Blogs

Why all the fuss over DSM-5? Why did Robert Spitzer, the editor of DSM-III, begin to protest about the “secrecy” surrounding its production as early as 2007? Why did Allen Frances, editor of DSM-IV, begin in 2009 to challenge the American Psychiatric Association’s (APA) announced goal that when making DSM-5 “everything is on the table”? Why did he dispute the APA’s position that there had been enough progress in neuroscience to call for a “paradigm shift”, and why did Frances and others go on to protest repeatedly what they viewed as DSM-5’s “medicalization of normality?”

The decision by the Institute of Psychiatry, Britain's leading centre for psychiatric research, to invite disgraced Professor Charles Nemeroff to speak at the inaugural lecture of the Institute's new Centre for Affective Disorders has caused a great deal of controversy, news that was recently featured on Mad in America. In the latest development members of the Critical Psychiatry Network in UK have written an open letter to Professor Pariantes, the Director of the new Centre for Affective Disorders, requesting that he cancel Nemeroff's invitation.

When children do things like recoil in fear from monsters and ghosts in their darkened bedroom at night, it’s easy to see the “out of touch with reality” aspect of their experience as being closely related to the faculty that gives them their ability to play – their imagination. We help children through such challenging experiences by being with them, and by playing together, doing things like creating scary images together and then figuring out how to cope with them or laugh at them. In the process we help them explore how to create a world view that works to at least some extent and has room for joy and originality - when their imagination helps them (and maybe others) see the world in new ways.

Saying we do not like the medical model will not make that model go away. I do not think we resolve these problems simply by declaring that emotional distress is not a medical concern.

This is not just about pregnancy loss and motherhood. This is reflective of how we treat many people who have experienced pain and are expressing it in ways not immediately relatable to those around them. It is about how we as a society may contribute to some of the truly awful things that happen not by failing to properly screen and assess, but by quite successfully fostering fear and alienation.

Greetings, MIA readers. Would you like to write your own review of the DSM-5 (even if you haven’t read it, never mind bought it.) I’ve done neither, but I’ve read, talked, written enough about it to have an opinion. Write your own review of the DSM-5 on Amazon …Here's the link

It has been a good time to bury controversy. With all eyes on Washington and the fallout from the publication of DSM-5, over here in England the Institute of Psychiatry has been discretely sending out invitations to a lecture. This is not a public lecture; it is by invitation only. And who is the esteemed guest? None other than Professor Charles Nemeroff M.D., Ph.D.

I've just returned from a meeting of 17 activists self-identified as users or survivors of psychiatry, or people with psychosocial disabilities, from all over the world. Literally all over the world. An international gathering of human rights defenders that makes me proud to be among them. It was a meeting where I felt heard and acknowledged and able to fully give what I had to give - to offer it up along with everyone else's contributions for the common deliberation. I gave all and received all in return.

Less than six months ago I had the great fortune to start working with a small group of fellow producers who had spent a chunk of time traveling and shooting at various conferences. Interviews with notable figures in the movement. Survivor stories. A mixed bag of “Mad Media”. Immersing myself in the now 200+ hours of raw footage was like swimming in a sea of the subconscious. So I was swallowed whole by the white whale, consumed with the energy to put my still-developing abilities to the best use I could think of.

Open the Paradigm.

The Minnesota Starvation Experiment was conducted at the University of Minnesota during the Second World War. Prolonged semi-starvation produced significant increases in depression, hysteria and hypochondriasis, and most participants experienced periods of severe emotional distress and depression and grew increasingly irritable. It really should not be a surprise to this audience that the brain’s functioning is highly compromised when the body is being starved of food (and nutrients). What we wonder is whether eating a diet of primarily highly processed foods low in nutrients has similar effects.

In my most recent blog post, “The Unmedicated Life”, I attempted to answer a question I’m frequently asked by other survivors — “How did you get better from psychiatric medication damage/withdrawal?” But there is also a part two to the question that I didn’t address, which is, “How did you know when you were better?”

You never know what you’re going to accomplish when you start something. Who could have predicted that Tom Insel and NIMH would throw the APA and the DSM under the bus? My guess is that two factors played a big part in NIMH’s decision. First, the unceasing barrage of criticism directed at the DSM – its lack of construct validity; its declining inter-rater reliability – had damaged its credibility beyond repair. On top of that, thirty years of DSM-based research had produced no biomarkers.

If you haven't been labeled mentally ill by the American Psychiatric Association, you have to ask yourself what's wrong. Perhaps you were ahead of the game: you knew not to reveal yourself to them, you knew how to avoid them, you found other social support, and if so, a big congratulations. If not, what's wrong? Why have you conformed?

