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).

Why I Work in the System

I find it to be a really difficult decision—some days more so than others—to do peer support in the traditional mental health system. I need to remind myself pretty often why I am doing this because it’s really, really hard! Here are the reasons I go to most often . . .

In Memoriam: Paula Joan Caplan

Paula Caplan, known for her fierce criticism of psychiatry and its diagnostic manual, died Wednesday at age 74.

Enough is Enough Series: An Hallucinogen for Depression? Psychiatry is Testing Ketamine (‘Special...

The article “Special K, a Hallucinogen, Raises Hopes and Concerns as a Treatment for Depression,” by Andrew Pollack in the New York Times, December 9, 2014, tells how far afield my field, psychiatry, has really gone - that it is even a consideration to use an hallucinogen for the treatment of depression.

November 11, 2010

Bob-- Today, I saw a bright, athletic lacrosse player who is a high school sophomore. She was seeing me to follow up on a mild...
Photo of a man in a white button-down and tie, sitting at a desk in an office, with one hand on a computer keyboard and the other holding a red toy airplane

Meaningless Distractibility, or Meaningful Mind-Wandering?

What do we lose when we view boredom and curiosity as "symptoms" of ADHD? It can rob us of intuitions that crucial life changes desperately need to be made.

What We Talk About When We Talk About Bipolar Disorder

On the 6th of June 2013, ITV's This Morning hosted the News Review. One story was about the actor Stephen Fry and his recent publicity on how he has battled with his ‘bipolar’ condition and suicide attempts. While we don’t have any issue with this and the important message Mr Fry was trying to put across, we do have grave concerns over the comments made by the two guest speakers, and with what was imparted to This Morning’s vast susceptible viewing audience.

Go Figure: Murder or Accident?

While Shipman’s killing spree with opiods was unfolding, North America was sinking into a prescription opioid epidemic that now accounts for 100 deaths per day, over 30,000 per year, over half a million since the epidemic began, perhaps the single greatest cause of death in America today.

Further Evidence of the Adverse Effects of Antidepressants, and Why These Have Taken so...

When the idea that selective serotonin re-uptake inhibitors (SSRIs) might make people feel suicidal first started to be discussed, I admit I was sceptical. It didn’t seem to me the drugs had much effect at all, and I couldn’t understand how a chemical substance could produce a specific thought. Because these effects did not show up in randomised controlled trials, they were dismissed and few efforts were made to study them properly. Then some large meta-analyses started to find an association between the use of modern antidepressants and suicidal thoughts and actions, especially in children.

Why Did I Stay?

I was in psychiatric treatment for eighteen years. For eighteen years I didn’t get the help I needed. Why didn’t I leave psychiatry long before? What made me stay in something that couldn’t help me and on the contrary worsened my mental health? Why did it take so many years before I turned my back on psychiatry and looked after alternatives?

Time to ‘Drop the Disorder’

It was February 2016, the UK-EU referendum debate was beginning to warm up and my tolerance for absorbing toxic tweets and frustrating Facebook posts was dwindling fast. What then pushed me over the edge was yet another celebrity-inspired media frenzy about a psychiatric “illness.”

Raising Our Voices at TED 2013

At the end of my TED Talk one of the conference’s co-hosts came onto the stage and asked me, with a respectful interest, whether I still hear voices. For a split second I hesitated, wondering whether to play it down with an airy “oh, not all that much now.” Instead I opted for the truth: “All the time,” I said cheerfully, “In fact I heard them while I did the talk – they were reminding me what to say!”

Terry Lynch: The Doctor Who Stands for Truth

In a Sunday newspaper in 2001, Mary read an article entitled ‘The Doctor, who won’t do Drugs.' It was written to mark the publication of a new book ‘Beyond Prozac’ by Limerick-based Dr. Terry Lynch. In our co-authored book, ‘Soul Survivor - A Personal Encounter with Psychiatry’, Mary describes her first meeting with Terry. “I was so inspired and encouraged by the article and the book that I wanted to thank him personally. I managed to locate his phone number and spoke to him for the first time. I subsequently met him a number of times and the enthusiasm and sincerity of the man were like a good tonic. From the word go, he believed in me as a survivor just as much as I believed in him as a professional and above all as a good thinker, someone who didn’t take things at face value and had the courage of his convictions. He listened to me, encouraged me and his great understanding of the psychiatric system greatly helped me."

What Are We Recovering From? Making a Case for Recovery

Is “recovery” a useful concept or is it overused, co-opted or simply not an accurate way to describe the process of learning to work with and through madness and life’s challenges. Mother Bear Community Action Network explores these arguments and makes a case for recovery.

