Featured Blogs

Many of us spend a lifetime avoiding our emotional pain, and it does become more and more toxic as long as we keep it buried. It will literally make us ill, physically and mentally, as Bessel Van talks about in the book, The Body Keeps Score. The little quip, "What you resist, persists" has proven very true in my life. The only way out of that trap is to stop avoiding and learn in whatever way makes sense to us as individuals to feel once again and to embrace and absorb and therefore transform the pain of our lives. This is how I am healing.

The Division of Clinical Psychology of the British Psychological Society published a paper titled Understanding Psychosis and Schizophrenia. The central theme of the paper is that the condition known as psychosis is better understood as a response to adverse life events rather than as a symptom of neurological pathology. The paper was wide-ranging and insightful and, predictably, drew support from most of us on this side of the issue and criticism from psychiatry.  Section 12 of the paper is headed "Medication" and under the subheading "Key Points" you'll find this quote: "[Antipsychotic] drugs appear to have a general rather than a specific effect: there is little evidence that they are correcting an underlying biochemical abnormality."

There were days that I’d wake up and all I could do was cry for no particular reason, just another miserable day of withdrawal. However, the idea of taking photos would get me out of the house. Especially on those days, the absolutely only thing that would get me to move at all was the idea of taking photos. One particular day, I was just crying, crying, crying, and as soon as I got to a beautiful spot that I loved, I stopped crying, took photos, and felt at peace. I even found that the days I felt the worst were the days I took the best photos.

Within the mental health profession, clinicians and researchers who value a system of categorical illnesses and individual defects too often proclaim that the major feature delineating "real psychosis" from other "disorders" is the presence of delusions. Two recent articles in the New York Times exemplified for me how skewed this assertion is. It also led to a greater awareness, more specifically, of how problematic it is to view so-called delusions as meaningless indicators of disease . . . for we all experience delusion. How one experiences the self, the world, and relationships (usually based on our relationships with our caregivers) determines the level with which one must cling to seemingly irrational ideas in order to maintain a sense of order and meaning in the world. Let me explain . . .

There are more and more of us who are determined to build an international movement that doesn’t forget its history, and that reweaves solidarity and community back into a model of mental and emotional and spiritual health. The system we live under is organized to keep a small number of people in control of the rest of us. Those who don’t fit into the model are drugged and silenced. We — the Mad Ones, the ones who have no choice but to feel the suffering of this planet and the people on it — we have a responsibility to create a new world that can hold our visions and brilliance. We have a responsibility to know our own histories of oppression and resistance. We carry with us the memories of the dead, the tortured, the exiled, and the ones whose flames can never be extinguished.

It is encouraging that more and more people - psychiatrists, patients, and researchers – are opposing drug treatments for depression, anxiety, and ADHD. But this is only half the battle. To oppose the level that psychiatry, my field, has sunk to comes with the obligation to right the ship. Obviously we need to recover from practices that violate the fundamental principle of “Do No Harm.” But over and above that, we have to constructively treat and heal the ‘pains’ of our patients.

This week a commentary, written by members of the University of Pennsylvania Department of Medical Ethics and Health Policy and titled “Improving Long-term Psychiatric Care: Bring Back the Asylum” was published in JAMA Online. The authors recommend a return to asylum care, albeit not as a replacement for but as an addition to improved community services and only for those who have “severe and treatment-resistant psychotic disorders, who are too unstable or unsafe for community based treatment.” The authors seem to accept the notion of transinstitutionalization (TI) which suggests that people who in another generation would have lived in state hospitals are now incarcerated in jails and prisons. While I do not agree, I do find there is a need for a safe place for people to stay while they work through their crisis.

The Scottish Anthropologist Ioan Lewis, wrote the book Ecstatic Religion in 1971, in which he suggested a ‘shaman is not less than a psychiatrist, he is more.’   He claimed psychiatry was just one of the functions of the shaman, and he invited comparison between shamans and psychiatrists.  Some diagnostic criteria for schizophrenia appeared rather similar to the desired conditions of shamans in an altered state of consciousness.  Other terms used (and misused) for therapeutic practitioners included: native or traditional healer, medicine man, witch doctor, soul doctor, sorcerer, magician, spirit medium, exorcist, curer, diviner and diagnostician.

Yoga helped me explore and reconnect with the body I’d abandoned and abused for years. My pain and sadness had me living exclusively in my mind, my body nothing more than a battleground for my inner wars. Through yoga and meditation, I slowly began to love myself again, learning to treat myself with care and respect. I felt a greater sense of self-awareness, and a sense of connection to something greater. This was a drastic contrast to the days when I felt as if god had forgotten about me, or like I was a mistake not meant for this world.

From 1951, a system designed for heroin and cocaine addicts – prescription-only status – was applied to all new drugs. Why? These were after all the first truly effective drugs in medicine. But the ability to do good came with a likelihood of doing harm. There was a trade-off to be made between risks and benefits. The new complex trade-offs could not be put on to the label of a drug or even captured in a forty page package insert. They needed to be individual to each person.

The version of psychiatry that many professionals, politicians and laypeople would like to be true is that mental illnesses are specific brain disorders with specific drug treatments, to which they are very responsive if identified early. In reality, the way we categorise mental illnesses is arbitrary, and the diagnostic criteria are over inclusive. Whilst psychiatric drugs can be helpful, the dream of a quick fix by targeted drugs has become a nightmare where we often do more harm than good in the way we use drugs, e.g. against depression, schizophrenia and ADHD.

