Profiles in Creative Maladjustment: AL GALVES
My path to becoming an activist began at a young age. My parents were both visionaries in their own ways. They both saw the possibility of creating a world in which all people would be able to live satisfying lives. They both were strong supporters of the Civil Rights Movement.
Where Do Messages of Hopelessness in Mental Health Care Come From?
The vast disconnect between prognosis (as predicted by mental health providers) and actual outcome (as reported by psychiatric survivors) forces us to ask the question: Why send messages of hopelessness when they are so often untrue?
Voices, Then & Now
As we approach world hearing voices day 2013 Karen and I are in Canada. We have just enjoyed running a preconference workshop for about 100 people in Winnipeg. I am sitting in my room before breakfast writing this piece and as I sit I am thinking back twenty-three years ago; I am in a psych unit in Manchester and I have a new support worker called Lindsay. By then I had been a psych patient for almost ten years and was fast approaching spending the rest of my life in the system. My support worker had convinced me to go to a new group that was starting in Manchester called a hearing voices group.
David W. Oaks’ Statement of Support for Protest of 2014 American Psychiatric Association Meeting
Thanks for everyone who supports the peaceful protest of the American Psychiatric Association Annual Meeting in New York City on May 4, 2014. There are too many wonderful people to mention here! Thanks to the millions of people all over the world who want real change in the mental health system.
Are We Discovering More ADHD?
This is an important issue. According to Centers for Disease Control and Prevention (CDC), the percentage of children with an ADHD diagnosis continues to increase, from 7.8% in 2003 to 9.5% in 2007 and to 11.0% in 2011. The CDC also notes that the base rates for ADHD varies substantially by state ranging from a low of 4.2% in Nevada to a high of 14.8% in Kentucky.
The United States of the Biomedical Model: Five Anecdotes
It is difficult to overstate the ubiquity and influence of the biomedical model that provides the foundation for psychiatric diagnosis and treatment in the United States. As a clinical psychologist who has spent the past 15 years working in medical centers, inpatient psychiatric hospitals, outpatient mental health clinics, a residential substance abuse treatment center, private practice, and academia, I have encountered the myriad effects of the biomedical model on a daily basis. Among these encounters, five are particularly memorable and help to illustrate the popularity and consequences of characterizing psychological problems in purely biomedical terms.
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.
The Science and Pseudoscience of Children’s Mental Health
Over the past two decades, there has been a meteoric rise in the number of children – now estimated to be 1 in 6 – diagnosed and treated for a range of psychological disturbances including ADHD, autism, mood disorders, and learning disabilities. Explanations in the popular media tend to polarize around two viewpoints. The truth is, neither of these perspectives tell the whole story. Without question, some children are diagnosed unnecessarily because their behavior is inconvenient to the adult world.
Father Munchausen, I Presume!
I’ve had some criticism of the recent Doctor Munchausen posts. They’re not fair on doctors. Many people have told me of lives saved by good doctors. It’s not fair to tar these good doctors with the brush of a few Dr Munchausens here and there. So there’s bad doctoring and good doctoring and great doctoring. What would great doctoring mean?
Is There Risk in Screening for Mental Health Disorders?
Recent calls for screening for a range of mental health problems point to an important recognition of the need to identify and address emotional suffering. Such screening offers an opportunity to decrease the stigma and shame that often accompany emotional pain. A powerful new documentary, The Dark Side of the Full Moon, calls attention to the under-recognition and under-treatment of postpartum depression. In one scene, a mother refers to resistance from doctors who lack resources to address positive screens as "absurd.” She is correct, if the alternative to screening is to look the other way in the face of women who are suffering.
Yes, the Tide is Turning Against Psychiatry
The suggestion embedded in this article’s title seems counter-intuitive. How could the tide be turning on psychiatry when the institution has never been so strong? And indeed indicators of its growing strength and tenacity are all around us. The exporting of its model to the global south via the World Bank, the emergence of outpatient committal, the explosion of funding for psychiatric research. Daily are there calls for most aggressive “detection” and “treatment.” And the mainstream press has never been more closed to truly foundational critiques. That acknowledged, let me suggest that such intensification is common when an old system is in the early days of crumbling.
In Search of Change: My Journey
It is more helpful to focus on what clients do well than what they are lacking. These are simple things, but it takes a lot of discipline for professionals to stay focused, stay simple, respect clients as the expert on their life and listen intensely for their strengths and resources.
Dispatches from a Reluctant Guide on the Path to Disability
I graduated in 1987 with a Bachelor of Science in Psychology. The attitude of my professors in the Psych Department was that the science of Psychology was coming to an end. The mysteries of the mind had been unraveled through the new neuroscience, and all that was left was some mopping up. It all seemed very convincing, and I believed it myself for many years.