The APA’s New Image

On April 25, 2014, Jeffrey Lieberman, MD, then-President of the APA, announced that the association had engaged the services of Porter Novelli, a prestigious PR company based in Washington DC and currently operating in 60 different countries. I expressed the belief at the time that it would take a lot more than some PR embellishments to remediate the fundamental flaws in American psychiatry's concepts and practices. In the intervening year and a half, I've been watching the APA closely for any indications of fundamental change; any hint of critical self-appraisal; any suggestion of genuine reform or remediation. But I've seen nothing of this sort. It's still the same old APA, with its same old spurious diagnoses, and the same old assurances that their "treatments" are efficacious and safe, and that the great neurological insights are just around the corner.

Eugenics & the 2014 Murphy Bill

Sterilization of the “unfit” and proposals to help families with a mental health crisis may seem to be disparate topics, certainly one historically more repugnant than the other. Yet, the two “solutions” have several things in common: The absence of choice by the individual affected, the paternalistic assumption that those with power know what is needed, both serve the interests of families, caretakers, guardians, and conservators, and both proceed out of good intentions.

Dear Boston Globe, Part IV: A Taste of Your Own Medicine

The Boston Globe paints a picture (in the vivid way that they so love to do) that pins the system’s decline primarily on budgetary issues, but there is more than one way for a system to be ‘broken.’ In fact, where the Globe goes most wrong in their latest piece, ‘Community Care,’ is in their failure to adequately recognize that the system has always been broken in one way or another in this country.

Common Sense, Deferred: Lessons From the “Fresh Air” Fight, Part Two

How and why the right to fresh air is continuously blocked by money, politics and ignorance. Plus, personal reflections on how nature heals.

Dare to Dream: Remembering Dr. Martin Luther King, Jr.

Reverend Dr. Martin Luther King Jr said that “of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.” For those of us diagnosed with mental illnesses and our families and loved ones, we know all to well the effects of these inequalities from personal and first hand experiences. For those of us like me, we also know of the extreme health and mental health disparities that exist within our communities of color.
empathy or compassion

Having Empathy Doesn’t Mean That You Also Have Compassion!

There’s a very common, pop-psychology, new-age misconception that conflates being empathic with being caring and compassionate. But some of the most highly empathic people I’ve ever known have been con artists, grifters, unrepentant thieves, cynically manipulative fearmongering politicians, and heartless predators of every kind.

Me, My Brain, and Baked Beans

I’ve spent much of my professional life studying psychological aspects of mental health problems. Inevitably, this has also meant discussing the role of biology. That’s my academic day-job. But it’s not just academic for me. I’m probably not untypical of most people reading this; I can see clear examples of how my experiences may have affected my own mental health, but I can also see reasons to suspect biological, heritable, traits. As in all aspects of human behaviour, both nature and nurture are involved and they have been intimately entwined in a complex interactive dance throughout my childhood and adult life.

A Positive Understanding of How Our Minds Work

Often it is a relief to get an understanding of how we have developed a psychological problem, and it is especially good if we can feel that there is a reason for the problem that it is understandable. When I suffered from a phobia, it was a relief to understand that I probably had linked fear to an insect when I was a child. And it was even more satisfying when I understood that there was nothing wrong with my brain — that the problem was in what I had experienced. It was in my “software.”

Schizophrenia Becomes Psychosis Susceptibility Syndrome

Anoiksis (the Dutch association of and for people with a psychotic vulnerability) has introduced a new name for the disease schizophrenia: Psychosis Susceptibility Syndrome (PSS). Together with the old name, its attached prejudices, misleading significance and stigma can be thrown overboard.

“The Lion King” Psychiatrized: What If Psychiatry Had Gotten Its Hands on Simba?

It is time for a new strategy. Rather than try to get adults to question their entrenched beliefs, why not reach out directly to not-yet-fully-indoctrinated kids? This could be done by creating psychiatrized versions of their favorite films that show how ridiculous and harmful the medical model is. Scene 1: Annoyed by Simba's exuberance, Mufasa takes him to Rafiki, the monkey psychiatrist.

Your Pharmacist is Tattling On You!

A CVS pharmacy recently sent me a standardized form by fax with a dire warning about one of my patients. The form was called “MEDICATION NONADHERENCE THERAPY ADVISORY” and it said: “A review of your patient’s retail and mail prescription history indicates that the patient has not obtained his or her first refill.”

Turning Distress into Joy, Part IV:  Gratitude

John Foppes had been born with no arms, among a number of other serious congenital abnormalities.  Doctors questioned whether he would survive at all.  In his deeply motivating book, “What’s Your Excuse?  Making the Most Out of What You Have,” John describes his life of growing up with no arms into one of full independence, and his feelings of stigmatization and isolation even in the midst of support from others.  In the depths of his struggle, John also notes evident gratitude in what most perceived as a very unfair situation.