Sunday, November 29, 2020


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).

William James’s Letter to His Depressed Daughter

If you discover that your child has been experiencing a bout with depression, what wise words might you share? Brilliant psychologist William James was forced to address this issue himself when his 13-year-old daughter, Peg, began to struggle with melancholy. I present his long, thoughtful reply for your consideration.

Conflict of Interest, DSM-5, and the APA

The point of this post is to bring your attention to the writings of some fellow bloggers, particularly 1 Boring Old Man (1BOM). For the past 6 months , but particularly in the past month, he has brought attention to a conflict of interest with David Kupfer, the head of the APA's DSM-5 task force.

Creatively Managing Voice-Hearing Through Spiritual Writing

I am a psychiatric survivor of over thirty-six years. Since my nervous breakdown in 1978, I have undergone multitudinous experiences ranging from the subtly humiliating to the horrifically debilitating at the hands of incompetent psychiatrists and psychopharmacologists who, in the name of medicine, did more harm than good.

Recovery – From Personal Reform to Social Change

From Mad in Sweden. One of the most important contributions made by research on recovery, is understanding people diagnosed with “severe mental health problems”, as not merely victims of an illness, but as agents in their own lives.

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.

The Shameful Story that Runs and Runs: A Review of The Bitterest Pills

If the blimp that is psychiatric treatment were a passenger aircraft, the authorities would have grounded it many years ago, but still it continues to inflict harm on countless thousands of people. I read Joanna Moncrieff's latest book with a growing sense of anger and shame. The roots of drug treatment in psychiatry are thoroughly rotten. They sustain the decaying trunk of psychiatric theory and practice through misrepresentations and untruths; it is snake oil peddled by quackery.

Reflections on a Pathologized Adolescence and a Vision for the Future

My heart envisions a future of grassroots community-based, free, accessible, welcoming, non-judgmental and safe spaces for young people in the middle of the hurricane of adolescence....They will be spaces facilitated by those of us who’ve reclaimed what it means to be human.

Landmark Victory against the “Oak Ridge Torturers” — Do We Cheer or Cry?

With reports of the horrid abuse at Oak Ridge surfacing frequently over the years, how could this travesty have continued unabated for so long? What is wrong with the “therapeutic” community that what happened here was hailed as a major advance?

Biology and Genetics are Irrelevant Once True Causes are Recognized

The psychiatric genetics literature contains few references to specific environmental factors that cause psychiatric disorders, and while researchers acknowledge a role for these factors, they usually claim that environmental causes are mysterious or unknown. As a leading group of psychiatric genetic researchers recently put it, while claiming that schizophrenia “has a substantial genetic contribution,” the “underlying causes and pathogenesis of the disorder remains unknown.” But research suggests otherwise.

Anti-Authoritarians and Schizophrenia: Do Rebels Who Defy Treatment Do Better?

Preface: Failing in my efforts to get this article published for the general public, apparently only here can I talk about a “cool subculture...


The movement to radically reform the modern mental health system is rooted in a desire to offer people going through emotional distress a wider variety of options for care. As a society we have largely shifted to a model of care that is limited to a select few options that primarily advocates the use of strong psychotropic drugs and simplistic diagnostic labels for complex and widely varying narratives. The stigma of going on an antidepressant has been lessened to such a degree that one out of nine people in the US now takes this class of drug. In the context of this astronomical growth in drug-based therapy, reformers are rightly calling for a dramatic reappraisal of how we are treating emotional distress.

Too Much Pies

On March 18th, Ronald Pies, a psychiatrist based in Lexington, Massachusetts, wrote a letter to the New York Times. He argued in favor of the usefulness and harmlessness (when well used) of psychiatric diagnosis and wondered as to the misgivings so many seem to have. The Times invited its readership to participate in a dialogue by submitting responses to Pies’s piece. Laura Delano, Paula Caplan and I were among the relative few who managed to get our voices heard. Pies had the last word, though: He gave just two short sentences to my dispatchment, and summarily disregarded so many years of pain and loss and abuse of power.