Prescribing Antidepressants for Girls: Intergenerational Adverse Consequences
Children exposed to SSRIs during pregnancy, a recent study shows, were diagnosed with depression by age 14 at more than four times the rate of children whose mothers were diagnosed with a psychiatric disorder but did not take the medication. Such reports are usually met, appropriately, with an outpouring of reassurances from clinicians who take care of pregnant women, who need to protect their emotional wellbeing in whatever way they can. From my perspective as a pediatrician specializing in early childhood mental health our attention must be on prevention.
Suicidal Behavior After FDA Warnings
On June 18, the British Medical Journal published an article by Christine Lu, et al., titled Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study. < /em>Here's the conclusion paragraph from the abstract: "Safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people. It is essential to monitor and reduce possible unintended consequences of FDA warnings and media reporting." Note the slightly rebuking tone directed against the FDA and the media.
A New Film Called ‘Beyond the Medical Model’
I am writing this post primarily to share a trailer for a new film. ‘Beyond the Medical Model’ is a product of our community in many ways. It grows collaboratively out of our hurts, our anger, our passion, our discoveries and our insistence that we be heard. Our collective wisdom and exploration drives its very purpose. It would be hollow without our stories.
Guilty
A little over a year ago, there was consternation in psychiatric circles as a French psychiatrist, Daniele Canarelli was found guilty after her patient hacked a man to death. She had not recogized the hazard he posed. Doctors didn’t like the implications they saw. In a series of lectures I have raised the question as to how long it might be before doctors would be found guilty for a suicide or homicide linked to an antidepressant, given that we have known that these drugs can cause suicide or homicide for over 50 years.
Well-Being Therapy: A Guide to Long-term Recovery
If a patient has high cholesterol or sugar, the doctor may prescribe a drug to lower what is too high, but he/she generally adds some suggestions: for instance to avoid certain types of food, to do more physical activity, to refrain from smoking. But if someone has a low mood and sees medical help, the doctor--particularly if he or she is a psychiatrist--will likely just prescribe a drug and not encourage any “self-therapy.” The problem with his approach to care is that psychiatric drugs, even when they are properly prescribed, may help very little in the long run and create a number of additional problems
Centering Lived Experience
Lately, after a number of discussions, we have been changing our practices around the issue of labels. No longer do we give a diagnosis at presentations. We place the young person’s story, as told to us, front and center. People listening rarely ask, “What is their diagnosis?” now that lived experiences are central. We are providing a sense of their struggles. We are trying.
Truth is Like a Lion: The 25th Hearing Voices Conference
The Hearing Voices movement is a beautiful thing, and last year it was 25 years old. What has happened in 25 years? A confidence has grown in a different approach to hearing voices, listening and embracing rather than trying to control and silence voices. Key to this has been Hearing Voices groups and conferences, where people who hear voices are listened to with openness and curiosity. It’s not about telling people who hear voices to throw away their pills if they are taking them, its about creating spaces to listen deeply to what is happening.
Illegal-Psychiatric Drug Hypocrisy, & Why Michael Pollan is Smarter than Me
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.
“Mental Illness”, the DSM-5, and Dreams for a Post-Psychiatry World
If, a little over three years ago, you asked me who I was, my one and only answer would have been, “Bipolar.” It was the word that defined me, that explained my emotions and behaviors, that gave me answers to the questions, Why am I so unhappy? Why do I want to die every day? Why is it so hard to get out of bed in the morning, to shower and brush my teeth and leave the house and interact with the world? Why do I find it impossible to keep a job, a relationship, a responsibility? Why do I never feel OK?
The DSM-5 Field Trials: Inter-Rater Reliability Ratings Take a Nose Dive
The American Journal of Psychiatry (January, 2103) recently published a series of articles that analyzed the outcomes of the field trials that were conducted by the DSM-5 Task Force, to determine the inter-rater reliability of the multiple diagnostic categories that will comprise the DSM-5. A table below tracks the downward progression of inter-rater reliability from DSM-III through DSM-5.
Against All Odds
Telling people emphatically how much I am suffering at times, asking for reassurance that my dear ones love and care about me and sense my purpose, may make me unpopular with some who pride themselves on being “more together,” yet it also fosters the intimacy, closeness and trust I feel with so many. And because of it, I don't need to ask myself if anyone will care if I die. I can experience that reassurance while I'm alive, if I have the humility to ask for it, and keep asking until my soul is met with other souls who genuinely care. That experience humbles me greatly and somehow makes all of my brokenness feel like love and open heartedness.
Don’t Harm Them Twice (Part II): What Can Be Done?
When language has been ingrained in a culture for a long time, it takes a concerted effort to change it. How do we stop using the word “addiction” in relation to cases of iatrogenic benzo dependence? Here are a few suggestions.
