connection in a society that doesn’t have much time for the soul. There is often pressure felt to get a job but the soul keeps throwing up roadblocks to employment. Somehow I need to be a benefit to an economically driven society without being economically motivated. The solution seems to be to take my psycho poison and if things don’t work out, just go into the hospital and take more psycho poison.

    If you’ve been dealt a lousy hand,
    Just take the drugs to zombie land.

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  4. There have been some damn fine psychiatrists who have left their mark on the planet in a good way, alongside of some damn dreadful ones, whose woeful treatment of people with mental health issues has led to oppression, injustice and the torture, suffering and even death of those in their care. The question I have is, how do you bring the insights of the great and fine ones into the practices of everyday psychiatry, and stop the abuses which seem endemic, in this so called ‘medical’ field.? Our materialistic and unenlightened culture does not seem inclined to run with the powerful insights of men such as R D Laing, or Peter Breggin for example, who long ago threw up massive concerns about the practice ‘norms’ within psychiatry.

    “To explain everything as the result of a single factor which, moreover, is fixed by fate, has a great advantage. For then no task seems to be assigned to one; one has nothing to do but wait for the imaginary moment when the curing of this one factor will cure everything else.”
    ― Viktor E. Frankl, The Doctor and the Soul: From Psychotherapy to Logotherapy, Revised and Expanded

    “Madness need not be all breakdown. It may also be break-through. It is potential liberation and renewal as well as enslavement and existential death.”
    ― Ronald D. Laing, The Politics of Experience/The Bird of Paradise

    “There is nothing worse that you can do to a human being in America today than give them a mental illness kind of label and tell them they need drugs and these children are 3, 4, 5, 6, 7, 8, 9 years-old being treated in this manner.” Peter Breggin

    “Is psychiatry a medical enterprise concerned with treating diseases, or a humanistic enterprise concerned with helping persons with their personal problems? Psychiatry could be one or the other, but it cannot–despite the pretensions and protestations of psichiatrists–be both.”
    ― Thomas Szasz

    “We have to recognize that spirituality is a legitimate dimension in the psyche. It’s a legitimate dimension in the universal scheme of things. It doesn’t mean that you are superstitious, that you are in to magical, primitive thinking, if you take spirituality seriously.” Stanislov Grof

    “Consciousness and healing to proceed very far through the desert, you must be willing to meet existential suffering and work it through. In order to do this, the attitude toward pain has to change. This happens when we accept the fact that everything that happens to us has been designed for our spiritual growth.” Scott Peck

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    • Great comment you added. I totally agree that there are “damn fine psychiatrists who left their mark on the planet in a good way.”

      To me, the difference between the damn fine ones and the dreadful ones is due to the model that they support.

      The psychiatrists you included quotes for don’t buy into the overly-simplified biochemical “disease” model of the brain. They recognize a person is part of a bigger scenario with specific issues.

      Which book is your Scott Peck quote from? When I went through a breakdown / breakout / breakthrough in 1998, one theme that pounded in my mind was from one of his books — “When faced with the desert, there is no going back, there is only going through.” (or something to that effect).

      The real issue is the model that a mental health provider believes and supports, not whether they are a psychiatrist or not. In my experiences, there were psychologists who bought into (were trained in) the biomedical model of illness and disease as well.

      Granted, I would say that a higher percentage of psychiatrists support the biomedical model than the percentage of other types of professionals.

      The real problem is the bad model — and the bad metaphor associated with it — the diabetes metaphor. I find that one interesting because that is about the only metaphor used with mental difficulties. Even within the medical field, they don’t treat everything like diabetes.

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    • The problem to me is that if they are to be great they have to come clean.

      They have to spill the beans about all crimes/torture or cuel, inhuman treatments they inflicted, or participated in, or were just bystanders and/or never, as duty demands, reported it to the authorities. Even if that was not know back then, was not a crime back then.

      Those are crimes NOW because they are acknowledged thus and DO cause harm, they always caused harm, no way around that.

      As a physician, admiting and repairing the harm one does is an obligation, not a preference, and certainly not a choice.

      Come clean to all of them.

      Even Dr, Mr, Frankel never was really forthcoming in a real clear way about the lobotomies he did.

      He argued, and some papers argued they were on cadavers.

      Some other sources argued he performed lobotomies on hebrews, poles, jews, ugh, whatever terminology while they were alive.

      Now, if Frankel is to be great, was to be great, regardless of his accomplishments, without demeriting them, he HAD to be clear about what he did.