December 22, 2010

Bob-- Many cases I have shared with you have been interactions with patients who are seeking a healthier way of dealing with mood disorders, or...

ISEPP Calling for Organizations to Join in Petition

Using an invalid diagnostic tool flies in the face of professional ethical guidelines. The International Society for Ethical Psychology & Psychiatry has drafted an open letter to the APA and other professional organizations, publicizing concerns with the DSM's lack of validity and asking for ethical guidance. ISEPP is soliciting other groups to join us in this effort.

How Much Does it Matter for Patients to Believe They Will Get Well?

Thanks to the work of Dr. Irving Kirsch, we now know that the majority of the effect of antidepressants is attributable to the "active placebo effect" or the belief that receiving a memified brain-chemical-corrector will actually help alleviate symptoms. As I discuss in this post, evaluation of published and unpublished data, in two metanalysis, demonstrated a non-clinically significant difference between placebo and antidepressants. A fascinating new study entitled The Role of Patient Expectancy in Placebo and Nocebo Effects in Antidepressant Trials further explores the power of belief in psychiatric treatment.

Starting the New Year with a Bang: A Medley of Antipsychiatry Resolutions

Every year at this time, from Canada to Ireland, from Turkey to South Africa, both determined and not-so-determined folk make a very unusual list, known traditionally as New Year's resolutions. What follows are antipsychiatry resolutions—ones that people may borrow from at will.

January 31, 2011

Bob-- Today, I saw an intelligent and sarcastic teenage boy for renewal of his Adderall. He presented with his well-meaning but frustrated father, who is...

January 17, 2011

Bob-- About a month ago, I started caring for a fifty-five year old Filipino woman. She speaks English well, though with a heavy accent. She...

Turning Distress Into Joy, Part I:  Forgiveness

The human condition is both incredibly unique and yet so much the same. Our experiences are as vast as the oceans and as similar as the atoms that comprise them. Our calls range from the most secluded of hermits to the most exposed of world leaders. But we are all faced with betrayal and disappointment. We are all faced with each other.

A Harm Reduction Approach to the Mental Health System

There are an ever-increasing number of professionals and lay people who advocate for reforms within the mental health system. Even the staunchest of biological psychiatrists agree that changes must be made. When I first decided to pursue clinical psychology as a career, I did so with the intention of trying to change the system for the better, or at least to offer a different experience to individuals in distress. Personally, I believe that peer-led alternatives and independent funding are the things that advocates should focus more heavily on, but that does not solve the problem of what to do to decrease the amount of harm that is being done on a daily basis in the present. In this sense, I believe that a “harm-reduction” approach to dealing with the current system is the best way to get what we can until something better exists.

The Meaningfulness of Anxiety

Anxiety can be a clarion call from our better self, a nagging inner tension that will persist until real-life changes are made that attend to deeper needs. When anxiety is reduced to a symptom to be medicated away, or an aberrant emotion based on cognitive distortions in need of correction, the all-important representational value of that anxiety can be lost.

Feral Psychiatry: More on the Garth Daniels Case

On Wednesday, May 18th, Daniels had what was probably his 102nd consecutive episode of ECT. As always, he told the staff that he did not want it and did not consent to it; as always, he got it. Later on the next afternoon, Garth left to join his family in Brisbane. None of us have a crystal ball but his position now seems much better than at any stage in the past. Let's look at some of the facts and opinions surrounding this case.

Why I Prescribe

This is about neuroleptics. It is about psychosis or madness or whatever term one prefers. It is about people 18 years and older. I take...

October 6, 2010

Bob-- Yet another challenging day. I had two more patients today whose trajectories would relate perfectly to Anatomy of an Epidemic. The first was an 61...

The Persecution of Heretics

Behind the apparent Biblical Authority of the Clinical Trial Literature in medicine lies an Inquisitional-like apparatus run by company PR agencies and agencies whose job it is to manage the perception of science - linking in academics - aimed at silencing dissent and ensuring that prescribing doctors continue to prescribe. It focusses most clearly on anyone who suggests that a brand-name drug might have significant adverse events.

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