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).

Anti-Psychiatry

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From time to time, I find myself feeling the urge to articulate my views and delineate them from people with whom I may be identified. Rightly or wrongly, I feel that way with this website. Although the goal is to have wide ranging goals there is nevertheless a distinct perspective represented here. I feel the urge to articulate where I part ways with some of the views expressed here. I do this in the spirit of discourse. I am not certain I am correct. I may someday change my mind. I am just expressing my perspective.

Medicalizing Poverty

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In his Alternatives Conference 2012 Address, Will Hall called attention to the ongoing phenomena of “medicalizing poverty and calling it mental illness.” Mental health systems and practitioners often tend to perceive and identify the myriad ways that impoverished people cope and adapt to adverse environments (such as food and housing insecurity) as pathological indicators of mental illness. A poor child who does not pay attention to the day’s lessons at school may be diagnosed with ADHD, yet focuses intense attention on how he will return home safely, take care of his siblings and get a meal. A young woman may be labeled as Oppositional/Defiant who bravely copes with an erratic mother and her abusive boyfriend. Behaviors that can make sense in one context (home, neighborhood), are flagged as dysfunctional and impaired in another (school & work).

The Logic of the ADHD Diagnosis

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When constructing the ADHD diagnosis, progenitors essentially say, "Let's study a group of people who do particular hyperactive, impulsive, and distracted behaviors that are associated with chronic and pervasive problems in school, social life, and work. If the person is an adult, the problems must be present in childhood and show consistency throughout development. We will call this group "ADHD" and study correlated biological characteristics and other associated difficulties. We will continue to tweak the criteria so that the diagnostic net falls on the people with the correlated dysfunctions and patterns of biology that we find in our research.

Code Black: When Time Doesn’t Heal

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In the world of emergency medicine time is a critical resource. But Ryan McGarry, ER physician and stage IV lymphoma survivor, understands at the bone that idle minutes mean something very different to a patient. He recalls “waiting on news if the therapy is working . . . is there more disease that we didn’t know about, is it getting bigger . . . the clock was torture, watching that dial go around is torture.” McGarry horridly remembers what it’s like to wait on a simple, overdue dose of anti-nausea medication. He reflects, “You’re clearly at an advantage as a physician or provider at any level if you’ve been a patient. It’s just an unbeatable perspective.”

Is Psychiatry the Tea Party of Medical Science?

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When I as a European follow American politics I can’t help being amazed by the  - I believe a polite expression would be – colorful personalities in the Tea Party and how they manage to continue to be a powerful part of American politics despite making claims that as I see them reported are easily debunked. American politics does not affect me directly but when I compare psychiatry as a part of the medical science to the Tea Party there are some striking similarities.

Simon Says:  Happiness Won’t Cure Mental Illness

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How do we distinguish between ordinary feeling down, on the one hand, and depression-the-illness on the other. Psychiatry's answer is that depression-the-illness causes " . . . clinically significant distress or impairment in social, occupational, or other important areas of functioning." This phrase occurs as a criterion feature in almost all psychiatric "diagnoses," and is embodied in the DSM definition of a mental disorder, but is unsatisfactory from a number of aspects. Firstly, the term "clinically" has no meaning, other than a thinly-veiled attempt to lend a medical flavor to the phrase. Secondly, the term "significant" is not defined, and inevitably rests on the subjective opinion of a psychiatrist, who, in many cases, has a vested interesting in "finding" a "diagnosis."

Prescription Privileges for Psychologists: Is Our Consent Fully Informed?

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This past June, Illinois became the 3rd state to allow psychologists to prescribe medications commonly used for psychiatric issues, after New Mexico and Louisiana have enacted similar laws.  When it comes to gambles for our profession, and frankly for the general public, it doesn’t really get much bigger than this. The following list provides a brief overview of some of the most serious issues that face this discussion, both for psychologists and the general public.

On Waking Up From the “American Dream”

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I grew up in an environment that taught me my worth as a person was directly tied to my grades, my athletic performance, my list of extra-curricular activities, and my SAT scores. That if I wasn’t the best, I was the worst. That if I wasn’t perfect, I was a failure. At thirteen and in all my psychiatrized years to follow, I never had the chance to step back and process what this all meant, and whether these were values I wanted to hold onto, and I continued through high school and on to Harvard in this existential limbo, simply because I saw no other way.

