Blogs

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).

“Tuff” Love: A Public Safety Alternative

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It is no mystery why everyone at the McNair Discovery Learning Center is alive today. Antoinette Tuff was respectful, responsive and kind to a man with a gun. She shared her own difficulties and offered her own humanity. This kind of “Tuff Love” involves real risk, but not more risk. It reaches across vast expanses of human confusion and distress - not to manage, control or subdue - but to attempt connection and offer a lifeline back to humanity. It is the public safety work of the future.

Photo ID Cards for “Mental Patients” Now a Reality

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In Butte County, California, Law Enforcement and NAMI have recently partnered to provide identification cards for people in the mental health system. The cards reveal the person's psychiatric diagnosis and current medication prescriptions. This White Card project may be well-intentioned, but it makes me very uncomfortable. I believe it is a form of psychiatric profiling that could be adopted by law enforcement around the United States.

DSM-5’s “Speculative” 2002 Diagnostic System Based On Expected Gene Findings

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According to a leading group of psychiatric genetic researchers, writing in 1999, “From the perspective of psychiatric genetics, the Human Genome Project is an immense factory producing and refining the tools we will need to discover the genes that cause mental illness.” A 2002 “speculative outline” by a group helping to revise the DSM envisioned a future DSM-5 practice of classifying disorders on the basis of "the patient’s genotype, identifying symptom- or disease-related genes, resiliency genes, and genes related to therapeutic responses and side effects to specific psychotropic drugs.” A dozen or so years ago, at least some of the DSM-5 architects believed that genes would at long last be identified and would be integrated into the next version of the DSM. As we know, this did not happen.

Elimination of Bias, Not Disclosure of Bias, Must be the Standard

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Disclosure is an insufficient strategy for mitigating bias because bias does not result from the concealment of financial ties but from their effects. Even worse, social psychologists have demonstrated that when individuals disclose a competing interest, they give even more biased advice.

It’s NOT all in Your Head

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Over 100 million people in the US suffer from chronic pain – defined as pain lasting longer than 12 weeks. Up to 80% of those sufferers are women, many of whom report having been repeatedly brushed off or referred out by medical doctors who could find no discrete medical cause for the symptoms they reported. Some patients report an even harsher finding by their doctors: “To the best of my ability to determine, your pain is not medical in origin. I believe you need to be evaluated by a psychiatrist or psychologist who is qualified in psychosomatic issues.”

R.D. Laing & Anti-Psychopathology: The Myth of Mental Illness Redux

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Twenty-five years after R.D. Laing’s death, are we more humane and compassionate in our treatment of those at our mercy? It is difficult to say. But one thing that we cannot deny, our culture has become even more “medicalized” than at any time in history. The medical metaphor that Laing found more or less acceptable when explaining what he thought therapy is, has become increasingly literal. More and more, anything that pains us is a condition that can be treated.

A Caregiver’s Story- And How I Became an Addict

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In 1994, my nineteen-year old daughter, Cristina, was diagnosed with chronic myelogenous leukemia (CML). It was a diagnosis that came totally out of the blue and as a complete shock. Soon after she was diagnosed, it became clear that I wasn’t going to be able to sleep because of the tremendous stress, so I asked the very kind doctor who diagnosed Cristina if he could give me a prescription for something that would help me sleep. He agreed, and so began my “relationship” with Xanax. I had never taken anything like that before and didn’t know anything about it. All I knew was that as my daughter’s primary caregiver, I needed sleep in order to fight to keep her alive.

Teens and Psych Drugs

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At the end of an hour long discussion with Holyoke High School students in Holyoke, MA, I was grasping quarter page slips of folded paper as it they were sheets of gold. On these slips of paper were questions the students asked me, as well as their answers to my questions, “What can you do to make yourself feel happier as an alternative to psychiatric drugs?” and “How do you get through hard times?” They included love, eating, snuggling, my boyfriend, my girlfriend, green tea, good friends, drawing, playing guitar, a new book, flowers, fluffy things (pandas), writing, music, talking to friends, not isolating myself and sex novels.

The Unbearable Heaviness of Psychiatric Drug Withdrawal

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Last week Matt Samet posted about a setback he’s recently had. Setbacks for me remain routine and normal. They are part of the excruciatingly non-linear process of recovery.

How to Parent a Dead Child

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Being the parent of a dead child is hard. Being the parent of a child who died from suicide may be even harder. I love my son and am proud of him and work to make sure that his having lived makes the world a better place.

Twin Studies and the “Nonreplication Curse” in Psychiatric Molecular Genetic Research

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Psychiatric molecular genetic research has failed to discover genes that underlie the major psychiatric disorders, the existence of which twin and adoption studies are assumed to have established. "Genome-wide complex trait analysis" (GCTA) was developed a few years ago as a means of solving what researchers call the "missing heritability" problem. One researcher believed that the new GCTA method would “drive a stake through the heart of” criticism of behavioral genetic theories and methods, and would finally put criticism of twin studies “to rest.” The opposite scenario appears to be playing out, however, as leading behavioral genetic and psychiatric genetic researchers struggle to prevent some recent negative GCTA findings and the obvious false assumptions underlying twin research from driving a stake through the heart of twin studies themselves.

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

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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.

