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On April 24, I had the pleasure of attending the conference “New Directions & New Hopes Call for New Practices in Clinical Psychiatry.” Jointly sponsored by the Yale Program for Recovery and Community Health, the Foundation for Excellence in Mental Health Care and the Connecticut Department of Mental Health and Addiction Services, this was a rich experience.

Why did I read Jeffrey A. Lieberman’s new book, “Shrinks: The Untold Story of Psychiatry”? Frankly, I have been befuddled by my profession. I am a psychiatrist — Board Certified, as they say, these past 37 years – for a long time. So finally, I thought, if I read this book, the pieces of the story would fall into place, right? Indeed, I was astonished!

The person living on the streets with whom no one will make eye contact, or who the police hassle for requesting spare change from passersby. The individual who has learned to cut themselves to manage emotional pain, and so is punished by emergency room staff who sew them up without anesthetic (both physical and emotional pain disregarded), or confuse their efforts for suicide and contain them against their will. The person of color who some might cross the street to avoid, or who is arrested for lashing out when another is murdered at the hands of those employed to ‘serve and protect.’ Each is only looking for a way to survive, but instead finds themselves ignored or blamed.

I think about a healthy early infancy, about reaching out and being gently held and about the attachment bond that nourishes the mind, body and spirit as I watch the inmate sitting at the table in SuperMax, where the inmates are in isolation due to their high profile status or history of repeated violence inside the jail. I will not touch him and he will not reach out to me. He is a 3rd strike inmate, sentenced to 25 years to life, housed in SuperMax jail while he awaits his last appeal.

An RCT is simply a research tool and, as a tool, it can be used in a variety of ways. Unfortunately, the idea of a hierarchy of evidence seems to be hypnotically seductive for many people and powerfully useful for the drug companies. In order to get a drug to market, regulators in the US such as the Food and Drug Administration (FDA) and also in Europe, only require the drug companies to produce two RCTs with statistically significant positive results. Perhaps this very low standard has contributed to the fact that RCTs can be much more useful as marketing tools for drug companies than for discovering new and useful ways for people to live healthy and meaningful lives.

In a well-researched, comprehensive article in today's Huffington Post Art Levine has brought to the attention of the mainstream media the government's complicity in the illegal psychiatric drugging of poor children, especially foster children, through Medicaid.  The article, Feds Pay for Drug Fraud: 92 Percent of Foster Care, Poor Kids Prescribed Antipsychotics Get Them for Unaccepted Uses is the only mainstream article I know about that has really pressed the federal government over its refusal to enforce Medicaid's coverage restrictions to "medically accepted indications."

I am a survivor of forced psychiatry, and I bring this perspective with me as a human rights lawyer. People with disabilities have a right to be as we are and not to have our bodies and minds made over to suit other people. We alone have the right to decide whether a medical treatment will support who we are or detract from who we are, and that is why free and informed consent is the essential requirement.

The BMJ article on The Marketing of Serotonin has stirred some interest. There are some  highly technical comments on the BMJ site but of course the key point behind the piece is the rather obvious fact that twenty-five years ago many people were saying it was all a myth. The extraordinary Michael Leunig nailed it twenty years ago in the sketch above. (Leunig is wonderful across the board and razor sharp on medicine and mental health).

Mental illness, as the eminent historian of psychiatry Michael MacDonald once aptly remarked, “is the most solitary of afflictions to the people who experience it; but it is the most social of maladies to those who observe its effects.” If psychiatry has typically, though far from always, focused on the individual who suffers from various forms of mental disorder, for the sociologist it is - naturally - the social aspects and implications of mental disturbance for the individual, for his or her immediate interactional circle, for the surrounding community, and for society as a whole, that have been the primary intellectual puzzles that have drawn attention.

The Hearing Voices Network is spreading in the United States… but not fast enough for my tastes. (The inactivity demanded by patience takes a ridiculous amount of energy to sustain.) In spite of being one of the more groundbreaking efforts to take hold in our country in the last several years, it’s still most often relegated to ‘balcony seating’ at public events and referenced only as an afterthought or honorable mention. (Never mind all the people in the mental health system who are left without options in the interim.)

The promotion of the chemical imbalance theory did occur, and continues to occur, and is a most shameful chapter in psychiatry's history.  It is arguably one of the most destructive, far-reaching, and profitable hoaxes in history. I could not begin to estimate the number of clients I've talked to over the years who told me that their psychiatrists had told them they had a chemical imbalance in their brains, and that they needed to take the pills for life to correct this imbalance. Even today, I regularly receive emails from readers contesting the assertions in my posts and telling me in no uncertain terms that they have chemical imbalances in their brains that cause their problems.

On a national Canadian radio show on Sunday (April 26), former APA president Jeffrey Lieberman called me a "menace to society" for my writings on the long-term effects of psychiatric medications (and other writings.) He said there was abundant evidence that psychiatric medications improved long-term outcomes for various psychiatric disorders. And so now we would like to issue a challenge: Dr. Lieberman, please point out these studies for us.

