Blogs

In spite of constantly increasing opportunities to tell different stories to the canonical story of bio-psychiatry, it can be risky for academics to voice a different perspective than the mainstream model of mental illness. In this conversation, a communication professor and a psychology professor discuss their challenges and personal experiences with going against the grain, such as what it means to be labeled “anti-psychiatry” by colleagues and responding to students upset to learn their medications may not be all they thought they were.

I find it to be a really difficult decision—some days more so than others—to do peer support in the traditional mental health system. I need to remind myself pretty often why I am doing this because it’s really, really hard! Here are the reasons I go to most often . . .

In the business of clinical trials, the most valuable commodities are the research subjects. Filling clinical trials is hard, and filling them quickly is even harder. That’s why in 2000 a clinical investigator told the HHS Office of the Inspector General that research sponsors were looking for three things from research sites: “No. 1—rapid enrollment. No. 2 — rapid enrollment. No. 3 — rapid enrollment.”

When we set out to restore GSK’s misreported Study 329 of paroxetine for adolescent depression under the RIAT initiative, we had no idea of the magnitude of the task we were undertaking. After almost a year, we were relieved to finally complete a draft and submit it to the BMJ, who had earlier indicated an interest in publishing our restoration. But that was the beginning of another year of peer review that we believed went beyond enhancing our paper and became rather an interrogation of our honesty and integrity. Frankly, we were offended that our work was subject to such checks when papers submitted by pharmaceutical companies with fraud convictions are not.

You may forget what people did for you, but you will never forget how they made you feel.

People with mental disorders or differences are often experienced as “hot stoves” in society — at work, at school, at home, in friendships. In addition, providers and consumers who embrace the medical model and those who don’t are often “hot stoves” for one another. The result of arguments for and against those and other divisive perspectives is interference with empathy, understanding, creative solutions, and forward movement as a mental health community.

The idea of schizophrenogenic or refrigerators mothers was an embarrassing era for psychiatry, and so psychiatrists were only too happy to explore the brain and the genome to unlock the secrets of mental illness. Today, the rhetoric has shifted away from intrapsychical conflicts and traumatic ruptures, and instead aberrant neurochemistry or delinquent genes are held as the source of mental illness. Regardless, the message is clear: mental illness is beyond our control and requires psychiatric intervention. The moral authority the mental health industry claims over our mental life rests on this claim.

I’m one of those maddass lone wolves who gets worse rather than better with conventional treatment. Don’t get me wrong. I really wanted it to work. Just to prove how hard I wanted it to work, I went to graduate school in mental health. I stayed longer than I needed to. I studied well beyond the masters degree that permitted me to practice. I took all the coursework for a doctorate, including 6 extra semesters of counselor supervision. I applied myself whole-heartedly. I engaged the literature and the latest science. I reflected deeply on my own emotions, biology, cognitions, family history. I worked to make sense of what was offered.

Here’s a newsflash – the hope for a molecular-biochemical explanation for psychiatry is a false hope. Most of my field has come to expect and believe that we are on the verge of a new paradigm. This paradigm is based on the illusion that the workings of the brain on the molecular level has anything to do with psychiatric conditions. The proponents believe we are on the verge of proving that psychiatry is a brain disease no different from cancer or diabetes. But all that the research has come up with is - nothing.

The new Social Security Act, an Obamacare-inspired, Open Payments report came out September 30th. As part of the new healthcare reform policy, this federal report requires pharmaceutical and medical device companies to annually share documentation of direct payments they provided to entities such as medical practices and teaching hospitals. But before anyone gets excited and thinks there is finally a reliable and valid monitoring method to document that such payments are minimal as well as on the up and up, please note that 40% of the payment records (considered for inclusion in the 2013 Open Payments report) were not included in the $3.5 billion due to “unresolved questions” being cited.

We can see how complicated it is to be human and how much human suffering (called psychopathology) is a complex and unique human phenomena.

Last year I visited the United States on a Winston Churchill Travelling Fellowship to explore ‘alternative routes to mental health recovery’ and to visit a range of peer-led, alternatives to the medical model, with the aim of using the knowledge gained to help develop alternatives in the UK. Looking back, all the organisations and services I visited came about because groups of people in the US decided they wanted something different to conventional mental health services, and then decided to work to make that dream a reality.

