âIâd Rather Die Than Go Back to Hospitalâ: Why We Need a Non-medical Crisis...
It was exciting going back to my old stamping ground. Years ago Iâd worked in one of the local community mental health teams and had referred many women to the Drayton Park Crisis House. Walking up the steps of the house brought back memories of standing there with desperate and suicidal clients, some of whom had told me that they would rather die than go back into hospital. As you can imagine, to say I had been glad that there was an alternative would have been an understatement.
So Long, and Thanks for All the Serotonin
The serotonin reuptake inhibiting (SSRI) group of drugs came on stream in the late 1980s, nearly two decades after first being mooted. The delay centred on finding an indication. They did not have hoped-for lucrative antihypertensive or antiobesity profiles. Even though a 1960s idea that serotonin concentrations might be lowered in depression had been rejected, drug companies marketed SSRIs for depression even though they were weaker than older tricyclic antidepressants. They sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety. The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance.
Time to Abolish Psychiatric Diagnosis?
âDiagnosingâ someone with a devastating label such as âschizophreniaâ or âpersonality disorderâ is one of the most damaging things one human being can do to another. Re-defining someoneâs reality for them is the most insidious and the most devastating form of power we can use. It may be done with the best of intentions, but it is wrong - scientifically, professionally, and ethically. The DSM debate presents us with a unique opportunity to put some of this right, by working with service users towards a more helpful understanding of how and why they come to experience extreme forms of emotional distress.
Thinking about Alternatives to Psychiatric Diagnosis
I want to follow up my first post by outlining the principles of possible alternatives to psychiatric diagnosis â that is, alternatives in addition to the most obvious one, which is simply to stop diagnosing people.
Study 329: Conflicts of Interest
The BMJÂ states that it takes on average eight weeks from submission of an article to publication. The review process for Restoring Study 329 took a year, with a three-month review process involving six reviewers to begin with, and then a further four reviews in a four-month process, leading to a provisional acceptance in March that was withdrawn.
A Critique of Genetic Research on Schizophrenia â Expensive Castles in the Air
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.
They May not Be Coming for Your Guns, But They Are Definitely Coming for...
In New Zealand, the government is passing legislation called the Natural Health and Supplementary Products Bill that will limit access to minerals and vitamins. While safety and efficacy are important, this Bill will ban for sale many NHPs that New Zealanders rely on for their health. In so doing, it will ban all of the formulas for which there is scientific evidence of benefit for mental health. We have some evidence that the result could be tragic.
Book Review: The Importance of Suffering
This is a very important, well-written book which should become essential reading for anyone involved in the healing arts, since suffering is - or should be - at the heart of our endeavors. Suffering tells us whatâs really important to us, and our approach to it tells us what weâre really made of.
Why Neuroscience Cannot Explain Madness
The decision by the National Institute of Mental Health to part company with the APAâs forthcoming DSM-5 should not be taken as evidence that biological psychiatry is entering a terminal decline. Far from it, as the Director of NIMH Thomas Inselâs blog of 29th April 2013 makes clear, the reason NIMH has opted for its own Research Diagnostic Criteria (RDoC) is because they believe psychiatric patients deserve something better.
DSM-5 Statement by the Critical Psychiatry Network
The Critical Psychiatry Network is concerned with the way the controversy over the publication of DSM-5 is being portrayed in the media and by some academic psychiatrists. The issues raised by the DSM are complex and require careful and studied consideration. There are two aspects in particular that concern us. These relate to the portrayal of the controversy as a guild dispute, and the polarisation of the debate as one of nurture versus nature.
Shamans and Psychiatrists: A Comparison
The Scottish Anthropologist Ioan Lewis, wrote the book Ecstatic Religion in 1971, in which he suggested a âshaman is not less than a psychiatrist, he is more.â  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.
It’s as Bad as You Think: The Gap Between the Rich and the Poor...
Many of us in the U.K. are mad - mad with anger at the injustice and cynicism of a political system that is turning the gap between rich and poor into an unbridgeable chasm. Mad with anger because the most vulnerable in society are now paying the price for a political ideology - neoliberalism - with their lives. We are mad and angry because they are blamed for failings that are not of their making, but which originate in the system under which we live. 'Psychological' assessments, online cognitive behavioural therapy (CBT) and other forms of 'therapy' are being used to force unemployed people with common mental health problems back to work. Mental health professionals responsible for IAPT (Improving Access to Psychological Therapies) have been relocated to help 'assess' and 'treat' claimants.
The Hearing Voices Movement: Beyond Critiquing the Status Quo
We have just celebrated the anniversary of the rapidly expanding global Hearing Voices Movement which was founded more than twenty-five years ago following the ground-breaking research of Professor Marius Romme and Dr Sandra Escher. Romme and Escher have advocated for a radical shift in the way we understand the phenomenon of Hearing Voices; in contrast to traditional, biomedical psychiatry which views voices as an aberrant by-product of genetic, brain and cognitive faults, their research has firmly established that voices make sense when taking into account the traumatic circumstances that frequently provoke them.
