Thursday, March 21, 2019


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 the Medical Model Won’t Go Away, Part Two

The short answer is that “health” has supplanted virtue or righteousness or sanctity as our culture’s prime normative ideal in personal behavior. “Mental health” is just a subsidiary of the lust after healthiness; mental illness seems, on the face of it, simply its corollary

Announcing an International Symposium and Institute on Psychiatric Drug Risks and Withdrawal

I have given up on psychiatry as a system capable of “being there” for people who are dealing with life and death issues. Psychiatry as a system of care lacks validity. Every day — unfortunately — we learn of new examples proving this statement. But here's the good news: every day we meet people who show us that the predictions of psychiatry are not true; that there are “cures,” that it is possible to reduce or withdraw psychiatric drugs.

A Chance for Ohio

While there was much to criticize in the final report of the President’s New Freedom Commission on Mental Health, the basic observation that the...

The Hot Stove Project: Learning From People who Think Differently

People with mental disorders or differences are often experienced as “hot stoves” in society — at work, at school, at home, in friendships. In addition, providers and consumers who embrace the medical model and those who don’t are often “hot stoves” for one another. The result of arguments for and against those and other divisive perspectives is interference with empathy, understanding, creative solutions, and forward movement as a mental health community.

Vertex Pharmaceutical Executives Cash in on False Hopes

Senior executives at Vertex Pharmaceuticals made millions of dollars each by selling company stock in the days after the Cambridge-based pharmaceutical reported promising clinical...

The Pond, Learning and Humility

What an amazing ride I’ve had in the past few days on the tsunami of commentary from my previous post. While it’s been fun (dare...

Diagnosing the Diagnostic and Statistical Manual of Mental Disorders

What can we say about the DSM that hasn’t already been said? Quite a lot, actually. The manual (full title: the Diagnostic and Statistical Manual of Mental Disorders), produced by the American Psychiatric Association, is incredibly powerful. It shapes research agendas, clinical practices, social care, economic decision-making and individual experiences internationally. As Rachel Cooper notes in her excellent new book, Diagnosing the Diagnostic and Statistical Manual of Mental Disorders, changes to it impact ‘the lives of as many people as changes in the policies of most countries’ (p. 2). The DSM needs to be talked about.

Enhanced Interrogation: Is It Psychology’s Only Scandal? by Lois Holzman

A shock wave hit American psychology this past July when news surfaced in the New York Times that the American Psychological Association (APA) “engaged in activity that would constitute collusion with the Bush administration to promote, support or facilitate the use of "enhanced" interrogation techniques by the United States in the war on terror.” The APA quickly responded. At its annual convention held in Toronto the next month, the APA Council of Representatives did the right thing and voted to bar psychologists from participating in national security interrogations. There were lots of mea culpas, praise for the whistleblowers, and vows of future transparency and “never again.”

Threats, Coercion and Chemical Restraints for Distressed Children

In the face of concerns that large numbers of children were being incorrectly diagnosed with pediatric bipolar disorder, the DSM–V introduced Disruptive Mood Dysregulation Disorder (DMDD). In the scramble by drug companies to produce evidence that their drug should be prescribed to this new population of mentally ill children, the manufacturer of Risperidone paid to test their drug on a group of children. The study does not investigate whether treatment with Risperidone has any therapeutic benefit to the children, whether it cures or treats DMDD or ‘rage outbursts.’ It is quite open that Risperidone is being trialled for its efficacy as a chemical restraint.

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.

The ADHD Label and Mortality

Most people on hearing that ADHD is a "neurodevelopmental disorder" would assume that a neurological pathology is implied. But all the DSM-5 requires is that the individual be functioning below par (for any reason) in one of several areas. It doesn't take a great deal of imagination to see how individuals who are distractible and impulsive have a higher mortality rate. But people who ride motorcycles routinely also have a higher than average accident-related mortality rate. Should we therefore conclude that riding motorcycles is a "valid" illness?

Study 329: Transparency in Limbo at the British Medical Journal

While making money from the publication of pharmaceutical company trials, and in the face of a complete failure by industry to adhere to basic scientific norms and make data available, BMJ and other journals — although BMJ in particular — have run a series of articles on supposed Academic Fraud. These articles feature instances of fraud sometimes as bizarre as researcher claiming he cannot show the data as it was eaten by termites. The universal feature is that these are academic studies, and academic fraud is an issue in academia.