      He had to judged by his peers, not by the Nuremberg Court. He absconded of that, and just for that, he can’t be great, to my mind. He refused to be acknowledge for what he did, not for what he was, we all are great.

      And he was great for surviving the camps, but “no decent folk came out of them”…

      What he did, if to be judged and acknowledged, requires honesty, full, complete and transparent, when not in a court of law, but in the court of one’s peers. He apparently did not do that, so how can anyone judge if he was great, regardless of his accomplishments?.

      Voldemort was great too you know?.

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      • Frankly I enjoyed MIA more when it had less. I am not interested in personal stories, which I often find poorly written. I’m not that interested in global mental health, or stories about social, economic and racial injustices around the world, which I have no doubt help create many mental health issues, but which will never be eliminated. I rarely watch podcasts on MIA or anywhere else.

        My interest is focused on research, psychiatric malfeasance, those types of things. I’ve liked articles by Gøtzsche, Moncrieff, Simons, Hickey ( when he used to write for you), and, of course, you.

        But, despite my criticisms, there’s still a lot that I like about MIA, and I wish you well.

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        • The ten most popular articles of 2023 look like research ones which probably means MH professionals are getting free access to information they could easily pay for compared to people on disability because of the harm caused by the MH system.

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  5. Well, the effective altruism folks should take notice of the expanded reach of MIA, it’s partial fulfillement of it’s mission. It’s utility at large and in short.

    Now, I think part of the problem of getting funds for MIA is precisely the rhetoric against evidence that psychiatric treatments bring benefit instead of harm.

    What Peter Gotzche, Peter Bregging, Thomas Szasz, Rober Whitaker and many others have pointed out is that when it comes to ALL people treated by psychiatry more harm than good is realized.

    Respectfull of disagreement, and admiiting my personal bias, I don’t think even a partial reading of the empirical research could lead to a different conclusion if not for at least the perception that psychiatry is a cult, responds to guild interests and Big Pharma.

    Even the “exchanges” of RW with GPT4 clearly and convincingly argue that even the bot had in principle access to ALL or most research in psychiatry, even in reviewed form, given it’s design and way of operating it can’t, refuses, to reach a sober rational conclusion: more harm than good. Even when proded repetitively about it’s false claims, repeated from the larger discourse around psychiatry.

    To make it relevant to the funds issue: precisely the rhetoric that psychiatric treatments are life saving or provide inmense benefit to a few people is besides what I argued comming from said individuals articles, interviews and books: on the aggregate psychiatry is pernicious.

    A few claims of benefits, even life saving, I don’t think negate the point made: on the aggregate, psychiatry, is pernicious.

    And that, overampliflying the few that benefited against the many more killed by it, harmed by it (even if only in their legal rights), disabled by it, etc., is to me a very selfish way to make propaganda, against evidence to keep going an activity that it is more harmfull than beneficial.

    It sounds selfish to me, simple as that.

    And that probably for some is triggering: they might, deep down feel responsible for benefiting from something that harmed many more, it makes them feel guilty and lash against, indirectly, criticisms against psychiatry, it’s practice and ideology.

    And that selfishness tarnishes, minimizes, negates the great work that MIA has done and, I hope, will keep doing in the future.

    So I invite promoters of their personal benefit from psychiatry to try to moderate your claims, try to put them in context, and be aware that by repeating already amplified claims, indirectly you are perhaps denying MIA some needed funds, or at least making it harder for MIA to get them. I am not trying to supress your experiences and opinions, just trying to show some lights on its consequences for MIA.

    For a proposal as to how to continue the pushing against psychiatric expansion and encroachment on anyone else: literature and arts.

    The empirical research is already there, more will be coming, but, being December and all, I condifently predict it will be as it always was: positive at first, then neutral, then harmfull when it comes to psychiatric treatments. It’s a cliche even, all psychiatric research has gone under that cycle of fanfare and failure, all of it…

    For diagnosis, similar: same diagnoses, a few changes, no reality, no validity in them. Going more ethereal with other “frameworks” for diagnosing, formulating, whatever, it will be fads and fallacies, deja vu all over again.

    I will go the way of the Philip J. Klass curse: You will never find the reality of mental illness/disorders. It will always be out of your reach…

    As for arts and literature: dramatic, satiric, comedy, tragedy can put more critical thinking into some people’s minds than hard data. A few well told movies, series can convince more people about the more harm than good psychiatric belief system and practice.

