Blogs

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).

Who Is Isaiah Rider???

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Our children are not safe. Not because of terrorists, but because it is becoming dangerous to advocate for their medical care without fear of losing them. A new charge, "Medical Child Abuse,” is now used by hospitals to remove inconvenient parents from the role of advocating for their children.

From Burning Man to Bellevue Hospital

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Every year around this time my thoughts turn to my friends participating in Burning Man. Burning Man is founded on these 10 principles. Stories I have heard over the years have often made me wonder when and how society condones public displays of madness. Stories from burners have often reminded me of some of my own emotional crises, and I wonder about expeditioning to places where what would be called madness by a psychiatrist may be completely normal, acceptable, and encouraged.

The Law’s Flaw

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Tom Burns, M.D., Psychiatrist and Professor of Social Psychiatry at Oxford, recently said of Assisted Outpatient Treatment (AOT) that “compulsion added to otherwise decent care makes no difference.” This was no easy conclusion for Burns, who for twenty years “argued ardently” for Community Treatment Orders (CTO’s), which are described as the British version of California’s newly passed AOT laws. "I worked for more than 20 years to get the CTO law passed," he said. "I thought such laws were going to make a difference, but they don't."

Dr. Pies Still Spinning

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Racially motivated invective and abuse are directed against people purely and simply on the basis of their skin color. Anti-psychiatry invective and abuse, however, are based on the activities of psychiatrists. For the past several decades, psychiatrists have been telling their clients, and the general public, and journalists, that virtually all significant problems of thinking, feeling, and/or behaving are caused by chemical imbalances in the brain. They have stated clearly and unambiguously that these putative imbalances constitute "real illnesses, just like diabetes," and that the imbalances are corrected by psychiatric drugs. So when we mental illness "deniers" point out that the various problems of thinking, feeling, and/or behaving listed in the DSM are not real illnesses, we are actually using the term illness in the same sense as is entailed in psychiatry's scandalously deceptive assertion.

Patient Centred-Care Doesn’t Go Far Enough: We Need Patient-Perspective Care

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A growing appreciation of the importance of involving people in their own health care has seen the development of initiatives such as “patient-centred care.” Patient-centred care has been defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.” While this definition seems reasonable enough, it appears to be very difficult to translate into practice; particularly in the area of mental health.

Creating Alternatives to the Medical Model

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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.

On Spiritual Emergence and Other Extraordinary Experiences

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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.

Believe it or not . . .

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Driving to work in my car this morning I was struck by a sudden thought; the problem with mental illness is not that people have it but it’s that they BELIEVE they do.

Forced Treatment Ineffective: Advocacy Essential

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Most Americans would agree that we have problem with mental health in this country, but what many do not know when they consider that people who are in distress are not getting the help they need is that hospitals in this country are not giving people a choice when they are in the most need. This is based on laws that currently exist in 45 US States, which allow individuals to be petitioned into an inpatient psychiatric unit against their will if they are deemed to be a “danger to themselves or others.” I have worked for 3.5 years as a Peer Support Specialist within my local public mental health system, where I see this happen to the individuals I serve, on a regular basis. I myself have been forced.

If Not Meds, Then WHAT?

A great deal of the information published on MadInAmerica is devoted to this very important question, so many constructive ideas are often presented. We think that nutrition and diet should always be part of the conversation.

Hope for Everyone

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I am a very optimistic psychologist, but with reason. For 25 years I've been working with people who have had psychological problems in every conceivable area. Many psychologists have problems with burnout, especially early in their careers. For me, this has been very different. By using the treatment techniques that I do, I feel anti-burned out. It is so gratifying to see people get out of their serious problems, that I look forward to every day of clinical work.

Do We Need More Hospital Beds?

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In an article published by the Treatment Advocacy Center, The Shortage of Public Hospital Beds for Mentally Ill Persons, the authors (D. J. Jaffe and E. Fuller Torrey) present the idea that we have far too few hospital beds in this country, and because of that there has been a dramatic shift towards the diversion of people labeled with mental illness into prisons and homelessness. Their answer to this issue is that we should radically increase the amount of hospital beds and we should also dramatically increase our reliance on outpatient treatment in the form of mandated involuntary medication programs. As many people know here, the TAC has been highly influential politically and the authors of this paper have been instrumental in getting laws passed that mandate the outpatient use of psychiatric drugs for people who have been civilly committed.

How Reliable is the DSM-5?

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More than a year on from the release of DSM-5, a Medscape survey found that just under half of clinicians had switched to using the new manual. Most non-users cited practical reasons, typically explaining that the health care system where they work has not yet changed over to the DSM-5. Many, however, said that they had concerns about the reliability of the DSM, which at least partially accounted for their non-use. Throughout the controversies that surrounded the development and launch of the DSM-5 reliability has been a contested issue: the APA has insisted that the DSM-5 is very reliable, others have expressed doubts. Here I reconsider the issues: What is reliability? Does it matter? What did the DSM-5 field trials show?

Peer Support in Mental Health: Exploitive, Transformative, or Both?

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The first time I tried to write about peer support—that emerging form of “service delivery” in which one person in recovery from what is described in the field as a “serious mental illness” offers support to another person who is in distress or struggling with a mental health condition—was in 1994. The manuscript was summarily rejected from an academic journal as representing what one of the reviewers described as “unsubstantiated rot.” That same article was eventually published 5 years later, and used by the President’s New Freedom Commission on Mental Health to support its recommendation that peer supports be implemented across the country. Now, more than a decade later and as peer support arrives at something of a crossroads, both of these reactions remain instructive.

