Monday, April 12, 2021


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).

An Opportunity for “Mad Caring”: David Oaks Needs Our Help

For decades, one of the most prominent voices for radical change, or “non-violent revolution” in mental health care has been David Oaks, former director of MindFreedom International. Many activists today were drawn into their work due to David’s influence. Robert Whitaker, for example has credited an interview he did with David in 1998 for propelling him into noticing and writing about the way psychiatric drugs were harming more than helping. My own journey in becoming outspoken on these issues has also been massively influenced by David’s activism and ideas, which is one reason I care strongly about the issue I am bringing up here. While David has been helpful, directly or indirectly, to so many of us, he now needs our help.

Recovering Myself

I have known altered states of consciousness since I was a child.  I clearly remember staring into the mirror in my mother’s bathroom and...

Letters from the Front Lines

Bob-- An encounter from this week: I saw a 24 year-old theater actress who was started on Lexapro nine months ago for a one-time "panic attack"...

Letters from the Front Lines

Dear Bob-- I've had a couple of remarkable conversations, not with my own patients, but with friends and acquaintances asking me for advice.  Each example...

NCMHR Does Not Speak for Me

I am appalled to read a press release by the National Coalition for Mental Health Recovery that lauds the proposals emerging from the Vice President's Task Force and accepts in principle a national database of individuals with mental health diagnoses that is "limited to those with a known history of violence."

Robert Whitaker: Looking Back and Looking Ahead

On March 5, Bruce Levine, PhD, published an interesting article on Mad in America  titled Psychiatry Now Admits It's Been Wrong in Big Ways – But Can It Change? Bruce had interviewed Robert Whitaker, and notes that Robert, in his book Mad in America, had challenged some fundamental tenets of psychiatry, including the validity of its "diagnoses" and the efficacy (especially the long-term efficacy) of its treatments. Bruce reminds us that Robert initially incurred a good deal of psychiatric wrath in this regard, but also points out that some members of the psychiatric establishment are beginning to express a measure of agreement with these deviations from long-held psychiatric orthodoxy.

Generative Narratives and the Counterculture Psychiatrists

For outsiders like me who are really critical of mainstream psychiatry, the first thing to understand is that "community psychiatry" is a counterculture within the larger culture of biomedical psychiatry. When I say "counterculture" I don't mean these people had flowers in their hair or face piercings.

Proposal From Italy: An International Collection of Recovery Stories

We want to start an international initiative to promote the writing of recovery stories in every country, with the ultimate goal of sharing at an international level the most compelling ones from each country. Our proposal is born from an awareness that recovery stories are necessary today in order to give back to mental sufferance its meaning and transparency, to fight the biographical opacity of biological theories (the broken brain) and to guarantee decisional power to those who are offered (or imposed) mono-dimensional or dehumanizing treatments.

Study 329: MK, HK, SK and GSK

It is appropriate to hold a company or doctors who may be aiming to make money out of vulnerable people to a high standard when it comes to efficacy, but for those interested to advance the treatment of patients with any medical condition it is not appropriate to deny the likely existence of harms on the basis of a failure to reach a significance threshold that the very process of conducting an RCT will mean cannot be met, as investigators' attention is systematically diverted elsewhere.

A Recovery Story, in Dollars and Cents

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.

The Empire of Humbug: Bad Pharma

Some psychiatric drugs are extraordinarily effective, for instance benzodiazepines for catatonia or SSRIs for premature ejaculation. These treatments are so effective that controlled trials are an irrelevance. Every trial conducted would show a positive result. The point here is not that it is impossible for a treatment to achieve effectiveness but rather that controlled trials have little useful to contribute to the issue of effectiveness. Randomized placebo controlled trials have not shown any drug within the mental health domain is effective. If a treatment were effective virtually every RCT undertaken would show a positive result.

Your Input Welcome For 2012 Alternatives Keynote Speech – SURVEY

I was invited to give a Keynote Address at the 2012 Alternatives Conference in Portland Oregon, and I'm collecting your input on what I should...

Update: ABC World News Wants to Know About Benzos

Note: The episode did not air as expected. ABC indicates it will air Tuesday, January 21. Six weeks ago a producer from ABC World News with Diane Sawyer contacted me. “ABC wants to do a piece on addiction and prescription drugs,” she told me. “Would I agree to an interview?” I was not without reservations. I have a healthy disregard for much of mainstream news, but I also realize their reach and potency. The proposition was risky, but one which I decided to take. It’s a cliché, but one with truth: If one person can benefit, then it’s worth it. I said “yes.”