There seems to be no end to illogical and even comical “findings” from MZ-DZ twin method comparisons, where the original twin researchers argue that the greater behavioral resemblance of reared-together MZ (monozygotic, identical) versus same-sex DZ (dizygotic, fraternal) twin pairs demonstrates the “heritability” of the behavioral characteristic in question. Among these we find a twin study whose authors concluded in favor of a genetic basis for being a “born again Christian” (65% heritability), another that found important genetic influences on tea and coffee drinking preferences, and still another that found that the heritability of “loneliness in adults” is 48%.

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.

Creeping from the shadows, emerging from the glen, is a cry for an existence much better than the one we’re living in. It is clear that drugs are becoming our crutch, an excuse to avoid experiencing the trials and tribulations as such. So below is an entreaty to return to simplicity, one in which much of what we need is available so readily.

Our success as a movement depends on our ability to sway the general public—and if the mainstream press and media never afford our books their due—not even the blatantly cutting edge ones (and if anything, these are treated worse) and the general public, as a consequence, remains largely unaware of their existence, the likelihood of succeeding in our primary mission(s) is substantially reduced.

A recent article on the website i09 titled, ‘The Most popular Antidepressants are Based on an Outdated Theory” has again raised the issue of Chemical Imbalances.  It is interesting that the author of the  i09 piece cites Dr. Peter Kramer and states, “Some psychiatrists vehemently disagree with the way journalists and other psychiatrists have pushed back against the chemical imbalance theory….” In both cases he cited what he considered the best evidence in support of the theory, but he did not discuss the research in any depth. Back in 2008, we took an in-depth look at the evidence that Dr. Kramer used to support the chemical imbalance theory. When one takes a closer look at that research we do not think it supports the theory. For this reason, we are reposting our 2008 essay about this.

The serotonin reuptake inhibiting (SSRI) group of drugs came on stream in the late 1980s, nearly two decades after first being mooted. The delay centred on finding an indication. They did not have hoped-for lucrative antihypertensive or antiobesity profiles. Even though a 1960s idea that serotonin concentrations might be lowered in depression had been rejected, drug companies marketed SSRIs for depression even though they were weaker than older tricyclic antidepressants. They sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety. The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance.

On April 5, Allen Frances MD, published an article on the Huffington Post blog.  The title is Can We Replace Misleading Terms Like 'Mental Illness,' 'Patient,' and 'Schizophrenia'.  It's an interesting piece, and it raises some fundamental issues. Dr. Frances' position in this and other recent papers appears to be that in general, psychiatric "diagnoses" and "treatment" are OK, but that they are being overused by unscrupulous practitioners with the encouragement of pharma, and perhaps other monied interests. But the central issue is the spurious medicalization of non-medical problems in the first place.

Dear Colin Powell: You shared that your wife was diagnosed by a psychiatrist as having a ‘chemical imbalance.’ You said she was, as a result, put on psychotropics and found success after doing so. I’m not going to attempt to take that away from her, but whereas so many issues encompass shades of gray, the chemical imbalance theory does not. The chemical imbalance theory is not just unproven; It is debunked. But you need not take my word for it.

I think I have underestimated just how hard it can be for people to approach mental health problems from a psychological and social perspective. The longer I work with people who are experiencing severe psychological distress, the more they teach me about the difficulties involved in breaking away from an “illness” mindset. Medications, by and large, are still the mainstay of helping people with psychological troubles despite an increasingly widespread acceptance that psychological problems are not medical problems. Mental illness is an “illness” only in the same way that love-sickness is an illness.

The impact of long-term SSRIs on memory-related nerve cell receptors does have functional consequences. Research shows that SSRIs impair the acquisition of fear memories. (Perhaps a positive outcome.) But unlearning fear memories involves new learning as well, and according to a study by LeDoux and colleagues, long-term exposure to SSRIs makes it harder to unlearn fear memories.

Within the communities that surround Mad in America one is likely to hear reference to "the movement." The basic meaning of this phrase seems clear enough. The movement broadly refers to the groups of people actively rethinking the mental health system, and the treatment of persons labeled as mentally ill, in the United States and abroad. Upon further inspection, however, we realize that there is no centralized ethos uniting these groups. There may be consensus that the current mental health models are troublesome, but within each subset of ‘the movement’ there are many different perspectives about such troubles' causes and solutions.

Much of what we term “madness” is, in fact, the awakening of the "Self" to its own Wholeness/Divinity. We are born totally pure. Throughout our lives we are subject to projections, flung at us from a multitude of directions: from Mom and Dad, from schools, religious institutions, the media, and the medical model. We are all buried, to some degree, under projections, and interesting symptoms emerge: nightmares, stress and anxiety, fear, flashbacks, and so on. These are not "Madness," but symptoms of health; of a "Self" attempting to break free from lies.

I felt persecuted from the moment I was given a psychosomatic label. I found myself hostage to a diagnosis that I hadn’t even known existed: “conversion disorder.” Even though the diagnosis was hidden deep within my medical file under piles of negative test results, it seemed to reveal itself at each new doctors appointment or ER visit. This diagnostic code was now part of me as if it were a scarlet letter on my forehead.