A Critique of Genetic Research on Schizophrenia – Expensive Castles in the Air

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In the light of the much trumpeted claims that recent research has identified genes for schizophrenia, it is important to review the track record of this type of endeavor. Despite thousands of studies costing millions of dollars, and endless predictions that the genetics of schizophrenia would shortly be revealed, the field has so far failed to identify any genes that substantially increase the risk of developing schizophrenia.

Does Long-Term Use of “Antipsychotic” Drugs Result in More Disability, and More Psychosis?

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This sounds like a weird question – everyone knows that psychosis is often very disabling, and antipsychotic drugs are widely recognized for their effects in reducing psychosis in at least most people, and most often taking effect in just a few days. And when people become psychotic again, it’s often understood that it’s because they “weren’t taking their meds.” But what if it’s trickier than that? What if “antipsychotic” drugs make things better in the short term, but make long term problems worse? How would we even know?

Stranger

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I am quarantined in Stabilization. In front of me an old woman with cherry lipstick and a clipboard asks questions about sexual abuse, but my mind is through the square window on the door behind her. In that room I see a steel bed surrounded by emptiness. On top of it lay leather straps that are uneven in width where they’re wearing thin. Each strap has a set of holes to fasten the buckles tight, and I can see quite clearly that the ones nearest the end are circles while the ones furthest away have stretched into ovals. Tonight will be a Haldol night.

Autism, Antidepressants, and Pregnancy: The Basics

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This month, the seventh study and eighth study came out on the topic of antidepressant exposure during pregnancy and autism.  And these studies showed, as essentially all of the others have, that antidepressant use during pregnancy (principally with selective serotonin reuptake inhibitors or SSRIs) is associated with autism in the exposed children. With so many children being diagnosed with autism and so many women taking antidepressants during pregnancy, everyone wants to know: are these things (the antidepressants) associated with autism or not?  Quite frankly no one has the time to read through all eight scientific papers (and dozens more animal and basic science studies) to understand this important area, so I will do my best to briefly summarize it here.

Positive Explanations for Psychological Problems

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I am a clinical psychologist working in an anxiety and OCD Clinic at the University of Oslo, Norway. In this clinic we do almost all the treatment without starting drugs, and for many patients we help them taper the drugs. One of the reasons for this is that taking drugs for psychological problems often may be seen as avoidance behavior, and this is exactly what maintains the anxiety, or in many cases makes it worse.

The Lessons of Ancient Philosophy

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As Michael Fontaine's recent piece illustrates, history has a great deal to teach us about the nature of this complex thing called madness and how we, as a society, might respond to it better. It is not only fascinating to know that modern debates about the nature of ‘mental illness’ are reflected in ancient teachings, we can learn much from seeing the issues aired in a radically different social and historical context.

On Religious and Psychiatric Atheism: The Success of Epicurus, the Failure of Thomas Szasz

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When the American psychiatrist Thomas Szasz killed himself a year and a half ago at the age of 92, I thought there would be a global outpouring in psychiatric circles of sympathy or scorn. Instead, his death was largely met with silence, a silence as deafening as the one that attended the second half of his long, prolific, and polemical career. Szasz’ name didn’t show up at all in the APA program last year, and this presentation of mine is apparently the only one to mention him this year. This silent treatment has, ironically enough, and surely against his will, forced him to fulfill the ancient Epicurean ambition to live and die unnoticed.

Embodying Peace in Times of War

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No culture or community or individual escapes the damage caused by war. War is the ultimate betrayal of humanity. It occurs when we have so completely lost our way and we cling desperately to concepts such as possessiveness, power and separation. Yet, psychiatry has declared war on big emotions; those very human experiences that help us find our way in times of difficulty. Big emotions are the heart’s way of calling out for support when we need someone’s good attention and thoughtfulness to help us get back to ourselves- to find our equilibrium.

Turning Distress into Joy, Part II:  Channeling

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Shane Neimeyer had just tried to hang himself. It, too, had failed. Like much of his life to that point, which had been spent in and out of state custody since his adolescent years, his road had hit a dead end. But in the depths of his despair, thoughts of a different kind surfaced, with one idea in mind: Ironman. Sitting in his straight jacket, awaiting sentencing as a homeless heroin addict, he had turned the pages of an endurance magazine to pass the time. As he began to read more about triathlons, there was something about the discipline, the drive, the pursuit of a difficult goal, which began to consume him. The thought entered his mind. Maybe he could be one of them. Maybe his life could change forever.

My Top 11 Ways to Reunite for a Mental Health Revolution!

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My very good friend Marcia Meyers of Portland, Oregon is one of the most powerful leaders I have seen in my nearly 40 years of activism in the little-known movement for deep change in the mental health industry. She joined my amazing wife Debra, some friends and me for a backyard party at our Eugene home this summer and brought to my attention an issue that deserves a larger audience. Marcia’s story riveted me because it involves activism, madness, psychiatric torture of her beloved daughter, Unitarianism, secret poisoned-pen letters, Scientology and global warming!

It Gets Better: Living Well While Being Sick

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The IT GETS BETTER collection (on Beyond Meds) is intended to help those who are currently dealing with the iatrogenic (medically caused) injury from psych meds. The intention is folks who are still suffering really badly might know that we can heal. The series will continue weekly for some time.