As a person who has been psychiatrized, but hasn’t faced long-term institutionalization, I have to accept that I can’t know that level of loss of power and vulnerability. (But I can tell you even short stays are enough to begin to understand.) And to be a person of color with psychiatric labels interfacing with the police? It’s like the perfect storm. (A type of ‘perfection’ that occurs more often than most, given that people of color are more likely to be diagnosed in the first place.)

For four decades I have been an activist challenging the mental health industry. More and more I feel that the climate crisis should be one of the highest priorities for social change led by people who have personally experienced psychiatric abuse, and our allies. I affectionately call us The Mad Movement. It seems that almost every speaker against global warming ends their message the same way, that we can stop this catastrophe if society has the “will.” I believe that participants in The Mad Movement have an important insight into real sickness in society. As a psychiatric survivor, I have seen too much labeling of creative maladjustment as ill. We need to shake off our world’s complacency and numbness, also known as “normality.”

With great regularity, I receive emails from people—“patients,” family members, and mental health workers—who are frustrated by this fact: the psychiatrists they meet, and the larger psychiatric community, are simply not aware of research that questions the merits of psychiatric medications. Many providers, for instance, do not know of Martin Harrow’s long-term study of schizophrenia outcomes. We at Mad in America started Mad in America Continuing Education to produce online courses that will fill in this knowledge gap. And now that we have our first courses up, we need your help.

When people are seeing the world really different than we do, it’s often reassuring to think that there must be something wrong with them – because if they are completely wrong, or ill, then we don’t have to rethink our own sense of reality, we can instead be confident about that own understandings encompass all that we need to know. But it can be disorienting and damaging to others to have their experiences defined as “completely wrong” or “ill.” And we ourselves become more ignorant when we are too sure that there is no value in other ways of looking or experiencing.

What are Extreme Experiences? Other terms for them are Spiritual Crisis or Spiritual Emergency. With the appropriate support many find the experiences profoundly transformative. However, observers or relatives may have different beliefs about extreme experiences: perhaps that a person is having a psychological breakdown or mental health problems, or is psychotic or experiencing schizophrenia.

On December 29, Nassir Ghaemi, MD, a psychiatrist and a professor at Tufts Medical Center, published on Medscape an article titled Psychiatry Prospects for 2015: Out With the Old, In With the New? In it, he writes that with the changes in health care "Clinicians can stop pretending that relationship and social problems have to be shoved into a biological-sounding DSM category (such as major depressive disorder or generalized anxiety disorder) and treated with the only thing insurance companies would reimburse long-term: drugs." So there it is, starkly stated: Clinicians, by which he clearly means psychiatrists, have been pretending.

Losing a loved one to suicide hurts like hell: there’s an obvious truth if there ever was one. But there are other truths, some hard, some hopeful. If you’ve suffered such a loss yourself, you know too much of these truths already.

When I was locked in a psychiatric hospital, I wasn't able to have much of a conversation with my parents about what was going on. Phone calls were tense and filled with silence, and as I stood at the ward payphone I was so confused and frozen in fear that each call just confirmed to them how lost I was. Every day as a patient centered around the various prescriptions I was on, and like so many people suffering in a psychosis, helping me became a wait to "find the right combination of medications."

In Paris today we have a lot of people mouthing words that come easily: "Je Suis Charlie." For anyone who wants to be Charlie, who wants to get to know what modern politics is all about, by feeling it in your marrow, try reporting an adverse event on treatment to your doctor. Outside your doctor’s surgery/clinic/ consultation room you can believe you are operating in a democracy. Inside the room you may be treated with courtesy and apparent friendliness but you are being treated in an arrangement set in place to police addicts. This is not a domain in which ideals of Liberty, Equality or Fraternity are welcome.

Psychiatry is fast approaching a death spiral which we as a society may not be able to recover from. In many residencies, psychotherapy is not even being taught. Many psychotherapists of all professions – psychiatric, psychologists, and social workers have been intimidated by specious neuro-biochemical theories, while others have simply given up. And now, there aren’t many remaining good therapists in practice anymore.

So here we go again; another meeting with another young person who describes how he is in an acute crisis - you may call it - and is diagnosed and prescribed neuroleptics. He is told by the doctor that he suffers from a life-long illness and he will from now on be dependent on his “medication.” As long as people are met this way I see no alternative than showing that there are alternatives. If that means being "antipsychiatry," then I am more than happy to define myself and our work in that way.

It is generally recognized in antipsychiatry circles that antidepressant drugs induce manic or hypomanic episodes in some of the individuals who take them. Psychiatry's usual response to this is to assert that the individual must have had an underlying latent bipolar disorder that has "emerged" in response to the improvement in mood. The problem with such a notion is that it is fundamentally unverifiable.

What are the philosophical underpinnings for what constitutes evidence and how have quantitative approaches so effectively trumped qualitative approaches in applied psychiatry, psychology, and the like? Furthermore, is it possible that quantitative ways of studying human experience may actually promote constricted, myopic views that hurt or oppress human beings? And how does this contribute to a global biopharmaceutical research enterprise reframing the understandable reactions to oppression as being the deficiencies and impairments of its victims?

The two most popular interventions for ADHD are drugs and stringent control. Those who believe in the traditional biological determinist view assert that others must provide the control that people diagnosed with ADHD lack. In this treatment protocol, diagnosed individuals are remanded into treatment that mimics institutional care (i.e., others control their access to resources and their behavior is restrained with drugs). While both of these impositions can yield some short-term benefits, they can also produce unwanted side effects much like what happens when there is incarceration