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These are not happy times for the embattled drug maker AstraZeneca.  The patent for Seroquel has expired; the company’s profits have plummeted; and its...

I have been immersed in the field of psychiatric diagnosis – and resistance to it – for more than a quarter of a century. In the late 1980s, I was a consultant to two committees appointed by DSM-IV Task Force head Allen Frances to decide what DSM-IV should contain. I resigned from those committees after two years because I was appalled by the way I saw that good scientific research was often being ignored, distorted, or lied about and the way that junk science was being used as though it were of high quality . . . if that suited the aims of those in charge.

The FDA's black box warnings on antidepressants, which incidentally were long overdue, had a negative impact on pharma-psychiatry's image, and on their business, but had no negative impact on client welfare. Nevertheless, psychiatry continues to resist the reality that their sacred drugs do in fact cause harm, and that the FDA warnings were needed. For psychiatry, business and professional status routinely trump client welfare.

As we struggle to invent a humane approach to the extreme states that get called “psychosis” or “madness” or “schizophrenia,” it may be helpful to investigate some of the better approaches developed in the past. While these approaches are not without their flaws, they are often surprisingly insightful. (It can also of course be depressing to notice how truths once more widely known were so easily “forgotten” as compassionate approaches got ditched in favor of the latest coercive innovations.)

With this second course we are focusing on the challenges that drug withdrawal presents to prescribers as more and more people seek to come off medications. As many have noted, prescribers may have extensive experience getting patients on psychiatric medications and then managing their drug use, but little or no experience helping patients taper off the drugs.

Last year I visited the United States on a Winston Churchill Travelling Fellowship to explore ‘alternative routes to mental health recovery’ and to visit a range of peer-led, alternatives to the medical model, with the aim of using the knowledge gained to help develop alternatives in the UK. Looking back, all the organisations and services I visited came about because groups of people in the US decided they wanted something different to conventional mental health services, and then decided to work to make that dream a reality.

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.

When I first heard of the proposed “Helping Families in Mental Health Crisis Act of 2013” (H.R. 3717)”, I felt relieved and thought “maybe somebody has finally got it!” However, as I read and processed the words I realized just how much Tim Murphy didn’t get it. Is this mental health system broke? Yes it is. Can it be fixed? Yes it can. But we must do it collectively and with the experience and voices of those with true lived experiences including their families and allies. I stand with millions of others who have shown through our resiliency that our movement is real, has saved lives and most of all we have people that can give voice to what really needs to be changed within the system. If only people will listen.

Dreams have fascinated people from the beginning of time. People believe dreams foretell the future; that they have psychological meanings; that we commune with spirits and the dead; that they are visitations from ancestors; that dreams make prophesies and are filled with omens and auguries. It’s always important to keep in mind that dreams, and our lives, are a human story. Our psychiatric treatments must always appreciate our stories. We do not need destructive pharmaceuticals. We need to appreciate the full scope of the human story.

Dear Bob-- A disturbing case from this week. I was working at an urgent care and saw a fifteen-year old boy for the complaint of severe...

During a recent dialogue training, Dr. Peter Rober, from Belgium, said, "listening deeply, going beyond categories, creates dialogical space in which life can come......

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.

I have recently read this book, and I think it would be extremely helpful for parents, teachers, and counselors who work with children in...

Bob-- A couple of weeks ago, I got a call from the mother of one of my teenage patients, a 14 year old Chinese-american boy...

One of the most remarkable aspects of Robert Whitaker’s (2010) outstanding book Anatomy of an Epidemic was his comparative data that contrasted outcomes for mental disorders prior to the introduction of pharmacological treatments with outcomes for mental disorders after pharmacological treatments became the main, and often only, course of action. I have asked people in workshops to estimate who might be better off – someone diagnosed with what we now call bipolar disorder prior to the introduction of lithium or someone diagnosed after lithium became a standard treatment. Almost without exception workshoppers estimate that the people diagnosed before lithium was available do much worse. Whitaker’s data indicate exactly the opposite. It’s a staggering finding.

The story starts on 19^th of March, 1986, when I withdrew myself from 30 mgs of Ativan daily and 360 mgs of Opiate painkillers daily—all doctor-prescribed—with no support or assistance, other than the love and full support of my lovely wife Sue. It took me 15 months of hell on earth to withdraw.  So afterwards I researched the issues involved (after my brain had started to function again) and started on the long road of campaigning for dedicated withdrawal services by contacting our local newspaper and telling them my story. Horrifying as the facts read, not only was it a release for me to express my emotions and observations, but it slowly informed the general public of the dangers of long-term prescribed addiction.

Within days of announcing the webinar and providing the link to register, we were deluged with enrollments. It turns out that a great many professionals, advocates and clinical managers are interested in learning about Open Dialogue and its application to an American community.

It was an awesome experience to give a TEDx Talk at my old school, because, frankly, it was an acknowledgement by an elite institution that I've done something in my life worth listening to. I hope you appreciate my talk and share it with others. So many people who are affected by the mental health system in North America today have no idea how much the rise of the DSM and biopsychiatry has to do with the Reagan era and neoliberal economic policies that reshaped the whole language and culture of mental health. It's like a bulldozed neighborhood with shiny new buildings, after a while people forget how they got there and they just seem "normal."

Many people now using psychiatric drugs have been convinced or forced to use them while being treated in the mental health system. A good number of people are eager to stop using these drugs, but are often discouraged by others from doing so. Many psychiatric survivors believe that they can never stop using these drugs because they were told they would need to use them the rest of their lives. We hope the Sunrise Center will become a catalyst for a movement of people creating places for people who want to stop using psychiatric drugs.

Dear Bob-- I have been working again, taking temporary assignments filling in for other physicians and working in urgent cares while I get my practice...

On one hand the use of prescription drugs in mental health treatment has been compared to insulin for the diabetic. You never hear about...

When a woman has a history of severe and relapsing mental illness, but is stable on her current treatment, and is planning a pregnancy or is postpartum, what is the best course of action for her and her baby?

A Note to the Reader: Thorough searches of my memory reserves have failed to provide me with a complete and detailed account of my...

I’ve been reading Dr. David Healy’s new book, Pharmageddon, and while some of it may seem like old news, I was struck by his...

Families are often very important for people encountering severe mental and emotional difficulties. But how can family members really know what is helpful, and what is likely to make things worse for the person having problems? Similarly, for those who want to help families, how can they know what will really be helpful for those families, and what will make things worse?