Blogs

I know that this might sound odd coming from a critical psychiatrist, but I believe that psychiatry has a future. Furthermore, I maintain that a good deal of psychiatry as practised now is helpful and that many psychiatrists manage to play a positive and therapeutic role in the lives of their patients. However, I also believe that we are at our most helpful when we depart from the current biomedical ideology that has come to dominate in our profession. As a first step, we need to get beyond the reductionism that currently guides most psychiatric research and education.

It seems I like to see people argue, or, if not to see it to read it, to be privy to it. I get off on argument; I grew up with it. I also avoid it at all costs. Yet, there is something about abuse, meanness and violent language that has always drawn me in. It could be simply because it’s familiar to me, like to many of us; it is so prevalent.

I was honored to present a lecture to the Department of Psychiatry of which Dr. Thomas Szasz was a member. The department has been hosting a celebration of his prolific career. I spoke of David Rosenhan's 1973 "experiment," in which he pretended to hear voices in order to gain admission to psychiatric hospitals. I argue that a 2000-year old stage comedy anticipates Rosenhan's experiment in virtually identical form, but it goes beyond the problems of diagnosis and approaches Szasz's view that mental illness is not a medical matter.

I became an apprentice spiritual healer among the Nacirema-Orue in 1986 and was considered culturally competent to assess and treat community members by 1992. Then, the wealthy class turned toward producing and marketing complex and dangerous elixirs and synthetic herbs which tranquilize, sedate, or hypnotize the afflicted community member rather than working with self-hatred and self-revulsion. This new Nacirema-Orue healing theory presupposes that such individuals actually have damaged brains which these elixirs correct. I’m writing this blog post because I’m afraid of being made invisible.

A recent report from the Bazelon Center for Mental Health Law on "Promoting Employment of People with Mental Illness" provided the same dreary picture that those of us working in mental health systems are familiar with: that people labeled with mental disorders are employed at a much lower rate than their non-disabled peers. The report calls for broader implementation of the evidence-based practice Supported Employment, which is scarcely available to any individuals across the nation served by public mental health systems which favor funding of other behavioral health services.

There are some things to applaud about the recently released update of the NICE bipolar guidelines, not least the recognition that the diagnosis has been inappropriately applied to children with behavioural problems. Hopefully this will help curtail the worrying trend of using toxic bipolar drugs in this age group. As usual, however, the Guidelines overlook glaring problems with the evidence base for drug treatment in general, and miss an opportunity to stem the diagnostic creep that has come to the UK and Europe via the United States.

With less than three weeks to go before the start of Alternatives 2014, I feel inspired to write about why the Alternatives conference is important to the c/s/x movement for social justice and why we at the National Mental Health Consumers’ Self-Help Clearinghouse feel honored to organize this year’s conference.

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.

In a couple of weeks, I may see some of you at the MIA Film Festival. I am honored to be on a panel called “Re-Thinking Psychiatry” with two esteemed colleagues. In advance of the festival, I decided to write about what has been most central in my own “re-thinking”: my basic understanding of psychosis - when a person does not share consensual reality. It has been a fundamental re-think: how do we define it? how do we understand it? when do we intervene? how do we intervene?

When searching for answers related to mental health, at times it can feel as if one is looking for a door in a brick wall. The task can become even more difficult when a family or individual embraces a diagnosis that seems to define one’s identity permanently.

To those who are still suffering, it gets better. Indeed, I do not consider myself ill anymore. I consider myself HEALING, which is a vibrant state of movement and change. My limitations do not mean that I am sick. Learning to make boundaries for my well-being has been one of the healthiest things I’ve learned to do. Deeply respecting the needs of this body/temple is one of the most wonderful achievements of WELLNESS.

Everyone and every group working for mental health justice ought to make fighting global warming a priority right now. Of course, the whole disability movement, and in fact all sentient beings should be concerned about climate crisis, but those of us working for human rights and more choices for mental wellness have special reasons to make this planetary catastrophe a unifying theme for all of us.

Racism refers to prejudice or discrimination against another person, or group, based solely on race or skin color.  But medical journals that insist on independent statistical analyses of pharma-conducted research are basing this policy decision on the fact that, in a compellingly large proportion of cases in the past, the statistical analyses of pharma-funded research was flawed.  And, by an extraordinary coincidence, was always flawed in a direction favorable to the company.