Healing from an Addiction to Patterned Ways of Thinking

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I had a soul-redemptive heart-to-heart reunion with a woman I had known from a distance but whom now (after our hours long coeur-a-coeur/heart-to-heart) I consider a close friend. I shared with her some very exciting and some challenging circumstances I have been experiencing of late. After I shared and shed a few tears she told me a story from her life that also poses, like my story, an invitation for profound change in our lives.

An Anti-Violence Mental Health Plan

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It seems almost every week now that we hear of a mass murder/shooting in the media. By now the pattern is too familiar to be as frightening as it once was. The response has also become reflexive: Guns should be made less available, especially to people with mental illnesses, and potentially dangerous people should be treated for their mental illnesses − involuntarily if necessary − so they can live safely in our community. Yet, nothing much changes, outraging the next set of victim’s families and communities.

Playing the Odds, Revisited

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It is hard to believe that a year has gone past since I posted Playing the Odds: Antidepressant Withdrawal and the Problem of Informed Consent. The feedback I received underscored the more controversial aspects of SSRI toxicity.  Common themes concerned the abrupt onset of new symptoms 3 to 12 months after stopping the drug, reinstatement of the drug failing to help withdrawal related symptoms, the possibility that withdrawal-related symptoms can persist indefinitely and concerns about using benzodiazepines to help with tardive akathisia.

The Use of Neuroleptic Drugs As Chemical Restraints

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On July 17, I wrote a post on the use of neuroleptic drugs as chemical restraints in nursing homes.  The article generated some comments, one of which touched on some very fundamental issues which, in my view, warrant further discussion. The comment read as follows: "All drugs can be dangerous toxic chemicals when not used appropriately. While many valid points are made in this article, it’s very one-sided and could be considered biased in that it’s written by a psychologist. I’ve seen many patients and families benefit from their use."

Illegal-Psychiatric Drug Hypocrisy, & Why Michael Pollan is Smarter than Me

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Before Michael Pollan gained well-deserved respect and influence authoring five bestselling books about food, he got my attention in the late 1990s writing about American illegal-legal psychotropic drug hypocrisy. Then he stopped writing about it. If he had continued his assault on American drug hypocrisy, he likely would have been attacked by many psychiatric drug users, mistaking his confronting this hypocrisy as challenging their decision to choose psychiatric drugs.

How Can Professionals Learn to Reduce Fears of Psychotic Experiences Rather Than Emphasize Pathology?

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The kinds of experiences we call psychotic are often incredibly scary: people feel they are being persecuted by strange forces, or that their brains have been invaded by demons or riddled with implants from the CIA . . . the list of possible fears is endless, and often horrifying. While standard mental health approaches counter many of these fears, they often create new fears of a different variety.   Wouldn’t it be helpful if professionals were trained in an approach that could help people shift away from both dangerous psychotic ways of thinking and also away from the sometimes equally terrifying explanations which emphasize pathology?

Los Angeles Increases Outpatient Involuntary Treatment in Spite of UN Declaring Force “Torture”

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Even as we have access to more and more information linking that which gets labeled mental illness to trauma — treatment that exacerbates the trauma response continues to gain legal traction all over the country. This, of course, leads to the epidemic of harm and iatrogenic illness we’re watching happen. (See: Anatomy of an Epidemic.)

Consent and Psychiatry: Problematizing the Problematic 

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It is rare to get involved in a dialogue over psychiatry without sooner or later someone defending the use of such “treatments” as ECT “as long as they are consented to,” with the term “informed consent” periodically employed. Herein lies the context for this piece. The issue that I want to probe, to be clear, is not whether force should be used—for of course it shouldn’t—but the thorny issue of consent itself—what exactly constitutes consent and what other issues besides consent are critical to factor in when considering what it is and is not legitimate for a “medical” professional to offer.

Suicide: A Permanent Solution to a Temporary Problem

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Many people who have never been severely depressed might ask, “Why would anybody want to kill themselves?” After all, taking one’s life goes directly against the survival instinct that nature has programmed us with. For example, if you were walking across the street and saw a car coming towards you − your first instinct would be to jump out of its path. Yet, when the brain becomes overwhelmed with chronic, intense pain that seems to have no end, then suicide becomes not only a rational choice, but a compelling option. After all, if you are faced with the prospect of being in eternal hell, then taking your own life seems like an act of self-love, not an act of self-detruction.

