Wednesday, April 8, 2020

Blogs

Essays by a diverse group of writers, in the United States and abroad, engaged in rethinking psychiatry. (The directory of personal stories can be found here, and initiatives here).

discrimination

The Psychiatric Narrative & The Boston Globe: Violence, Force, & Derogatory Labels  

The Boston Globe recently published an atrocious opinion piece, “Massachusetts law meant to protect people with mental illness may make them sicker.” Though framed as an attempt to shed light on a need for better mental health laws, the piece insults those of us of who have been labeled with mental health diagnoses.

Me, My Brain, and Baked Beans

I’ve spent much of my professional life studying psychological aspects of mental health problems. Inevitably, this has also meant discussing the role of biology. That’s my academic day-job. But it’s not just academic for me. I’m probably not untypical of most people reading this; I can see clear examples of how my experiences may have affected my own mental health, but I can also see reasons to suspect biological, heritable, traits. As in all aspects of human behaviour, both nature and nurture are involved and they have been intimately entwined in a complex interactive dance throughout my childhood and adult life.

Haloperidol is Neurotoxic

This is the headline of an editorial in the most recent edition of Current Psychiatry. It is written by a prominent psychiatric researcher. Read more on why I am not so comfortable with his suggested solution.
schizophrenia

Reexamining Schizophrenia as a Brain Disease

Schizophrenia has occupied, and continues to occupy, a position of great import in psychiatry, and it is frequently used to assert the supposed biological nature of the field. What evidence is there to suggest that what we call schizophrenia is a disease of the brain? Surprisingly, very little.

On a Paradox Revealed: Discontinuing Neuroleptics

In Anatomy of an Epidemic, Robert Whitaker posits that long-term exposure to neuroleptics does more harm than good. I will discuss how I have wrestled with this in my practice.

Mental Illness, Right & Wrong, Drugs, and Violence

The recent incident in the grounds of Washington Capitol, involving a young educated woman, brought shock to many people. It was another opportunity to blame a victim of mental illness and demand further restraint and medical attention for such individuals. Yes, we are lacking dignified, caring, discerning and attentive treatment for those whose spirits are broken. But we certainly don’t suffer from a lack of medical treatment for such individuals. It is time for policy-holders, and our scientific community to ask the 'heretical' question; “Could the drugs be the culprit behind the violence?”

The Winding Road and the Importance of Going Sideways

The winding path is very often the only path that a human being can follow. It has to become an acceptable path. We have to stop pushing young kids because WE want them to be somewhere without regard to what they are ready for.

What Would CRPD-Compliant Mental Health Legislation Look Like?

Let’s be clear – I prefer to have no mental health legislation at all. The history and legacy of mental health legislation is anti-human rights, discriminatory, segregative, othering of people whose experiences of distress and states of consciousness are disapproved of by those who are able to fit more easily into social norms. Often too, “mental health legislation” is synonymous with “mental health acts” that are concerned with regulating involuntary commitment and compulsory treatment. It is with this in mind that I promoted the goal of “repealing mental health laws” and started the Campaign to Repeal Mental Health Laws.

On Religious and Psychiatric Atheism: The Success of Epicurus, the Failure of Thomas Szasz

When the American psychiatrist Thomas Szasz killed himself a year and a half ago at the age of 92, I thought there would be a global outpouring in psychiatric circles of sympathy or scorn. Instead, his death was largely met with silence, a silence as deafening as the one that attended the second half of his long, prolific, and polemical career. Szasz’ name didn’t show up at all in the APA program last year, and this presentation of mine is apparently the only one to mention him this year. This silent treatment has, ironically enough, and surely against his will, forced him to fulfill the ancient Epicurean ambition to live and die unnoticed.

Suicide Tsunami

Losing someone you love to suicide can be a devastating experience. A legacy of torment is created where stigma, shame and secrecy reside. These are echoes of a world that does not know how to respond to what is now termed an epidemic. The baton of collective discomfort is passed from someone who has completed suicide to those intimately involved, making grieving suicide a lonely sentence of social disapproval. I know. This happened to me.

My 6-year Anniversary off Psych Drugs: How I Made it Through the Darkest Times

Last week was my anniversary off a huge psych drug cocktail I’d been on for 20 years. In this video I speak to the inner resources that kept me going. The fact is there is nothing in society to help those who love us to understand what we are going through.

Flibanserin: The Female Viagra is a Failed Me-too Antidepressant

Since a Food and Drug Administration (FDA) advisory committee, on June 4, recommended approval of flibanserin (AddyiTM) in June, there have been numerous editorials and news stories about the controversies surrounding the first “pink Viagra” to hit the market. We have sought to understand the process and financial incentives that led the advisory committee to recommend its approval, with Sprout Pharmaceuticals prepared to market it as a treatment for a new disorder in DSM 5: Female sexual interest/arousal disorder.