On August 15, 2014, McGill-Queens University Press published Psychiatry Disrupted: Theorizing Resistance and Crafting the (R)evolution.  The work is a collection of papers by various authors, edited by Bonnie Burstow, Brenda A. LeFrançois, and Shaindl Diamond.  There is a Foreword by Paula Caplan, and a Preface by Kate Millett. It is no secret that there is growing opposition to psychiatry.  No longer marginalized and ignored, as in former decades, anti-psychiatry writers are proclaiming psychiatry's spurious and destructive nature in a wide range of venues.  Even the mainstream media is taking tentative steps in our direction.

I have lost interest in making sense. Insofar as anti-stigma entails a reassertion of my apparently forgotten humanity via the retelling of some personal narrative in which I generalize my unique experiences toward some universal wisdom, I have lost interest in the reduction of stigma. I would much prefer it if you didn’t need me to be comprehensible.

Various instruments of the United Nations have commented on forced treatment, or involuntary confinement, or both (for details, see Burstow, 2015a), and a number of truly critical additions to international law have materialized. Arguably, the most significant of these is the Convention on the Rights of Persons with Disabilities. What makes it so significant? For one thing, it is because this landmark convention puts forward nothing less than a total ban on both involuntary treatment and the involuntary confinement of people who have broken no laws.

This shorter-than-usual contribution signifies a departure from my earlier blogs. It is the first in an occasional series that uses semi-fictional clinical narratives to examine some of the difficulties that face people who use psychiatric services in England, and the psychiatrists and other mental health professionals who work in them.

"The Antidepressant Era" was written in 1995, and first published in 1997. A paperback came out in 1999. It was close to universally welcomed. It was favorably received by reviewers from the pharmaceutical industry, perhaps because it made clear that this branch of medical history had not been shaped by great men or great institutions but that other players, company people, had been at least as important.

On April 25, 2014, Jeffrey Lieberman, MD, then-President of the APA, announced that the association had engaged the services of Porter Novelli, a prestigious PR company based in Washington DC and currently operating in 60 different countries. I expressed the belief at the time that it would take a lot more than some PR embellishments to remediate the fundamental flaws in American psychiatry's concepts and practices. In the intervening year and a half, I've been watching the APA closely for any indications of fundamental change; any hint of critical self-appraisal; any suggestion of genuine reform or remediation. But I've seen nothing of this sort. It's still the same old APA, with its same old spurious diagnoses, and the same old assurances that their "treatments" are efficacious and safe, and that the great neurological insights are just around the corner.

Judging from the responses of several readers, certainly not all, to my previous post of March 7, “Poverty & Mental Illness: You Can't Have...

The November 5 hearing on the UN Convention on the Rights of Persons with Disabilities in the Senate Committee on Foreign Relations reached new heights of absurdity and opens new ground for concern. It may be worse for us to ratify with the reservations, understandings and declarations (RUDs) being proposed, and with the legislative record that is being created for the specific purpose of rejecting any application of the treaty's standards to US law than not to ratify at all. All the proponents of CRPD ratification who are allowed a voice in these discussions are in agreement that the US ratification is aimed ONLY at giving the US greater influence over other countries and over the development of customary international law, and NOT at improving the enjoyment of human rights by persons with disabilities in the US itself.

In the March 1 issue of the New Yorker, Louis Menand surveyed the topsy-turvy world of treatments for depression, writing in part of the...

What are Extreme Experiences? Other terms for them are Spiritual Crisis or Spiritual Emergency. With the appropriate support many find the experiences profoundly transformative. However, observers or relatives may have different beliefs about extreme experiences: perhaps that a person is having a psychological breakdown or mental health problems, or is psychotic or experiencing schizophrenia.

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.

About a year ago, my partner Ron Coleman said to me "let's have a recovery camp." I said "what’s one of those?" and he said "I'm not sure, but let's invent it." And so, from June 7^th to 12^th 2015, we created a community of recovery for a week. The next step is to create communities of recovery around the world — not just as temporary camps, but long-lasting oases within our communities.

The NIMH's CATIE trial of antipsychotics for adult schizophrenia is regularly understood to have shown that atypical antipsychotics are "no better" than the old...