    Even as fantasy, can do more to educate, to informe, to convice and to challenge believers in the creed of psychiatry than hard data based analysis, I think.

    So, an invitation to the talented writers, filmakers and the like: write fiction, do fiction questioning the psychiatric creed and rhetoric, that I think will bring more good than harm, in the aggregate…

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  6. A great interview. It’s a remarkably humane and courageous feat that Robert Whitaker took on 10 years ago and diligently kept moving forward with. Kudos to Mr. Whitaker for his high level of journalistic integrity and professionalism and all he has done to expose corruption and harm in psychiatry and facilitate change. Every organization needs funds to be operational. I always try to donate to the most worthwhile causes and Mad in America is at the top of my list. I greatly appreciate the work of Mad in America and hope they can keep going another 10 years or longer. Cheers and all the best in 2024 to everyone at Mad in America.

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  7. Yay for this article.

    Humility is a quality I could find nowhere as I scrambled out of the industry. During my dr-guided withdrawal (2+ yrs), I still found myself in the ER w/heart palpitations, dehydration, panic…The cause-ALWAYS preparing or enroute to ANY doctor appt….(go figure).

    2 young (rotations) docs stood out…1 contacted me at home with a suggested doctor for (perhaps) better services. (Ironically, it was a years-ago Phantom-Network listed guy, so No)….it was the thoughtful kindness that touched me…he had found me credible!
    Another closed the door, pulled up a chair and listened, also finding me credible….allowing ME to instruct HIM to prescribe the smallest mg of Valium, ONE pill-(I knew my brain well @ that point)… & I needed to split THAT….to get me past the waves of periodic, stark fear that rolled thru these 2 years.
    So much could derail my exit. There was no peace, no victory, no safety yet.

    I’ll never forget their kindness…and the bitterness knowing that after 11 years of entombment, the people that had known me the fewest amount of minutes, at my most ‘symptomatic'(DSM)…showed me the greatest compassion and humility as medical professionals…AND acted on it, attempting to alleviate my suffering.

    No small thing.

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  8. Thank you, Robert and MIA for doing the hard work of relentlessly challenging the Medical Industrial Complex and its narrow and harmful framework surrounding, particularly “mental” health.

    I am not sure why you are supporting/advancing narratives of the WHO. This agency is supported/funded by billionaire investors and orgs. that are ALL IN on pharma money and directives. They do not appear to have much vested interest in individual and varied approaches to the monolith of “mental” illness, except in the most cursory way.

    As the “mental” health narrative crumbles under the weight of it excess, the alternative voices seem to be corrupted by political motivations including the packaged post modern framework of oppressor/oppressed intersectional philosophies which are grounded in “narratives” not open to honest and rigorous scientific scrutiny. As a person who fits under the label of DSM criteria, I honestly feel ZERO assistance in a narrative that holds me in the victim category of this dialectic.

    The “mental illness” we suffer can be understood as fueled through a variety of sources, including the iatrogenic harms of the meds designed to disable our brains and otherwise disrupt normal bodily functions. There are, of course, a series of physical ailments that contribute to mental health effects, and malign social influences so eagerly promoted to hold you in the thrall of some other class of “experts” (read- strangers that have no knowledge of you or your history) that sell facile explanations for complicated phenomena. The expert class has so thoroughly sold the ubiquity of mental illness, that our youth are now considered in the middle of a “mental health crisis”, that experts are ready to swoop into schools more expansively now through “crisis” counselors etc. that are poised to advance further diagnostic labeling and the accompanying drugs to “Cure”. Our kids are guinea pigs and have been for some time (as are we all), but to thrust this approach on developing brains and bodies- seems truly evil.

    What if, we simply refused to be controlled? What if we really embraced each other, the complexity of our circumstances and reactions? The REAL may be experienced in complex and varied ways, but it is necessary and useful to focus there and not on expanding abstractions delivered by those who profit from same.

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    • I LOVE your comment, especially the following:

      “…the alternative voices seem to be corrupted by political motivations including the packaged post modern framework of oppressor/oppressed intersectional philosophies which are grounded in ‘narratives’ not open to honest and rigorous scientific scrutiny.”

      And this: “What if, we simply refused to be controlled? What if we really embraced each other, the complexity of our circumstances and reactions? The REAL may be experienced in complex and varied ways bur it is necessary and useful to focus there and not on expanding abstractions delivered by those who profit from the same.”

