Monday, December 5, 2022


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).

Inpatient Hospitalization: An Inside Perspective

When someone is in severe crisis due to feeling emotionally overwhelmed, one of the main access points for care is an inpatient hospital setting.  Though many disparage the hospital setting, there are few alternatives to this setting during an acute mental and emotional crisis. At the same time, there are a number of barriers to individuals getting optimal care. I will try to examine some of these barriers and some of the main critiques of hospitalization. In a perfect world, those experiencing severe emotional crisis would be able to find true sanctuary; a place for rest and healing. With enough time, nourishment and self-care, people experiencing severe emotional distress can and do get better.

Playing the Odds, Revisited

It is hard to believe that a year has gone past since I posted Playing the Odds: Antidepressant Withdrawal and the Problem of Informed Consent. The feedback I received underscored the more controversial aspects of SSRI toxicity.  Common themes concerned the abrupt onset of new symptoms 3 to 12 months after stopping the drug, reinstatement of the drug failing to help withdrawal related symptoms, the possibility that withdrawal-related symptoms can persist indefinitely and concerns about using benzodiazepines to help with tardive akathisia.

Integrative Mental Health: 27 Non-drug Options that Work

Four years ago I dove into a deep and murky pond: the bottomless depths of medical databases that hold mental health research. After examining over 4000 studies, and hundreds of meta-analyses, I surfaced from my research and was hit with a startling “Aha” moment: non-drug approaches really work.

Convention on the Rights of Persons with Disabilities: Breaking the Silence

It’s time to speak about what is happening with the Convention on the Rights of Persons with Disabilities in the United States. I have been...
resisting illegitimate authority

Psychiatric Marginalization of Anti-Authoritarians – Excerpt from New Book

Anti-authoritarians are a threat to authoritarians because they don’t provide unquestioning obedience, but instead first assess the legitimacy of authorities. Consequently, authoritarians have attempted to shun, punish and psychopathologize anti-authoritarians throughout history.

It’s About the Trauma: How to Truly Address the Roots of Violence and Suffering...

Representative Tim Murphy is a psychologist who proposes unsatisfactory solutions to our most pressing social problems. In a "shockingly regressive" piece of legislation known as the “Helping Families in Mental Health Crisis Act of 2013” (H.R. 3717), he proposes to expand the highly controversial practice of Involuntary Outpatient Committment (IOC) for persons with serious mental illnesses. But that approach is not the answer, as documented in a fact sheet authored by the National Coalition for Mental Health Recovery:
Mad in America MIA

MIA at Eight Years: Are We Fulfilling Our Mission?

Mad in America is about to turn eight years old, and as we are launching a fundraising effort to keep us going through 2020, I think it’s appropriate to ask the relevant question: Are we accomplishing what we set out to do?
A mother takes her young son to an imposing psychiatric hospital

You’ve Got to Be Crazy to Go to a Psychiatrist

To those who say that major scientific/medical advances since 1975 have made going to a biological psychiatrist a rational choice, I say: What advances? 45 years have passed: Is any psychiatric “diagnosis” now verified by lab test, x-ray, or physical exam finding?
An older woman holds an hourglass

Peer Support Research: Is It Time Yet?

Researchers could be doing a better job of defining peer support. We could also have a better understanding of what the “positive effects'' of peer support really are.

One Year of Mad In America


In January 2012, Mad In America went live with a handful of bloggers and the mission to become a central community in the effort to rethink and transform the paradigm of psychiatric care.

I want to offer some thoughts and figures about where we've been in the past year and what we are growing into.

Then I want to ask you for money.
crazy letters

Waiting for Gravity

Of course one wishes for an easy answer, but the things that conspire to drive a person over the edge are too numerous and varied ever to point and say, it was this one; one can never really be so certain. No one can say it wasn’t that one, or that it wasn’t really all of those together, or that, when it came my own turn for “insanity,” I wasn’t standing halfway over the edge already, waiting for gravity to kick in and for me to fall.
drug dealers

Warning to Parents: Psychiatry is How Kids Get High and Die in the USA

Street drug dealers and stimulant-peddling doctors both get clients high and addicted for profit. So there is really no difference between what they do except that doctors are more ‘successful’ at it, since they enjoy many advantages over illicit dealers and can get away with doing it legally.
abolish psychiatric slavery involuntary commitment

End Kendra’s Law Now: Racist, Classist Practices in Involuntary Psychiatry Persist

In addition to involuntary outpatient commitment being an assault on and targeting people who are living in or near poverty, the statistics demonstrate racial disparities in the application of involuntary outpatient commitment.

