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).

Fire In The Belly

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What goes wrong for the 10-15% of women who feel like hiding under the covers instead of gazing blissfully into their newborns peaceful face? Is it expectations unmet? Is it hormones? Is it the brain? Having spent several years treating these women, I believe that what we are calling postpartum depression and anxiety is in fact postpartum immune dysfunction, and its attendant inflammation.

Slices of Pies: A Dialogue with Ronald Pies

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For those of you who haven't read it, I published a blog post called, 'Too Much Pies,' on Mad in America on Wednesday, April 10th.  The post included an invitation to psychiatrist Ronald Pies (who caught the interest of many when he wrote a letter to the New York Times about psychiatric diagnosis) to a real dialogue, not limited by number of words, frequency of reply or professional licensure. I copied the letter directly to Mr. Pies, not knowing if he would reply.  On Thursday, April 11th I received a direct reply that Mr. Pies has authorized me to repost here.  I am also including my response to him.

Too Much Pies

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On March 18th, Ronald Pies, a psychiatrist based in Lexington, Massachusetts, wrote a letter to the New York Times. He argued in favor of the usefulness and harmlessness (when well used) of psychiatric diagnosis and wondered as to the misgivings so many seem to have. The Times invited its readership to participate in a dialogue by submitting responses to Pies’s piece. Laura Delano, Paula Caplan and I were among the relative few who managed to get our voices heard. Pies had the last word, though: He gave just two short sentences to my dispatchment, and summarily disregarded so many years of pain and loss and abuse of power.

The Tragedy of Lou Lasagna

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In 1956, Lou Lasagna was on his way to being the most famous doctor in the United States; an advocate for controlled clinical trials of both the safety and effectiveness of medication, as well as for a revision to the Hippocratic Oath to include a holistic and compassionate approach to medicine. Then, caught in the nexus of reason, regulation, and the pharmaceutical machine, his star fell.

“That’s Just How It Is”

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Those of us, the survivors, who speak from experience, with nothing to gain from sharing our stories and in fact a hell of a lot to lose, risk having them revised or repudiated at every turn by the very people who, and paradigm which, sickened us. I’m simply trying to tell my story as I lived it, because I know exactly what I went through and why, and I don’t think anyone else should have to suffer this way if they need not do so.

Living Mindfully with Voices

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I hope this will be of help to people who hear voices and their friends and supporters. I also hope it will be helpful to the voices which are parts of many people's lives. Many voices I have come across and the people that hear them are convinced that their voices are spiritual in nature. I take an agnostic position on this, and therefore endeavour to respect different spiritual understandings. My intention is not to explain all voices psychologically but to help people make peace with their voices so they can get on with their lives.

Winners of the American Dream

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Since I left the psychiatric prescribing trenches and came south for the winter, I’ve been staying in a beach town within driving distance of a technology metropolis. I take breaks from my writing and walk to the beach. There, I meet and talk with the winners of the American dream. They are intelligent, highly educated and financially successful. They take their beach vacations here.

Please Defend the Right to Bear Arms

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I remember the first time I read the Bill of Rights. I was a child suffering with extreme states and didn’t have any idea what I was experiencing. I believed and I was told that I was different. At the same time, I watched my mother get fired from a job she worked so hard for and went to school for, because of a diagnosis. I then watched all her rights stripped away in psychiatric hospitals. Through it all I felt hope because of those rights contained in the Constitution.

Using Formulation to Change Team Cultures

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I am returning to the subject of psychological formulation after rather a lengthy gap, during which controversy about the forthcoming 5th edition of DSM has continued to grow – sign the petition ‘Stop the Insanity’ at  www.dsm5response.com if you share others’ concerns about the creeping medicalisation of everyday life and the risks that it poses.

False Arguments, Part. 2: Anti-Anti-Stigma

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It’s taken me a while to write part 2 of this series, and honestly I’ve been torn between several compelling topics. But, here I land. Just a brief re-cap before I get rolling: The foundation of this ‘False Arguments’ series is that sometimes I, you, we... all get drawn into arguments and belief systems that are based on a particular starting point that is assumed to be, or acted upon, as if they are valid.

Making Plans for the Long Flight – Re-visioning Icarus’ Next 10 Years

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It’s been the kind of contemplative, hibernating winter that’s left us ready for an action-packed spring. Jacks and I spent two months living in a little house in the woods finishing our first solo books and revising the classic Icarus text Navigating the Space Between Brilliance and Madness...

The U.N. Asks the U.S. to Defend its Use of Forced Psychiatric Drugging

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The United Nations Human Rights Committee has asked the U.S. government to clarify how the possibilities for nonconsensual medication in psychiatric institutions comply with their obligations under Article 7 of the International Covenant on Civil and Political Rights - i.e. the obligation to ensure that no one is subjected to torture and ill-treatment. This is the fruit of successful advocacy by Maxima Kalitventsev and myself; we went to Geneva last month to meet with members of the Human Rights Committee and urge them to ask questions related to forced psychiatry and psychiatric profiling as violations of our human rights.

eCPR (Emotional CPR): A Tool & a Process of Peacemaking

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A few months ago I had the great honor of speaking with Kofi Annan, former secretary general of the United Nations, after a talk he had given locally here in Washington, DC. We spoke about eCPR and there was a moment that I will remember for the rest of my life. He looked deep into my eyes and said, “We are in the same line of work. We are peacemakers.” It was a profound statement that inspired me to think more about eCPR as a tool of peacemaking.

