I Talked About Mad in America on WNYC’s The Brian Lehrer Show!
Hey I did an interview this morning on WNYC about my new book, Maps to the Other Side, and told the thousands of listeners to check out the Mad in America website if they want strong and articulate views on what's happening in the world of mental health. I have this exciting feeling that the Icarus Project underground culture is breaking up out of the pavement and crossing paths with the mainstream. Check out the interview here and tell me what you think!
January 17, 2011
Bob--
About a month ago, I started caring for a fifty-five year old Filipino woman. She speaks English well, though with a heavy accent. She...
Social Services and Psychiatry
The controversy surrounding Justina Pelletier and her family has expanded its scope in recent months, and has now become a general public scrutiny of Massachusetts’s Department of Children and Families. I think there’s a very real risk of confusing some issues here. Every state in the US has a social services department, one of whose statutory responsibilities is to investigate reports of abuse and/or neglect. The system isn’t perfect. But this I do know: the spotlight has been taken off psychiatry. This is critical, because without the “diagnosis” of somatic symptom disorder and the subsequent allegation of medical child abuse, none of what’s happened to Justina and her parents could even have gotten off the ground.
All Sorts of Realities
In previous posts in this series, I noted that the standard treatment of conditions labeled as schizophrenia (and related disorders) is to start neuroleptics early and to continue them indefinitely. This is based on the belief that untreated psychosis is bad for the brain and that relapse is much higher when the drugs are stopped than when they are continued. The rationale for this approach, and my discussion of the limitations of these assertions, were the topics of previous blogs in this series. In this final post I want to discuss how realistic this paradigm of care is.
Better Living through Chemistry?
Reading the article “Risky rise of good-grade pill” in the New York Times on Saturday once again raised the philosophical issue of how to...
Real Psychiatry and Darwinian Evolution are One and the Same: Molecular Psychiatry has Missed...
The basic principle for the development of human personality is the very same as for Darwinian evolution. In our quest to understand human biology, we have lost our way. We are looking in all the wrong places. The human organism from the beginning adapts to its salient environment. We can trace our adaptations from a zygote, to an embryo, to a fetus, to a newborn, a baby, a toddler, a child, an adolescent, all the way to adulthood. This also tells us how psychiatric problems arise, and informs us of the appropriate and effective treatment.
October 21, 2010
Bob--
I'm going to try to be quick today (unlikely), but I want to share two cases:
1) I saw a pleasant 32 year old woman...
Many Ears Make Light Listening
When we share our stories publicly, whether in speaking, writing, or another art form, we acknowledge we are part of something bigger. We are aware we aren't the only ones who have been abused or witnessed abuse, or who are scared to let go of our ancestral shame and fear. We are, rather, part of an entire generation, an entire society that is moving away from silence, blame and abuse. In sharing our stories, we instantly recover from a big hunk of loneliness, loneliness that might not be so easily resolved sitting in a room across from a professional, with a few non-offensive art pieces on the walls. We acknowledge that every single one of us who experiences physical or emotional symptoms is holding onto things for others, in our bodies, and together, word by word, we can break free.
Complexity
The movement to radically reform the modern mental health system is rooted in a desire to offer people going through emotional distress a wider variety of options for care. As a society we have largely shifted to a model of care that is limited to a select few options that primarily advocates the use of strong psychotropic drugs and simplistic diagnostic labels for complex and widely varying narratives. The stigma of going on an antidepressant has been lessened to such a degree that one out of nine people in the US now takes this class of drug. In the context of this astronomical growth in drug-based therapy, reformers are rightly calling for a dramatic reappraisal of how we are treating emotional distress.
December 22, 2010
Bob--
Many cases I have shared with you have been interactions with patients who are seeking a healthier way of dealing with mood disorders, or...
June 17, 2011
Bob--
Here is a letter that I wrote several months ago in response to an early reader of my blog here. She expressed concern about...