Letters from the Front Lines

Bob-- I want to share with you a success story that has played out over the last three months. I have been working with a woman...

Announcing the Mad in America Continuing Education Project

The Mad in America Continuing Education Project is preparing for takeoff after months of planning. The project will provide on-line classes on the full range of psychiatric medications, and the ways in which they affect the neurology, physiology and outcomes for people taking them. The overarching goal is to change the standard of practice so that it becomes consistent with well-designed research.
recovery porn story

Recovery Porn: Tell Me Your Story, I’ll Tell You Your Value

There is little denying the power of story… until our own stories get taken from us, positioned against us, and used to determine our value as some sort of human commodity. We deserve to have our stories heard and to hear the stories of others, but on our own terms, without being fetishized or controlled, and without competition for paltry awards and recognition.

Tearing Apart the DSM-5 in Social Work Class

I'm currently a student at the Silberman School of Social Work. This was the final paper for "Human Behavior 3." HB3 is a required class which is basically a crash course in understanding and using the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders). In Human Behavior 1 and 2 they cover all kinds of ideas from psychodynamics to systems theory, and have the students practice writing biopsychosocial evaluations. I'm not sure what it looked like in the past but in recent years HB3 has become a DSM memorization class, so much so that we did most of the 5 week class online with modules that looked like the image I'm posting below. I don't know what other people's papers looked like, but here is what I turned in to my professor last week.

ADHD: More of It, Better Diagnosis, or Both?

Psychiatry, at large, is coming under correction after decades of collusion with industry and media. Yes, those “healers of the soul” (can you believe that’s what the original meaning of psychiatrist actually derives from?) have to begin to take responsibility for their part in overdiagnosis and overtreatment of vast swaths of the population. What has been less explored is the collusive role of the media in generating public beliefs about mental illness and its best treatment.

Is there Any Value In Psychiatric Diagnosis?

The medical model of diagnosis has become a dominant idea in the field of mental health, but it hasn't always been this way. As...

Schizophrenia Becomes Psychosis Susceptibility Syndrome

Anoiksis (the Dutch association of and for people with a psychotic vulnerability) has introduced a new name for the disease schizophrenia: Psychosis Susceptibility Syndrome (PSS). Together with the old name, its attached prejudices, misleading significance and stigma can be thrown overboard.

How to Escape Psychiatry as a Teen: Interview with a Survivor

When I lived in Massachusetts I taught yoga and led writing groups for alternative mental health communities. While the organizations I worked for were alternative, many of the students and participants were heavily drugged with psychiatric pharmaceuticals. There was one skinny teenager I'd never have forgotten who listed the drugs he was on for me once in the yoga room after class: a long list of stimulants, neuroleptics, moods stabilizers; far too many drugs and classes of drugs to remember. I was at the housewarming party of an old friend, and who should walk in but that boy who used to come to my yoga classes and writing groups religiously. And he was no longer a boy; he was now a young man. “I'm thinking yoga teacher,” he said. I nodded. Did he remember where? “I'm not stupid,” he said, as if reading my mind. “I'm not on drugs anymore. I'm not stupid anymore.”

Rx Resilience: Cultivating the Ability to Bounce Back

In many respects, resilience is the most important sign of health. This is true in physical health, and even more so in mental health. Resilience is what I spend my working hours trying to help others achieve. Resilience is what I have spent my own life discovering, harnessing, and finally thriving with. Quite simply stated, resilience is the ability to bounce back or recover from the trials and tribulations that living as a human being inevitably comes with.

The Case of the Missing Schizophrenia

This past Thursday I attended the American Psychiatric Association's Institute for Psychiatric Services in San Francisco, and then a talk by the Bay Area Mandala Project on "Providing Loving Receptivity Can Help People in Extreme States." I would like to thank both groups for the motivation to publish this — particularly as they would seem to be at odds in the reductionist "dialogue" we so often have — but really aren't so different in my mind for reasons discussed herein: Who is not "in crisis" for questioning their identity and fit within dominant paradigms?

I Got a Break from Reality for Christmas!

The more we worry about the separation from reality, the more scared we get and the more separated we get. This month I found out about another trap. When you can see the beauty and spirituality and mystery and magic of what is going on, it's tempting to do things to make it last longer and help yourself get further into it, like skip sleep or skip meals or use drugs. I had to fight those temptations often through this month, and still am, to be honest, because there is so much of this process that was not just scary, but glorious and giganticly interdimensional and impactful.

Finding Meaning in Suffering: How Existentialism Can Help

Suffering is a universal human condition. But without making meaning of suffering, it can overwhelm us. Finding meaning in suffering might help to find the will to survive when life is difficult.

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