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As I write this, the New York Times is asking readers to respond to the question “What should be done to prevent mass shootings?” The more responses the New York Times receives from people who understand that the answer is gun control — not misguided legislation that would only harm those it purports to help — the more they will take notice. Please write!

The strongest evidence we have as to whether a drug causes a problem does not come from RCTs or any other controlled study but rather from good clinical accounts. Even if RCTs were done by angels, so there was no hiding, no miscoding, nothing untoward, RCTs can still hide adverse events. The onus is on large and powerful corporations who have a lot of resources to pinpoint the populations where the benefit is likely to exceed the risk, if they want to continue to make money out of vulnerable people.

Mad in America readers are familiar with the variety of negative effects caused by emphasizing biologically based treatments for psychological disorders. Yet, over the past five years, research has identified another negative consequence which, I think, is less well known: increased prognostic pessimism. Long story short: numerous studies have found that individuals who more strongly endorse biological etiologies of psychological disorders tend to have increased prognostic pessimism.

Although it is axiomatic in psychiatry that genetic factors are involved in bipolar disorder (manic-depression), and that they play a predominant role, there currently exists little if any scientifically acceptable evidence that bipolar disorder and other “affective disorders” are caused by disordered genes. Given almost 50 years of gene discovery claims that were not confirmed by replication attempts, we must assume by default that current gene finding claims are false-positive results as well. In the 1920s, pioneering psychiatric geneticist Ernst Rüdin decided against publishing his large family study of “manic-depressive insanity,” most likely because the results did not fit his theories of Mendelian inheritance, and failed to support his advocacy of eugenic policies.

In the wake of transitioning from relationship to true friendship with my Beloved, I am continually struggling with what to do with myself in light of heartbreak, hardship on socially moving forward — alone, as it were — and ways to keep Hope alive. Were I to ably move forward in silence and in privately held pain and suffering, weeping in heartache, hoping for relief and release, wouldn’t falling apart be easier without as much aforethought? Placing blame on my mental diversity, my moods, as it were…

In inpatient eating disorders care, we were required to step on the scale but were not allowed to know what we weighed. We were told it was “against recovery” to know our weight; that knowing it would surely cause a devastating relapse.

Sometimes as a journalist one thing leads to another and you suddenly find yourself going down a dark rabbit hole that you hadn’t planned to visit. That’s what happened to me recently when I was writing a piece about how the Veterans Administration’s mental health system and the military in general were failing women in need of care following sexual assault. Retaliation is rampant in the military against those who tell the truth about what happens to victims of abuse, with pseudo-psychiatric diagnoses like “Borderline Personality Disorder” often used to damage or end a victim’s career.

This is my 31^st article on MIA and the most personal. It's about being tender and loving with myself when I'm suffering, and how for me that means being merciful and defiant at the same time. For me to mercifully nurture myself and allow my need for comforting myself to be claimed, I have for long now, first needed to defy the perceptions of others that would say I don't deserve such loving mercy.

Scapegoating the “mentally ill” every time violence or chaos breaks out allows us to absolve society of any blame. It allows us to ignore the problems that give rise to anger, distress, and violence (i.e., poverty, rejection, discrimination, oppression, injustice, abuse, etc) and instead focus on the one thing that can never be proven or defined and yet so easily can be identified in another. It provides relief without any reflection on how our society and way of life, and the inevitability of death, may be contributing to the terror that overwhelms us.

Every year about this time I review my template file for new client notes. It has blank sections for name, presenting concern, history, plan, and a number of other categories. This year I found myself staring at it, considering whether a revision was in order. And the category that leapt out at me was “Diagnosis.” The truth is, I seldom use it any more.

Two facts about Robert Califf are beyond question. He is an expert on clinical trials, who is already seen as a leading architect of the future of medical research. And as the New York Times put it, he has “deeper ties to the pharmaceutical industry than any FDA commissioner in recent memory”. A lot of senior figures in medicine support Califf in spite of his ties to Pharma. The guy is just so bright, and understands the nuts and bolts of drug research so well! Surely a person like this is more useful than some outsider who offers only a squeaky-clean resume, they argue.

A total of one hundred and fifty-eight school-related shootings since Columbine, carried out by one hundred and ninety-nine shooters, have resulted in two hundred and twenty-four deaths and two hundred and eighty-eight injuries; a rate of one shooting a month during that almost sixteen year period. Eighty-five of these shootings have occurred since Newtown, i.e; in little less than three years, doubling the rate of shootings to one every two weeks. A ritualized public and political response to the shootings has evolved, particularly in the wake of the mass murders, which always attract the most media attention: shock, outrage and a demand for action to prevent a recurrence. Who are these teenagers who are doing the shootings and why? How are they getting their hands on the powerful weapons they’re using? Where are the stricter gun controls needed to deny the shooters access to these weapons?

A "little white lie" is an inconsequential falsehood, told to avoid causing embarrassment or hurt. So the question becomes: did Dr. Pies believe, or argue, that the chemical imbalance hoax was an inconsequential falsehood, designed to shield individuals from embarrassment or hurt? Of course, I have no way of knowing what Dr. Pies believes. Nor, to the best of my recollection, have I ever speculated on such matters. But I do know that he has argued that the chemical imbalance theory is an inconsequential falsehood designed to shield individuals from guilt and self-blame.