One of the suggestions in the comments from my last post has really got my imagination going. Chaya Grossberg suggested that we can all edit Wikipedia entries. I went in and got surprised at how easy this was. Then I checked the hit rates on Wikipedia to see how big an impact this could have, and I was totally amazed.

I worked as an IHS psychologist from 2000 to 2004 and personally witnessed disturbing practices all around me at that time. I’ll likely hark back to encounters with those IHS dysfunctions from time to time on this blog, but I want to make an important point right away with respect to understanding at least some of them: Follow the money.

John Foppes had been born with no arms, among a number of other serious congenital abnormalities.  Doctors questioned whether he would survive at all.  In his deeply motivating book, “What’s Your Excuse?  Making the Most Out of What You Have,” John describes his life of growing up with no arms into one of full independence, and his feelings of stigmatization and isolation even in the midst of support from others.  In the depths of his struggle, John also notes evident gratitude in what most perceived as a very unfair situation. 

Doctors in the 1950s and 1960s made psychiatric diagnoses on orphaned children that led to treatment with antipsychotic drugs, and one of the drivers of this seemed to be that the Church got more money from the State as a result. The doctors, of course, also got paid. This feels like a seriously corrupt nexus operating with near impunity on the basis that no one is going to be bothered to investigate the fate of some orphans.

A few weeks ago I saw for the first time the powerful movie “12 Years A Slave,” based on the memoir by Solomon Northup, a free black man in the 1840’s who was kidnapped and sold into slavery. It is a hard film to experience. But as I watched the scenes of unending brutality and humiliation, somehow I felt calm and almost comforted. I identified with the men and women who were treated as animals and property, to be abused and tortured just as I was as a child. But I knew that eventually the atrocity in the movie ended, and slavery was abolished.

If human beings were meant to be entirely stable entities, then “stabilizing” them would be an entirely good thing; a target for mental health treatment that all could agree on. But it’s way more complex than that: healthy humans are constantly moving and changing. They have a complex mix of stability and instability that is hard to pin down. All this relates to one of my favorite subjects, the intersection of creativity and madness.

Recently I wrote an article on MIA entitled Trauma, Psychosis, and Dissociation. Several people responded privately with some very thought-provoking questions that I would like to explore and possibly answer to some extent here. Dedicated readers of the MIA website are all too familiar with the myriad problems that exist with diagnoses in general, the stereotypical (and often untrue) assumptions associated with these various categories, and their lack of scientific validity or reliability. First, though, I want to state that my area of experience and research is with trauma, psychosis, and dissociation . . .

There is this enormous reluctance among psychiatrists, even those who clearly have begun to see the light, to take a clear, unambiguous stand against harmful interventions. So often, they settle for the old face-saving caveat – "use caution." But how can one use caution in prescribing a drug for an age group in which it has been shown to lack effectiveness and has a very high incidence of serious adverse effects? Surely the cautious approach would be not to use these drugs at all, especially since it's virtually impossible to predict which individuals will suffer adverse outcomes, including death.

An Imaginary Conversation Between a World Health Organization Mental Health Provider and an Indigenous Scientist

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.

Anne Hull and Dana Priest, of the Washington Post, received a Pulitzer prize for breaking the story of the horrid conditions at Walter Reed Army Medical Center where men were “afloat on a river of painkillers and antipsychotic drugs” Each morning, they were expected to rise at dawn for formation, though most of them were snowed under by benzodiazepines, opiates, alcohol – anything that would push Iraq and the pain away. A year later I too would be snowed under and would fight an invisible war of my own. It wasn’t until months later, deep in withdrawal tolerance that I realized my slide into disability was caused by the drugs.

On June 13, 2014, United States District Court Judge Carol E. Jackson issued a Memorandum and Order decision holding that a former psychiatric inmate was allowed to bring federal civil rights claims under 42 U.S.C. §1983 against hospital personnel when the hospital continued to hold her against her will after authorization had expired. In her Memorandum and Order decision, Judge Jackson took Ms. Pierce's rights seriously and, reading through it, one gets a sense that the court was offended by the cavalier attitude of hospital personnel towards their patients' rights. It is clear that if the Court's ruling is upheld, it can result in dramatic improvement in the way people are treated in Missouri psychiatric hospitals.