Monday, March 1, 2021


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).

Anosognosia: How Conjecture Becomes Medical “Fact”

Readers on this site have wondered how the notion of a "chemical imbalance" could have been accepted by so many when the research did not actually support the concept. A recent paper from the Treatment Advocacy Center that summarizes studies of anosognosia in psychosis gives some clue as to how this type of thinking becomes entrenched and accepted.

ECT for Agitation and Aggression in Dementia

The International Journal of Geriatric Psychiatry published an article titled Safety and utility of acute electroconvulsive therapy for agitation and aggression in dementia,  which concludes "Electroconvulsive therapy may be a safe treatment option to reduce symptoms of agitation and aggression in patients with dementia whose behaviors are refractory to medication management." But the participants were not a random selection of people taking the drugs in question. Rather, they were individuals selected because of aggressive behavior, most of whom had been taking some or all of these drugs on admission. So it is a distinct possibility that the aggression was a drug effect for many, or even most, of the study participants.

Is Psychiatry the Tea Party of Medical Science?

When I as a European follow American politics I can’t help being amazed by the  - I believe a polite expression would be – colorful personalities in the Tea Party and how they manage to continue to be a powerful part of American politics despite making claims that as I see them reported are easily debunked. American politics does not affect me directly but when I compare psychiatry as a part of the medical science to the Tea Party there are some striking similarities.

What Will Cause Psychiatry to Change?

I've been on hiatus for a few months now, and I decided that an informal entry would be most fitting at this time. I have had one question on my mind lately: what would motivate Psychiatry to drastically change its mission and practices in a way that is most consistent with contemporary evidence and moral responsibility?

Troubled by Individual and Collective Psychosis? Maybe Compassion and Dialogue Could Help!

We need to learn to listen and respond in a caring way to the disturbed and disturbing voices within the population—to really engage with them, while also not believing any lies or distortions or letting destructive forces take over.

Psychiatry’s Troublesome History: How Far Have We Come?

Many mental health advocates promote ending a perceived stigma surrounding treatment. I wonder if a Mental Health Awareness Month campaign in 1940 would have led to greater humanization of mentally ill people, or if it would have just paved the way for more lobotomies?

Can Psychosis be Treated With Nutrition?

We are immersed these days in the erroneous idea that only randomized placebo-controlled studies (RCTs) constitute scientific data. We will discuss the origins of the over-reliance on RCTs in a future column. For now, we shall simply assume that many of our readers understand that a well-documented case study can provide information relevant to many. And so, we would like to tell you about a Calgary-based child who we refer to as ‘Andrew’.

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.

Start with a Solid Foundation

How are we going to do this?  That’s the question we asked ourselves when a few likeminded bureaucrats sat down and said, our current...

Drug Companies ‘Just Say No’ to Psych Drugs

The market for psychiatric drugs is, of course,  booming. In 2011, spending on psychiatric medications can expect to top $40 billion. Yet, in spite...

ADHD: A Destructive and Disempowering Label; Not an Illness

In recent years, we've seen an increasing number of articles and papers from psychiatrists in which they seem to be accepting at least some of the antipsychiatry criticisms, and appear interested in reforms. It is tempting to see this development as an indication of progress, but as in many aspects of life, things aren't always what they seem.

Limits to Medicine: Re-visiting Ivan Illich

We have come to believe that technology can eradicate all human suffering and provide unblemished and everlasting happiness. We have paid for this irrational expectation with our autonomy, our dignity and our ability to endure.

A Clashing of Worlds (and Perspectives) on the Problem of Suicide

The controversy with 13RW is essentially a clashing of worlds — the world of entertainment (and its predominant audience of teens) and the world of science and practice. Who’s to say those from each perspective cannot find common ground in the service of something with life and death consequences?

ADHD: A Destructive Psychiatric Hoax

Nobody is denying that inattention, hyperactivity, and impulsivity can be real problems. The issue at stake, however, is whether it makes any sense to conceptualize this loose cluster of vaguely-defined problems as an illness.

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.

How Come the Word “Antipsychiatry” is so Challenging?

So here we go again; another meeting with another young person who describes how he is in an acute crisis - you may call it - and is diagnosed and prescribed neuroleptics. He is told by the doctor that he suffers from a life-long illness and he will from now on be dependent on his “medication.” As long as people are met this way I see no alternative than showing that there are alternatives. If that means being "antipsychiatry," then I am more than happy to define myself and our work in that way.
hearing voices

Hearing Voices: Where We Locate Them Shapes Our Experience

My experience began when I heard two people talking about me when I was home alone. I needed a reasonable explanation, and concluded that it had to be my upstairs neighbors. Then I began to hear the voices outside of my apartment — this new presentation meant that my explanation no longer made sense.

Intentional Peer Support: Creating Relationships, Creating Change

IPS is about creating a power-balanced, relational context in which we can begin to explore and even challenge the stories we have been taught. We can name our experiences, and challenge the meaning that we have constructed around those experiences. This fundamentally alters what we think of as “help,” but also challenges social and political constructs of disability.

Psychiatry is Edging Dangerously Close to Eugenics

In psychiatry, there has always been a swing between the two poles of nature and nurture. Unfortunately, psychiatry is firmly back in the nature camp. Lip service is paid to the emotional environment and trauma. But that is as far as it goes. The accepted (and dangerous) belief is that psychiatry deals with brain diseases – inherited brain diseases. We are back to absolute genetic determinism.

Mad Pride and Spiritual Community: Thoughts on The Spiritual Gift of Madness

Let our Mad Pride movement be grounded in humility and kindness for each other in our diversity of life experiences, a recognition that social movements need good communicators and organizers more than charismatic leaders and messianic visions, and that the beautiful language we use to describe ourselves is only as powerful as the grounded actions we take to back up our words.

Financial Stress:  Auditing Our Money Woes

The American Psychological Association (APA) recently released its annual 2015 Stress in America survey.  For the 9th straight year (since the survey began), financial issues were reported as the number one stressor in America.  Even while many parts of the U.S. economy have shown a resurgence, many Americans are reporting that financial strain continues to take its toll, likely having significant effects on our health and well-being.

Black Hats, White Hats, and Financial Reckonings

It is clear now that the marketing of ayptical antipsychotics over the past 20 years was, in essence, a criminal enterprise, as the makers...

Study 329 in Japan

By 2002 GlaxoSmithKline had done 3 studies in children who were depressed and described all three to FDA as negative.  As an old post on Bob Fiddaman’s blog reproduced here outlines, several years later they undertook another study in children in Japan. (Editor's note: This is a re-print, by David Healy, of a post by Bob Fiddaman)
blurred psychotherapy

Blurring the Line Between “Us” and “Them”

Most, if not all, mental health providers, will face dealing with major ethical issues. In their quest to reach as many consumers as possible, to streamline the process, to be as efficient as possible during this pandemic, was the therapeutic process truly helpful? Were key components of what “should” happen between both parties still prioritized?

Madness Radio: Sharna Olfman on Medicating Children Diagnosed Bipolar

Professor Sharna Olfman has researched and written extensively about children in society, including education and sexuality, and her perspective on so-called bipolar disorder is...

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