Psychiatry Beyond the Current Paradigm, and DSM-5

Recently, two more waves of criticism have broken onto the beach of opinion concerning mental health services and practice. Allen Frances has mourned approval of DSM-5 in his Psychology Today blog and the British Journal of Psychiatry has published a paper by members of the UK Critical Psychiatry Network. What is notable about both of these is that they give further voice to criticism of conventional mental health services by those who have spent years providing and researching them.

Oliver Sacks Helps Me Explain Hypersensitivity

In this passage Oliver Sacks writes about an altered state in which the capacity of the smell sense opens up. That is what it’s like for me all the time — hypersensitivity. I have this sort of acute capacity with all my senses all the time… it’s overwhelming, and it’s also the source of all my healing.

Reared-Apart Twin Study Mythology: The Latest Contribution (Part One)

The latest endorsement of claims from research on twins reared apart comes from cancer physician and researcher Siddhartha Mukherjee, who published an article in the May 2, 2016 edition of The New Yorker entitled “Same but Different: How Epigenetics can Blur the Line between Nature and Nurture.” Mukherjee is an influential author due to his medical credentials, accessible writing style, promotion by the mainstream media, and award-winning book. Unfortunately, Mukherjee is only one of many authoritative authors to misreport the methods and findings of human genetic research.

Neuroleptics for Children: Harvard’s Shame

Thirty years ago, the prescription of neuroleptic drugs to children under 14 years of age was almost unheard of. It was rare in adolescents, and even in adults was largely confined to individuals who had been given the label schizophrenic or bipolar. By 1993 about a quarter of 1% of the national childhood population were receiving antipsychotic prescriptions during office visits. The percentage for adolescents was about three quarters of 1%. By 2009, these figures had increased to 1.83% and 3.76% respectively. The devastating effects of these neurotoxic drugs are well known, and it is natural to wonder what forces might be driving this trend.

The Hidden Gorilla

Three weeks ago What would Batman do Now covered the issue of suicide in the military – an issue that had Batman missing in action, and...

Study 329 Continuation Phase

All the fuss about Study 329 centers on its 8-week acute phase. But this study had a 24-week Continuation Phase that has never been published. Until Now.

Is Psychiatry “Salvageable”?

A reader in the commentary here asked me if I think “psychiatry is salvageable.” This is a timely question that requires careful consideration. First, I’ll...

There Is no Shame in Being Safe

You might wonder why it’s so important to include gun stores in suicide prevention efforts. No one wants to be the one who sells someone the weapon they use to end their life. My father has experienced this once. The guilt is overwhelming. There is no shame in being safe. The shame lies in the lives that could have been saved.

On Spiritual Emergence and Other Extraordinary Experiences

In a nutshell, I switched coasts and moved from Philadelphia to attend CIIS in San Francisco, because I couldn’t tell my story. In Philly I was known for my role as Storytelling Training Trainer, in which I facilitated a workshop to help people share their stories of mental health and substance abuse recovery. But I never felt I could tell my own real story, because the culture there wouldn’t allow it. The culture allowed me to be a person diagnosed with bipolar with psychotic episodes, who was living a meaningful life, but it did not allow me to be a person who is undergoing a very profound developmental process where my psyche was perceiving and processing my universe in ways that were shifting my paradigm of the potential of what reality can be, which for me, is a very spiritual process, and my true story.

Questioning the Integrity of Psychiatry

The Royal Australian and New Zealand College of Psychiatrists claimed that “the prescription of antidepressant or antipsychotic medications is something that a psychiatrist only ever does in partnership with the patient and after due consideration of the risks and benefits.” How could a responsible professional body make an assertion so patently wrong?

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.

“Mental Disorders in the Classical World” (A Review)

The current view of mental illness and its accessory idea, mental health, were born of the Enlightenment. Formerly, spiritual ailments had been considered sins or heresies. They were allegedly produced by the diabolical interventions of witches, Satan, and/or Jews, and confessors relied on prayer or holy water to remedy the soul. With the decline of Christianity in Europe, those ailments were reinterpreted in secular (mechanistic, atomistic, materialist) terms that reduced the self to its molecular substructure. The mind became equated with the brain, and remedies naturally became mechanical or chemical—insulin shock, lobotomy, electroshock, surgery, and drugs.

Boycott The DSM-5: Anachronistic Before Its Time

When plans for the DSM-5 were first announced about ten years ago, most folks’ reaction was “Why?”. Many of us asked that same question several times as the publication date for the new tome kept on getting pushed back. Finally, the curtain enshrouding the DSM-5 Task Force and its several committees began to part and proposed revisions/additions began to appear on its website. To our dismay, we found our question answered.

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