You Are What You Eat – Part 2

There has been much attention in this site to the role of psychiatry and psychiatrists for people who are experiencing mental or emotional distress. One area that I have chosen to focus on with my patients is food since it is a place where I believe I can have a positive impact on their lives.

Conference at Vatican Holds Great Promise: You Can’t Always Get What You Want…

I am just back from a conference - or what was called a study meeting - at the Vatican, entitled, “The Child as a Person and as a Patient: Therapeutic Approaches Compared.” Held under the auspices of the Pontifical Council for Health Care Workers, the two-day meeting on Friday June 14 and Saturday June 15 in the Vatican’s Pope Pius X Hall drew some 250 participants from 30 countries. This has been 6 years in the making, mainly representing the hard work and perseverance of Marcia Barbacki. I have also participated for the duration because I thought it was, perhaps, the best opportunity ever to spread the word about the risks of psychotropics for youth given that Catholic Health Care represents 26% of the world’s healthcare and the Church’s ability to disseminate information to all corners of the globe.

Doctor Munchausen: Hear no, See no – What?

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.

Changing Trends of Childhood Disability, 2001-2011

On August 11, Pediatrics, the official journal of the American Academy of Pediatrics, published an article that was based on data derived from a random selection of families concerning their health problems or concerns. Surprisingly, the incidence of disability due to physical conditions declined by 11.8%, while disability due to mental/neurodevelopmental conditions increased by 20.9%. The highest increases were among children under the age of 6, and children from more advantaged homes. At least part of the reason for this stems from the fact that while the prevalence of physical disability is limited by the prevalence of the particular pathology in question, no such limitation applies to "psychiatric disabilities."

Chapter Ten: A ‘Victim of Circumstance’

Upon arriving home at the end of sophomore year in college, which had been devoted to hyper-control and a carefully maintained, entirely black-and-white existence,...

22 Human Rights Defenders Tell Senate: Ratify Disability Rights Treaty Without Limitations

Psychiatric survivors know that U.S. law does not protect our rights under the CRPD and needs to be changed; it is also contrary to human rights principles for any country to assert that its own law represents the limit of its treaty obligations.

Dr. Friedman Criticizes the Overuse of the Atypical Antipsychotics

Just being “safe and effective” is not a strong endorsement, and it lacks any justification for the exorbitant amounts of money that have been paid for these medications. Their commercial success was due to the fact that they were advertised as “better” not just safe. Texas and 36 other states have now realize that they were misled about second-generation antipsychotics being better, and they are recouping their money.

Dr. Lieberman’s Swansong

As my readers know, I am a great fan of Jeffrey Lieberman, MD, President of the APA. In his capacity as president, Dr. Lieberman writes a regular bulletin in Psychiatric News. These literary and intellectual gems have been a wonderful source of inspiration to me in my efforts to draw attention to psychiatry's flaws, and I don't think it would be an exaggeration to say that in many respects, Dr. Lieberman has been one of our greatest allies.

Chapter Eleven: Teetering on the Edge

Frantic, fearful, and desperate to get my life together, I returned to Cambridge in the middle of August to move into my off-campus apartment....

Implications of the Trans-Pacific Partnership Agreement on Equitable Access to Healthcare

A new generation of multilateral and bilateral trade agreements is likely to significantly threaten access and cost of healthcare, and limit signatory Governments sovereignty to prioritise health care policy to protect and improve the health of citizens. The Trans Pacific Partnership Agreement (TPPA), a Pacific Rim regional trade agreement involving 12 countries — including New Zealand, Australia and the US — is one such agreement, and it has the potential to significantly alter the domestic environment for health policy-making.

The Foundation for Excellence in Mental Health: Finding Our Way in a World of...

Every day we read, on the one hand, another compelling headline touting "news" of a “scientific breakthrough” that claims to have discovered the “cause” of “mental illness,” while another headline tells of researchers uncovering egregious falsification in the clinical trials of the pharmaceutical industry. The list goes on and on. Though many people report that they find medications helpful when they are in an extreme state (mostly to help them sleep ), given that there is as yet no scientific evidence confirming a specific disease/illness process underlying "mental illness,” and evidence that most if not all of the perceived effect is comparable to placebo, the fact remains that any positive effect of these meds are based on theory, while their harms are well-established.

From Protesting to Taking Over: Using Education to Change Mental Health Care

As we develop critical awareness about the mental health “treatments” that don’t work and that often make things much worse, the question inevitably comes up, what can those who want to be helpful be doing instead?

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