The last four years I've been running Poetry for Personal Power, a stigma reduction campaign funded by SAMHSA. Poetry for Personal Power has been going to Missouri Universities and asking students what they do to get through hard times and we now have about 400 incredible videos on You-Tube, with youth wellness tools.

The Critical Psychiatry Network is concerned with the way the controversy over the publication of DSM-5 is being portrayed in the media and by some academic psychiatrists. The issues raised by the DSM are complex and require careful and studied consideration. There are two aspects in particular that concern us. These relate to the portrayal of the controversy as a guild dispute, and the polarisation of the debate as one of nurture versus nature.

Americans have increasingly lost community and autonomy, and have acquired instead the tyranny of institutionalization: domination by gigantic, impersonal, bureaucratic, standardized entities — visible in large corporations, the workplace, health care, schools, and much of our lives. This institutionalization has made many Americans feel small, isolated, helpless, scared, inattentive, bored, angry, alienated, and depressed.

For several decades, since the days when I was a patient, I have seen and heard how an obsession with questions damages psychiatry. Many of us have been asked the same questions day after day, year after year: ‘Do your thoughts seem faster than normal?’, ‘Do you ever have thoughts in your mind which are not your own?’, ‘Do you feel anxious?’, and so on. Hearing only what a patient says under questioning when frozen by paralysis, or subject to the hyper-arousal of anxiety, the professional misses the opportunity to hear the threads of something new, the possibility of weaving with the patient a narrative of hope and recovery.

People in roles of power in the mental health system often don’t realize how much complicity they have in actually creating the symptoms they claim are biologically-based in individuals with psychiatric labels.

The recent furore surrounding publication of the new DSM has provided a much-needed opportunity to discuss and debate crucial issues about how we make sense of, and respond to, experiences of madness and distress. Many psychiatrists, psychologists and other mental health professionals have expressed their dismay about the dominance and inadequacy of a biomedical model of mental illness. Whilst we share these concerns, welcome these debates and support colleagues that are willing to take a stand, The Hearing Voices Network believes that people with lived experience of diagnosis must be at the heart of any discussions about alternatives to the current system.

For me there are at least four separate questions to be addressed. The first is whether neuroscience is capable of understanding human emotion and higher level cognitive experiences. The second is the extent to which that understanding - even if it is achievable - is critical to our being able to help people in distress. The third is whether is it is correct to assume, as many people seem to do, that if we come to some basic understanding of brain function as it pertains to core human emotion and suffering that this will automatically translate into treatments that are commonly thought of as "biological," such as drug treatment. The fourth relates to the limitations and relevance of studying the brain in isolation when we are constantly in interaction with our environment.

Tomorrow, May 18, the American Psychiatric Association kicks off its 166th annual conference. That same day, its new DSM-5 will be officially published. Given the occurrences of the past couple of weeks, which I’ll review briefly below, some members of the APA might wish tomorrow’s events would go unnoticed. But they won’t.

I think it’s helpful to see the psychiatric/pharmaceutical complex as being somewhat analogous to one of those large inflatable giants that you sometimes see hovering over car lot sales. Sure, it looks big and powerful, and it really is so long as “we the people” buy its propaganda and its drugs and continue feeding it billions of dollars and continue “bowing down” to its “almighty wisdom.” But its entire foundation consists of a model that simply doesn’t fit the research evidence at all, and quite frankly is propped up by many outright lies.

There has been a lot of talk lately about neuroscience and the future of the medical model of "mental illness." It was made clear, in NIMH director Thomas Insel’s statement, that the DSM is a system of identification and classification of what are deemed disorders within our human experience. This isn’t exactly news to the vast majority of people who have spent even a little bit of time thinking about whether or not psychiatric diagnosis makes sense.

Imagine being able to live harmoniously amongst others without fear. I cannot. Cannot imagine it even a little bit. What can be created for people in my camp? People who are sensitive and had so much trauma in childhood that life among others is highly stressful, scary and worrisome? I'm allowing myself sanctuary-time alone, quiet time, time to write… yet… will things ever be different? Will I ever find my niche in this world, where I feel safe and able, valued and worthwhile, loved, adored and comfortable? I have no idea.

Cognitive Behavioral Therapy (CBT) has been a hot topic of late. In the recent MIA blog posting, “Colonization or Post Psychiatry,” multiple references were made about “system therapists” promoting CBT coming into the Hearing Voices Movement to possibly dilute or co-opt the essential revolutionary character of the movement, thus turning it into something more mainstream and less threatening to the status quo of Biological Psychiatry’s oppressive medical model.