Better Broadband
So many treatment colleagues have shared that prior to finding an approach that really works to turn a child’s intensity to greatness, they felt no recourse other that to look for ways to moderate the accelerating poor choices that children they worked with were making. Most relevant here is, that in retrospect, they felt that it boiled down to simply being faithful to their training, which it turns out so often is a set up to fail with difficult children.
New Study on a Non-Toxic Intervention for Those at High Risk of Psychosis
A new multi-centered study was released about using cognitive therapy for young people who were seen as being at high risk of psychosis.
The article reporting the study is on the British Medical Journal website, available in full – http://www.bmj.com/content/344/bmj.e2233. It’s curious to see how it is being reported in the press.
A New Model of Service
What should the relational and emotional stance of the therapist be? Just who exactly is the therapist in relationship to the person coming to see the therapist? What is the therapist's job, exactly? What should the therapist's disposition be toward the person sitting across from them? What kinds of assumptions or presumed power come with the label therapist and are those assumptions harmful or helpful?
September 15, 2011
Dear Bob--
As I share with patients my new perspectives on the ineffectiveness and potential harm of psychotropic drugs, I have found that many, even...
The Church of GSKology, Part 2
A century ago Freud and Jung made us aware of the biases underpinning what patients say. Not everything should be accepted at face value. In particular claims of abuse may not be based on reality. We needed experts – analysts – they claimed, to tease out what is real from what is not. The Catholic Church was once intensely hostile to Freud, but when it came to child abuse adopting a Freudian approach was very convenient. But while Freud essentially denied that real abuse was taking place and got away with it in his life-time, the Catholic Church has learnt to its cost that many claims of abuse are real.
February 14, 2011
Bob--
Recently, I saw a thirty-six year-old Bulgarian man for a follow-up visit. He is my age, with three children almost exactly the same ages...
More Delays on Sandy Hook Reports
The Sandy Hook Advisory Commission (SHAC) and the State Child Advocate's office still have produced no reports, and the deadlines continually come and go, with virtually no interest on the part of Governor Malloy or Connecticut state lawmakers. What is of interest, though, is the complete run-around and disconnect by those involved in producing the reports.
The Children Lead
How is it that we allow the agendas of others to occupy our childrens’ minds? Is it possible that a stranger can know our child better than we do? Is there anything a baby needs to learn that can’t be taught by being held in a parent’s arms? Because my children’s eyes and ears and thoughts are on me every day, they are key players in my ongoing efforts to live a right life. I count on their eyes and ears and thoughts to shore me up during times of temptation. They always lead me home.
Elimination of Bias, Not Disclosure of Bias, Must be the Standard
Disclosure is an insufficient strategy for mitigating bias because bias does not result from the concealment of financial ties but from their effects. Even worse, social psychologists have demonstrated that when individuals disclose a competing interest, they give even more biased advice.
Short Notes from a Muddled Island (with apologies to Bill Bryson)
There has been quite a bit going on in the UK mental health world of late, and MiA already shares some of this in the form of open letters from Anne Cooke, et al. and Richard Bentall. Both are responses to a series of BBC programmes. In their letter Kinderman, et al. also make reference to a recently published report; The Five Year Forward View for Mental Health. This has been published by a so-called independent body; The Mental Health Taskforce to the NHS in England. Readers would find it encouraging; it refers to a need for closer attention to early intervention, to the need to address stigma, for a focus upon life’s transitions, and innovations that could support recovery, personal autonomy and well-being. What happened? Nothing!
Doctors Need Support
An old friend suggested to me that doctors need support after hearing the messages in Robert Whitaker’s book, “Anatomy of an Epidemic”. I agree....
One Year of Mad In America
In January 2012, Mad In America went live with a handful of bloggers and the mission to become a central community in the effort to rethink and transform the paradigm of psychiatric care.
I want to offer some thoughts and figures about where we've been in the past year and what we are growing into.
Then I want to ask you for money.Letters from the Front Lines
I saw a patient recently, a 35 year-old woman who needed a refill of her Zoloft. She been started on it four years prior,...