Imperialist Psychiatrists, Psychopathic Corporatists — But I Repeat Myself

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Journalist/humorist Jon Ronson’s TED talk “Strange Answers To The Psychopath Test” addresses the DSM, diseasing normality, faking mental illness, and the psychopathy of former CEO “Chainsaw” Al Dunlap. The Huffington Post, for their TED Weekends section, asked me for a reaction to Ronson’s talk—but then refused to print my blog because, a Huffington Post staffer emailed me, “the TED Weekends team said that the wording of the post was too strong.” Below is the original post.

On World Autism Day: Why I Am Concerned About the Use of Antidepressants During...

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Autism rates are on the rise, with the latest report from the US Centers for Disease Control showing 1 in 50 children to be affected.  Prozac, the first of the SSRI antidepressants, was launched in 1987 and sales have risen since then. Estimates are that up to 13% of US pregnancies are exposed (or around 500,000 US pregnancies per year). Available scientific data from animal and human studies raise serious concerns that exposure to SSRIs during pregnancy damages the developing brain and may cause neurodevelopmental abnormalities, including autism.

A Recovery Story, in Dollars and Cents

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In these days of sequestrations, budget cliffs, and congressional gridlock, everyone is feeling pressured to cut back, cut corners and find the most inexpensive way to accomplish anything and everything. For those of us who have been working so hard over the past decades, this leads to the obvious question, "can we afford recovery?" I mean, after all, it is usually cheaper to just give someone a drug than to invest in the time and effort needed to bring human spirits back alive to strive and thrive. So I decided to look at this question, from the vantage point of my own singular life.

Managing a Movement or Community

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This post is a bit different from my typical system sausage making pieces in that I would like to reflect on the Mad in...

Optimal Use of Neuroleptics, Pt. II; The Monkeys Were Not Psychotic

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A major research group mentions in a paper published in an academically rigorous psychiatric journal (and I get it that some readers consider that an oxymoron) the possible influence of super-sensitivity on increasing the risk of relapse when neuroleptic drugs are stopped. Yet those of us who raise this as a reason to moderate our use of these drugs are considered biased or scientifically naive.

Situational Schizophrenia

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The label of schizophrenia has a chilling ring. It carries with it the suggestion of a wrecked and wretched life. It is also a diagnosis that is notoriously difficult to shed. For this reason, the diagnosis of schizophrenia should not be applied lightly and not without a thorough understanding of the patient’s family and wider circumstances.

Can a Profession Be any More Confused?

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Yesterday I attended psychiatry grand rounds, where Andy Miller presented his latest research. Andy has been a pioneer in the field of psychoneuroimmunology and an exponent for the view that major depression reflects systemic inflammation. (I have published a review of this literature recently in Frontiers in Psychology which is available for download).

After the Statement by the Special Rapporteur on Torture, Taking Stock of Where We...

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The logic of equating forced psychiatry with torture is undeniable, it is a severe injury to the body, soul, mind and spirit, and it is only because of discrimination that such violence has enjoyed social and legal approval in western societies and unfortunately spreading throughout the world. The logic that comes from a non-discrimination analysis is rooted in our self-respect and pride, our unwillingness to let go of the last spark of identity and resistance that makes us who we are. Non-discrimination is advancing in the world, it represents the best of humanity and we are part of this truth.

Not So Bad Pharma

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The invitation from the London Review of Books to review Ben Goldacre’s Bad Pharma™ reads: “We were unsure, at first, what a review could add that isn’t already in the book – scrappy summaries and bits of praise are not for us. The book is of sufficient importance that the main thing is to get someone who knows what they’re talking about to present the material confidently... frame the discussion”. My head said it was inconceivable that the LRB wouldn’t take a review, even if it was at odds with the invitation to praise Bad Pharma. But my gut told me the inconceivable was about to take flesh.

Life, Liberty, & the Pursuit of Happiness? Protesting the Legislation of Systematic Civil...

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On March 26th, a small group of us gathered outside the State House in Boston, Massachusetts, to rally and protest against several oppressive, dehumanizing, and dangerous bills put forth by the House and Senate.  If you’re interested in reading more about them, go to www.malegislature.gov/Bills, and search for House Bills 110, 141, 1802, 3253, 1792, and Senate Bill 41.  This is my speech from the event.

The DSM-5 Field Trials: Inter-Rater Reliability Ratings Take a Nose Dive

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The American Journal of Psychiatry (January, 2103) recently published a series of articles that analyzed the outcomes of the field trials that were conducted by the DSM-5 Task Force, to determine the inter-rater reliability of the multiple diagnostic categories that will comprise the DSM-5. A table below tracks the downward progression of inter-rater reliability from DSM-III through DSM-5.

Do Antipsychotics Worsen Long-term Schizophrenia Outcomes? Martin Harrow Explores the Question.

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Martin Harrow and Thomas Jobe have a new article coming out in Schizophrenia Bulletin that I wish would be read by everyone in our society with an interest in “mental health.” Harrow and Jobe, who conducted the best study of long-term schizophrenia outcomes that has ever been done, do not present new data in this article, but rather discuss the central question raised by their research: Does long-term treatment of schizophrenia with antipsychotic medications facilitate recovery? Or does it hinder it?