Why Mainstream Psychiatry Fears a Balanced Understanding of Psychosis

Many people are now familiar with the BPS report, Understanding Psychosis and Schizophrenia, and they have appreciated how it integrates both science and a humanistic understanding to convey a fresh and progressive approach to difficult and extreme experiences. But it has come under attack by psychiatrists, using arguments that are often quite slick, and sound reasonable to the uninformed. But they are wrong, and the better we can articulate how and why they are wrong, the better we can advocate for a more humane and skillful response to people having the experiences that are called “psychosis.”
Mind Fixers by Anne Harrington cropped

An “Even-Handed” History of Psychiatry as Damning as the “Polemics”?

Where Professor Harrington's book seems to differ from books that others might call polemics is that she does not attribute nefarious motives to the psychiatric establishment. I worry that she underplays the ways in which the current model causes harm, but I support her suggestion for a retraction of psychiatry's scope.
Split

Spoiling Split: Hollywood’s Latest Run at ‘Alternative Facts’ 

Will ‘Split’ lead directly to someone dying or being beaten up? No, probably not. But, is it a pretty outrageous piece of evidence illustrating cultural trends that regularly represent people with psychiatric diagnoses as frightening and volatile? Absolutely.
human rights

Joint Statement on COVID-19 and Persons with Psychosocial Disabilities

During this global pandemic, organizations have come together to issue a joint statement making recommendations to governments on how to respect and ensure the human rights of people with psychosocial disabilities, who are among the groups more vulnerable to human rights violations as well as infection with and severity of the illness.
Mickey Nardo (photo by Abby Nardo)

Farewell Mickey Nardo, 1 (not very) Boring Old Man

Mickey studied how the intimacy between leading academic psychiatrists and the pharmaceutical companies had impacted our profession. His blog was a treasure trove of analysis and information. Mickey did some heavy lifting, and for that we are all indebted.

The Myth of Mental Illness Revisited, NIMH Style

When Thomas Szasz’s name comes up in debates over defining mental illness, it is fairly common to hear people say something along the lines of, “Well, he made some good points, but he was just too extreme.” Yet I am struck by how conversations about DSM-5, being released this month, make the crisp arguments Szasz consistently offered for 50 years just as timely as ever. I’d even go so far as to suggest that a large number of counselors, psychologists, social workers, and psychiatrists pretty much agree with the main tenets of Szasz’s argument, despite their ongoing disclaimers.

Coercion in Care

To this day I do not know how I found my way back. I think it might’ve had something to do with willpower, as I was NOT going to lose myself. I was NOT going to end up like those people who were living indefinitely in the hospital—those “chronic schizophrenics”, as they say. I was going to find my way back, back to myself.

eCPR: A Health Promotion Approach

eCPR is a public health education program designed to teach people to assist others through emotional crisis through three steps: C = connecting, P = emPowering, and R = revitalizing. eCPR recognizes that the experiences of trauma, emotional crisis, and emotional distress are universal; they can happen to anyone, at anytime, anywhere.

Trinkets and Lunches and Dollars for Docs Really Do Pay Off

Mad in America readers will not be astonished by the news that Big PhRMA showers physicians with “free” trinkets and samples and lunches and dinners and junkets and dollars. Such tactics are common throughout the world of commerce, where they are described by terms ranging from “promotion” to “commercial bribery.” But do bribe-like actions ensnare physicians?

Persecution: Dangerous Liaisons

If you participate in a clinical trial, the new industry "consent" forms mean you put your children and your wider family and community in a state of legal jeopardy. Because they can hide the data of your experience in the trial, even if you have been significantly injured by the treatment, companies can declare there were no side effects and your invalidated experience can then be used to deny justice to someone who is injured in exactly the same way you have been.

Psychiatry & Suicide Prevention: A 30-year Failed Experiment

It takes courage and integrity to make changes to your beliefs and approach. In 2008 Professor Roger Mulder, head of psychiatry at Otago University, published research in which he concluded “Antidepressant treatment is associated with a rapid and significant reduction in suicidal behaviours. The rate of emergent suicidal behaviour was low and the risk/benefit ratio for antidepressants appears to favour their use.” In Dr. Mulder's conference presentations last week, he stated that the medical/psychiatric paradigm that has dominated approaches to suicide since WWII has largely failed to influence suicide rates. In Dr. Mulder’s view “New approaches are required – possibly public health, sociological, community or combinations in addition to, or instead of, medical approaches.”

How Can We Spread the News?

Ever since I read Mad in America and later Anatomy of an Epidemic by Robert Whitaker, I have been wondering how to spread this knowledge to the masses and how to do this in a way that will make a difference to as many people as possible.

The Drug-Free Solution to Ending Depression

First, let me tell you that I was once a typical doctor, not to mention a typical American who loved pizza, soda, birth control, and ibuprofen. I believed in the science that I was taught to believe in. I felt that medication was the answer. And that symptoms were problems that needed to be fixed, suppressed, eradicated. That every patient was just one chemical prescription away from functioning “normally.” It wasn’t until my fellowship specialized in medicating pregnant and breastfeeding women, at a time when I was also pregnant, that I began to feel into a voice inside me that said, “I’m writing prescriptions that no amount of reported ‘safety data’ could convince me to take."

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