Talking Over Fences: Why I Am Helping to Organize Community Dialogues on Mental Health

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I understand that some people are staunchly opposed to public mental health services, and I understand why. However, millions of people reach out to these organizations and agencies for assistance in getting through difficult times. It is common knowledge that the “help” they get is not always helpful, but I have known a few people who found the support they were looking for and, let’s face it, until there are widely available and accessible alternatives that people are able to turn to, many people who are struggling reach out to public and private providers for help. Some people call me naïve because I have faith in the human capacity to make good choices, when given the opportunity and presented with evidence that supports a decision that is informed not only by data, but by recognition of their potential to be a force of healing and justice in the world.

A More Comprehensive Approach to Ethical and Effective Prescribing

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Like most doctors, I feel like I prescribe medications ethically and effectively. The basic foundation for that confidence is three things: 1) Knowing that my primary motivation is almost always to help my patients. 2) I try to defend myself as best I can from being too influenced by the profit seeking motivations of the pharmaceutical industry. And 3) I try to resist responding to various self destructive motivations of my patients. Prodded by Robert Whitaker’s books, I feel the need to build a more comprehensive approach to ethical and effective prescribing than I was taught or modeled or even than is expected of me. Here are four more foundations I’m building: 1) Individualized prescribing, 2) Recovery-based prescribing, 3) Trauma-informed prescribing, and 4) Toxicity-informed prescribing.

Could Your Doctor Be Mentally Ill or Suicidal?

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At a time when psychiatrists are considering whether suicidal behavior constitutes a disorder rather than a symptom, there is strong evidence that physicians have far higher rates of suicide than the general population, with psychiatrists found to be at the highest risk of suicide. In light of this information, you may be asking yourself, as I am, whether it would be wise to conduct a brief mental state examination of any physician we consult (particularly any psychiatrist) as a way of ensuring our physical and emotional safety? To this end I have prepared a quick diagnostic test that you may carry in your pocket or purse for easy administration next time you are visiting a health professional.

A Recovery Movement Deterred?

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I had the good fortune to be working at a dynamic Recovery program for adults beginning in 1990. I passionately believed that not only does recovery happen – but that we would be able to demonstrate it by reporting significant improvements in quality of life outcomes such as employment, housing and social supports. The program's commitment to Supported Employment, for instance, was emphatic and we took pride in doing “whatever it takes” to support our members’ integration into the community. The Recovery movement was just taking root in California and throughout the U.S. When I look back on the following 19 years, I can’t help but feel some sense of disappointment about the overall outcomes.

We Are Meant to Heal in a Community

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In my last blog, I talked about how I was attempting to cope with a “mini-relapse” without using psychiatric drugs. One Sunday morning in the midst of this episode I awoke in a particularly dismal state. I didn’t have a structure planned for the day. And without something to look forward to, both my anxiety and depression increased.

Top Ten Reasons Alternatives 2013 is the “Cannot-Miss” Event of the Year

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As you may know, the annual Alternatives Conference is the largest peer-run conference in mental health in the country and will take place December 4-7 at the Hyatt Regency in downtown Austin, Texas. You may not know that this year Alternatives is truly a cannot-miss event, for several reasons, the top ten of which are outlined below. But first, perhaps a little background on the conference would be helpful.

Setbacks

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Oddly enough, it had occurred to me over this past year as I’ve been writing these essays for Mad in America that maybe I was “too healthy” to speak to the withdrawal experience with authenticity, to have street cred. It’s now a moot point. I write this not to scare people, but to present a reality. This reality has been difficult to accept, but the fact remains that my nervous system is more sensitive than before and might always be so, at least to some degree.

Moving ‘Beyond the Medical Model’: HELP WANTED

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This summer, Sera Davidow, Laura Delano, Sean Donovan and Caroline White began a collaborative process with many others from the Western Mass RLC and beyond to develop two new films (not yet titled) focusing particularly on the topic of psychiatric drugs. And that’s where YOU come in.

UN Prohibition of Psychiatric Commitment: Review and Analysis

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On September 21, I posted here that the UN Committee on the Rights of Persons with Disabilities took a definitive stand against psychiatric commitment in its Concluding Observations on El Salvador and Austria.  The Committee held that the "danger to self or others" standard cannot legitimize psychiatric detention, and that all legislation authorizing such detention must be repealed. This is of huge significance, which I did not expand on in my earlier post.  Another set of Concluding Observations has now been released, this time on Australia, which gives me another opportunity to discuss what has happened.  I hope that both lawyers and non-lawyers will follow the discussion, since it has both legal and political implications.

5 Reasons To Meditate

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A few years ago I had the intuition that meditation was the most important survival skill for these shifting times. It came after reading...

My Story and My Fight Against Antidepressants

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I’d like to share a bit about what happened to me after being placed on these medications, and how I successfully got off. Until recently, I was embarrassed to talk about my personal experiences publicly, as I’m a professional who specializes in anxiety and depression. Today, medication free, I feel better than ever before, and I am now on a mission to help my current clients get off medications, and to inform others through my writing about the dangers and pitfalls of starting antidepressants.

Experiencing the Possibility of Change in the Digital Age

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If you are reading this, you are probably involved in the mental health system. You might consider yourself a patient. You might consider yourself a professional or perhaps a caregiver. Maybe you consider yourself a survivor of the system. If you are reading this, you are probably interested in change. The interest of change, and the exploration of its possibilities, unites the readers of this site.

Internal Guidance

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We would be much better served if we were told by mental health professionals from the very beginning to trust ourselves. Instead, the entire system is fraught with the infantilization of the client. This is (in general) true of both psychology and psychiatry as currently practiced.