Blogs

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.

The relevance of pellagra to psychiatry is that it also can present with psychosis, obsessions, mania, depression and confusion. It involves the main organs of the brain, the gut and the skin – many referred to the 4 Ds: dementia, diarrhoea, dermatitis and death. Pellagra (meaning rough skin) was first described in 1735. At the time, the cause was unknown but it was associated with poverty. Although linked to the poor person’s diet (often consisting mainly of corn products), the going wisdom at that time was that it was contagious (Pellagrans, as they were called, tended to live in close proximity) and was perhaps hereditary (sound familiar?).

As co-chair of the Diagnostic Summit Committee of the Society for Humanistic Psychology, I am pleased to announce that today we officially launch the Global Summit on Diagnostic Alternatives (DxSummit.org), an online platform for rethinking mental health. Our goal is to provide a place for a collegial and rigorous discussion of alternative ways to conceptualize and practice diagnosis. Today's launch is marked by the appearance of our first eight posts. These posts come from a variety of prominent people in the field, each offering a unique perspective on the current state of diagnosis and where we might take things as we move forward.

It is time for a new understanding of suicidal feelings and actions. Perhaps a more open dialogue, without fear of sirens and police and involuntary hospitalizations, would have made a difference for one young man here in Asheville last month. Perhaps more public local conversation would have saved some of the 45 lives we lost here in Buncombe County in 2010. Perhaps a more public and safe national conversation would have saved some of the 22 veterans who died from suicide every day in 2010.

As I write this, my daughter is 18 months old. She operates 24-hours-per-day, 7-days-a-week under a baby’s natural assumption that she is loved and accepted exactly for her. She throws her whole self at you with complete faith that you’ll not only want to catch her, but be delighted to do so. She flashes her round belly, expecting those around her will fight for the privilege to kiss or blow on or tickle it. Any sign that you are questioning her wants and needs leads to shock expressed with wild abandon and never self-recrimination.

Greetings! My name is Michael Rock.  Until now I have been participating on MadinAmerica.com as a commenter named “Marcellas”.  It is very nice to finally introduce myself to this community under my real name.  Although I only occasionally commented, I have been a regular visitor and reader of MadInAmerica. I feel like I need to apologize for hiding behind Marcellas. Anonymity is not something I am proud of, nor was it a trivial matter to me. I have been working with people in groups for twenty five years.  I love my job, and believe I am helpful. I felt that "Marcellas" allowed me to continue to work quietly for change within the system.

Lucy Johnstone from the British Psychological Society on the influential BBC radio news programme, Today (13th May 2013), a great room 101 on changing...

What makes the DSM so pernicious is that it is a cultural document whose influence transcends not only psychiatric practice but also the Western civilization from which it originates. Each revision of the DSM rescripts and reimagines how we make sense of our experiences, reinterprets what thoughts, feelings and behaviors are socially sanctioned, and ultimately what it means to be human.

As the medical director of a community mental health center, my colleagues look to me for guidance on how to approach the new edition of the DSM. How many should we buy? How much time should be devoted to staff training? This is my answer.

In a bold and unprecedented move for any professional body, the UK Division of Clinical Psychology, a sub-division of the British Psychological Society, issued a Position Statement today calling for the end of the unevidenced biomedical model implied by psychiatric diagnosis. In brief, the argument is that the so-called ‘functional’ diagnoses – schizophrenia, bipolar disorder, personality disorder, ADHD and so on - are not scientifically valid categories and are often damaging in practice.

When Thomas Szasz’s name comes up in debates over defining mental illness, it is fairly common to hear people say something along the lines of, “Well, he made some good points, but he was just too extreme.” Yet I am struck by how conversations about DSM-5, being released this month, make the crisp arguments Szasz consistently offered for 50 years just as timely as ever. I’d even go so far as to suggest that a large number of counselors, psychologists, social workers, and psychiatrists pretty much agree with the main tenets of Szasz’s argument, despite their ongoing disclaimers.

If, a little over three years ago, you asked me who I was, my one and only answer would have been, “Bipolar.”  It was the word that defined me, that explained my emotions and behaviors, that gave me answers to the questions, Why am I so unhappy?  Why do I want to die every day?  Why is it so hard to get out of bed in the morning, to shower and brush my teeth and leave the house and interact with the world?  Why do I find it impossible to keep a job, a relationship, a responsibility?  Why do I never feel OK?

Mad in America has been under a low-grade attack by hackers for several weeks. I first noticed an odd traffic pattern in our Google Analytics account, indicating that the front page was receiving more than ten views for each unique visitor. This means that some minority of accounts was reloading our front page over and over again. This is called a botnet attack, where a hacker uses a set of zombie computers, often compromised by malware, to perform repetitive tasks.

Psych meds can not only put weight on regardless of how you otherwise care for yourself, they also tend to make people feel gravely lethargic and vaguely sick all the time. I could not exercise as I had before. Could not. It doesn't matter how much mental health professionals try to tell us that if we just exercised we'd be okay in the face of neurotoxic drugs that cause weight gain, because the fact is the drugs impede that capacity. This is not widely appreciated or understood and people on psych meds are again traumatized and made to feel guilty for something that is truly outside of their control as long as they are taking these medications.

My goal now is to focus on solutions for emotional distress, not talking about medical harm. We all know about the problems with medical harm, but not all people are clear about solutions. I'm not that clear, either, but I'm working on it. I'm not talking about revolution any longer, just trying to make my piece of the pie work.