      There’s plenty wrong in the world, but that doesn’t mean I like it when BIG HEADS open their BIG MOUTHS with BIG WORDS which usually leads to one thing: THEM asking for more BIG MONEY which usually ends up in their BIG FAT POCKETS.

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  9. All brilliant stuff however I still think there’s a wrong assumption in the approach. There appears to be this assumption that fans of abusive psychiatry and toxic drugs will somehow change there ways once the evidence is in. However historically this is not how things have changed. It was Franco Basaglia, the Italian psychiatrist, who got to the bottom of this. The problem has underpinnings that are essentially identical to racism, antisemitism and other forms of discrimination. UK and USA society carries out an apartheid against the distressed with violent outcomes very similar to lynching. Therefore the bigot *wants* the distressed damaged by toxic drugs and electroshock. So reporting back that 30 years of the use of toxic drugs has bad outcomes is exactly what they want to hear. It’s mission accomplished for them.

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  10. Unfortunately I missed the chance to ask a question earlier.
    Here’s a question: I am writing a memoir of my disastrous journey through psychiatry and the mental healthcare system. I want to tell the truth as accurately as possible, but I have no allies or resources with which to defend myself should I be attacked. How does MIA do its reporting without being attacked or sued?

    Many thanks for the work MIA has done. It has really helped keep me going.

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      • I appreciate your comment Steve, but yeah, people are nasty and will do anything to discredit or intimidate whistleblowers outside of the legal arena.

        I mean, there are even self-avowed anarchists who proclaim that those of us who are critical of psychiatry are anti-science extremists, and they won’t be convinced otherwise, perhaps because they are afraid we want to take away their meds.

        I’m not a journalist, I am an artist. I lost all my friends and family and support network after psychiatry put me in the poor house. So the last thing I need is to fear speaking the truth and being put in an even worse situation.

        So…I need more advice and perhaps a pep-talk if I’m going to go through with this and take one for “the team.” Thanks.

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  11. The bio psycho social model was developed in Rochester New York by George Engel in the 1960s. It is a perfectly valid way of understanding the forces that lead to mental illness. There is also no doubt that some medications have been extraordinarily useful in these disorders, and others less so. It is also true that much severe and incapacitating mental illness usually has a genetic root.

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  12. Kim Masters,
    What the…. ?
    “It is also true that much severe and incapacitating mental illness usually has a genetic root.”
    You forgot to reference the science for that big, absolute, really important, science-y sounding ‘truth’.

    During my experience in the psychiatric industry with a “severe” diagnosis (BD-SMI) accompanied by “incapacitating” drug prescribing….”usually” was a common-as-dirt ‘tell’ for a dangerous Bu11shiffer with a prescription pad…..
    as in….”‘Usually’ this drug for your “severe and incapacitating mental illness” doesn’t create the problems you’re reporting”…as I point to the “usual, severe and incapacitating” side effects listed on “much” of the prescription hand-out…and the side of “much” of the packaging.

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  13. I appreciate the inclusion of my question here.

    It’s interesting that “capitalism” was brought up as a possible “problem.”

    I know a lot of people like to blame human greed, selfishness and evil intentions on “capitalism.” However, there are many health care systems (such as most of Kaiser) that are non-profits, and society could push all health care out of the for-profit model if it wanted to. But I think “capitalism” is an easy scapegoat for the petty foibles of human beings. On the Right, people with perfectly good intentions blame Socialism or Communism for essentially the same problems that Capitalism is blamed for by the Left.

    The fact is, that human activity MUST involve profit. If it did not, we could not care for our children, our sick and our old people. Though capitalism normally includes professional “capitalists” who earn all their money by investing relatively large sums that they control into various profit-making ventures, that is not a totally necessary part of capitalism. Many working people who have savings, investments, or IRAs are also being “capitalists.”

    I think the much more important measure is how much agency a society leaves in the hands of the individual and smaller communities of people, and whether society incentivizes a local approach to social problem-solving as opposed to a centralized approach.

    Beyond that, there is an awakening appreciation for a wider spectrum of healers both in the field of body health and in the field of mental health. These people should be allowed into the system to compete for patients on a more equal basis with medical doctors. This means breaking the choke hold that MDs have on the health care system in America. This is a significant challenge; those guys wield a lot of power, and they are considered, today, the highest-paid profession. I consider the stranglehold of organized Medicine on human life in the West to be one of our major political or social problems.

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