Changing the Role of Case Management

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When I became a case manager at a community mental health agency in Cincinnati, Ohio, I had a bachelor’s degree in journalism, 11 months of experience working in the advertising world, and 10 months of serving with AmeriCorps under my belt. I was not the most qualified person for the position, but I was hungry for experience in the mental health field, and I was determined to be good at the job. My supervisor said he hired me because he knew I had the interpersonal skills to do the work, and that he could teach me the rest. Two of the main axioms I learned as a case manager were that mental illnesses are due to chemical imbalances, and psychotropic medications are the solution. As a result, I spent an abundance of energy negotiating with my clients to take their meds or try new ones that the pharma reps encouraged us to promote.

The Use of Neuroleptic Drugs As Chemical Restraints in Nursing Homes

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There's an interesting article in the July-August 2014 issue of the AARP Bulletin.  It's called Drug Abuse: Antipsychotics in Nursing Homes, and was written by Jan Goodwin.  AARP is the American Association of Retired Persons.   Jan Goodwin is an investigative journalist whose career, according to Wikipedia, ". . . has been committed to focusing attention on social justice and human rights…" The article is essentially a condemnation of the widespread and long-standing practice of using neuroleptic drugs to suppress "difficult" behavior in nursing home residents.

What Is Biological Psychiatry? Pt. 3: Thoughts on Hastening Its Demise

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In Part 1 of this blog I attempted to summarize and define the evolution of psychiatry into its present day incarnation of Biological Psychiatry. In Part 2, I focused on analyzing the anatomy of its enormous power and control within our present day society. Given the difficult circumstances we now face in confronting such powerful institutions, I still believe there are many opportunities to expand our struggle and grow our movement. History has taught us that “where there is oppression there will always be resistance.” With each person and family abused by this system, combined with every lie the system tells us, there is a constant regeneration of favorable conditions to expose them and gather allies.

Doctor Munchausen, I Presume!

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In 2000 when I gave a lecture on "Psychopharmacology and the Government of the Self" at the invitation of the University of Toronto, I ran into a problem.  In the public domain our shared difficulties were because of this lecture.  In fact, the difficulties stemmed from a member of the Establishment – Charlie Nemeroff – who put the frighteners on the U of T about hiring Healy. 'The psychopharmacology establishment in the face of adverse effects from drugs' is the same as 'the medical establishment in the face of treatment-related adverse effects' is the same as 'the British establishment in the face of allegations of paedophilia and child abuse' is the same as 'the Vatican in the face of allegations of abuse.' It’s about power.  We have it – you don’t.  Get lost.

Some Thoughts on Insanity Defense

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I am not comfortable with an all-or-nothing insanity defense that is both legally and socially stigmatizing because it sets the person apart as someone who is legally determined to be incapable of being treated as a moral agent. This stigma spills over onto all people who are psychiatrized, and it is part of the conception of madness that also ends up serving as a justification for civil commitment, since we are perceived (incorrectly) as outside the reach of ordinary law.

On Fighting Institutional Psychiatry With the “Attrition Model”

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In a recently released article I provided an overview of antipsychiatry, teasing out its features and both its overlaps with and differences from related movements and constituencies (Burstow, 2014). Necessarily, the commitment to psychiatry abolition emerged as definitional as well as pivotal. In this article, I will be attempting to shed further light by clarifying and probing a particular model of psychiatry abolition. The question being addressed here is: Okay, so you know what you want—but just how do you go about figuring out what to do? A question that has been plaguing the movement for some time.

SELF: Sharing Experience Lived Firsthand

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Service users and survivors who work in a behavioral health settings are faced with important questions about whether or not to share their lived experience and when. We may ask ourselves: Am I ready? What about the risks and politics of disclosure? How do I address an associated expectation or barrier, or deal with the possibility of discrimination? What kind of support is available to me in the process? I’m pleased to announce Sharing Experience Lived Firsthand (SELF).

Connecticut State in Mental Health Denial

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The recent July 9th Ct. Mirror article, Children Stuck in Crisis, accomplishes the intended purpose of deceptively convincing the people of Connecticut that there’s a severe mental health services crisis in the state. On the surface, the article’s author provides a compelling scenario of the state’s youth failing to get the needed mental health care and forced to rely on emergency room services. The problem with the presentation is the failure to address a key piece of information in the reported mental-health-crisis-puzzle – the increased psychiatric drugging of Connecticut’s children.