As a former practicing clinical psychologist, I find Congressman and psychologist Tim Murphy's actions deplorable, a disgrace to the profession, a violation of the ethical principles that guide psychologists in their duties, and an attempt to use his credentials as a psychologist to manipulate the public and Congress to believe obviously false statements. As a result of becoming increasingly concerned about Congressman Tim Murphy's false, public statements conflating mental illness with violence, I contacted the Pennsylvania Psychology Licensing Board and formally requested the implementation of a State ethics investigation of Representative Tim Murphy, Ph.D. I invite you to do the same by emailing the PA board at [email protected]

How are we going to get anywhere at all if people believe that speaking to alternatives just means occasionally putting something out there that isn’t about psychiatric drugs? Assuming that the Mental Health Channel folks genuinely believe they’re offering a product that’s ‘well-rounded,’ how do we even get to a point where they understand why it’s not, and can make a well-reasoned decision about where to go from there? Yes, it’s about the drugs. But, in some ways, no, it’s not at all about them. It’s about the damage we do by convincing people that there’s no other choice than to take the drugs because of a ‘chemical imbalance’ or ‘chronic brain disease’ that, just like cancer, will only get worse if it goes untreated. It's about the inescapable nature of the boxes people put us in (even some of those boxes not filled up with pills).

We hope we have convinced you by now (this is our 24^th blog) that the field of Nutrition and Mental Health is a vital piece of the solution, for preventing as well as treating mental health problems. What we have not talked to you about at all is how behind-the-times the regular granting agencies are. The two of us have always been very successful at obtaining research grants, as long as we do not want to study multinutrient treatments. When we (and some other colleagues in the U.S.) want to study multinutrient formulas, the reviewers react by asking “but which is the important ingredient?”

One of my problems with Mad In America is that not enough seem quite mad enough. I would like to encourage more outrage. I feel that if we were talking about a situation in another country, the US would be outraged. If we were talking about a common substance (like Big Macs), there would be outrage. If it were a business, citizens would be outraged and the government would intervene and shut it down. What is the “it” that I’m talking about?

For the past few years, I've been trying to put words on my multiple dissatisfactions with mainstream psychiatry and its shameful lack of rigour, compassion, reflection and ethical practice: hence my enjoyment of Bonnie Burstow’s percussive, hard-hitting MIA article in September. (I have not read her new book, and am almost afraid to do so, since it may well make irrelevant the final draft of my own critical monograph on psychiatry!)

I have long been concerned with the way society responds to people who come back from war. Veterans are routinely funneled into psychiatry’s grasp. Over the decades, some people who fought in wars have shared with me their experiences of being psychiatrized upon return from war. Sometimes these experiences included veterans being stripped of their second amendment rights, and a host of other constitutional, civil, and human rights violations as they began to be forced into complying with psychiatric regimens, and on several occasions this included veterans being subjected to electroshock.

In the early 1970s I became acquainted with the work of R. D. Laing and in 1973 I decided to relocate from California to London to work with him. I thought I would stay there a year and then return to my graduate studies in San Francisco. Instead I stayed there for seven years; seven years that changed my life completely.

ADHD (or “Attention Deficit Disorder” - with or without Hyperactivity) is not among the “cutting-edge pathologies” of contemporary clinical practice, such as the addictions, eating disorders, narcissistic disorders, chronic fatigue syndrome, or fibromyalgia; however, in my view ADHD is paradigmatic of the contemporary ethos that some have described as hypermodernity. The advocates of ADHD explain to us that a hyperactive child with an attention disorder is a disturbed and often disturbing child, who does not comply with the adults’ rule, often has his own idea of development, and whose problems, unless they are treated, threaten to undermine his autonomy and self-esteem; the two supreme values of the hypermodern society.

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.

As I've told Bob Whitaker and many others, it's taken me 45 years in my career to get to the point where I feel completely free to "do the right thing." By that I don't mean to downplay the work I've done in the public mental health and addictions systems. But now, the Mad in America Continuing Education project moves me in a more recovery-oriented direction than ever, and has a specific focus on the ways in which most programs have over-used psychiatric medications to the detriment of the people we are serving.

A couple of years ago I had a novel called Stranger Than Kindness published in the UK. It was about  the cumulative trauma that can accompany work in the caring profession; how people can become bruised and reshaped by caring for a living, and what they might do to repair themselves. It was essentially a comic novel about hurt nurses. When promoting the book I found myself talking to two different audiences. The first, were people who like books and come along to events and chat about them. The second were occupied by people with a special interest or expertise in mental health.The questions asked and the conversations that we had were different in those two spaces.

The mission statement for the Western Mass Recovery Learning Community’s peer respite (Afiya) is “To provide a safe space in which each person can find the balance and support needed to turn what is so often referred to as ‘crisis’ into a learning and growth opportunity.” Although I sometimes question our choice to use the word ‘safe’ (given how impossible an absolute version of ‘safe’ is to achieve and how saddled with distasteful meaning such a term can be within the mental health system), I’m not sure that statement could otherwise be any more straight forward and meaningful. Yet, so often, It’s unclear what meaning people are truly making of it.