Pinball Wizards and the Doomed Project of Psychiatric Diagnosis
The DSM claims to be a scientific system of classification. The validity of any system of scientific classification is the extent to which it can be shown to reflect the real world. Fifty years of study and investigation, and huge sums of money spent across the Western world on neuroscientific research institutes, on careers and equipment, has failed to establish the validity of a single psychiatric diagnosis.
Hope for Everyone
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.
âAngels and Demonsâ: the Politics of Psychoactive Drugs
Prescription drugs like antidepressants, antipsychotics and so-called âmood stabilisersâ are widely promoted as good for your health. But the history of prescription and recreational drug use is more intimately intertwined than most people recognise. Attempts to disentangle the two have created a false dichotomy â with prescription drugs, at least some of them, set up as the âangelsâ that can do no wrong, and recreational drugs cast as the âdemonsâ.
Madness and the Family, Part III: Practical Methods for Transforming Troubled Family Systems
We are profoundly social beings living not as isolated individuals but as integral members of interdependent social systemsâour nuclear family system, and the broader social systems of extended family, peers, our community and the broader society. Therefore, psychosis and other forms of human distress often deemed âmental illnessâ are best seen not so much as something intrinsically âwrongâ or âdiseasedâ within the particular individual who is most exhibiting that distress, but rather as systemic problems that are merely being channeled through this individual.
How to Parent a Dead Child
Being the parent of a dead child is hard. Being the parent of a child who died from suicide may be even harder. I love my son and am proud of him and work to make sure that his having lived makes the world a better place.
“Psychiatric Prejudice” – A New Way of Silencing Criticism
âPsychiatric prejudiceâ is a term being bandied about these days, mainly by aggrieved psychiatrists. Ordinary people, other doctors and medical students are all prejudiced, they say, because they do not appreciate that psychiatry is a proper medical activity, and critics of psychiatry are prejudiced because their analyses undermine this medical point of view. However, many people remain inclined to view the difficulties we label as mental disorders as understandable reactions to adverse life events or circumstances and, importantly, evidence suggests they are more, not less, tolerant of such situations. In my view, there is a role for medical expertise in helping people with mental health problems, but that does not mean we have to call those problems illnesses.
Unwarranted Criticism of âPsychiatry Gone Astrayâ
On 6 January 2014, I published the article âPsychiatry Gone Astrayâ in a major Danish newspaper (Politiken), which started an important debate about the use and abuse of psychiatric drugs. Numerous articles followed, some written by psychiatrists who agreed with my views. For more than a month, there wasnât a single day without discussion of these issues on radio, TV or in newspapers, and there were also debates at departments of psychiatry. People in Norway and Sweden have thanked me for having started the discussion, saying that itâs impossible to have such public debates about psychiatry in their country, and I have received hundreds of emails from patients that have confirmed with their own stories that what I wrote in my article is true.
Can Co-production Really Transform UK Mental Health Services?
Is "co-production" public service citizen involvement? Is it individual, âresponsibilisedâ health and social care consumerism? Is it power shifting to communities through participatory governance? Perhaps itâs the ultimate post-modern policy concept. But can it work for mental health?
Madness and the Family (Part Two): Towards a Unified Theory of Family Dynamics and...
In Part One of this article series, we reviewed the contemporary research into the links between psychosis, problematic family dynamics, and other forms of childhood trauma. After reviewing this research, we find that a very interesting and important question emerges: What do all of these have in common? In other words, is there some common denominator that all of these types of trauma and patterns of problematic family dynamics share, a single underlying factor that makes someone particularly vulnerable to experiencing a psychotic crisis? Indeed, I believe that there is.
Are Micronutrients a Waste of Time? – A Randomized Controlled Trial
Julia has received a lot of media attention in the last few days as a result of her blinded RCT published in a prominent journal, the British Journal of Psychiatry, showing that micronutrients were better than placebo at improving ADHD and mood symptoms in adults. But what interests us far more is the amount of public emails we get as a result of this work. And the theme running through almost every email is that the child/adult/husband/wife has tried all kinds of medications and the symptoms are still there and, often, getting worse. Could the micronutrients help?
A National Scandal: Psychological Therapies for Psychosis are Helpful, But Unavailable
For years, drugs were it. If you felt paranoid, heard voices or were diagnosed with schizophrenia, the only thing likely to be on offer was âantipsychoticâ medication. Like all drugs, these have a number of different effects on our nervous system. Some of the effects can be helpful, for example calming us down or making our experiences less intense or distressing. Others may be less desirable.
Time for a Policy Against Psychiatric Bullying
Sometimes regarded as âtreatment,â psychiatric bullying and harassment can no longer be considered as such. During the past two decades, the often devastating effects of psychiatric bullying and harassment have evidenced themselves on the wellbeing of consumers, and the climate of mental health facilities.The advent of mandatory anti-bullying policies in schools and workplaces has shifted thinking towards an acceptance that bullying occurs, causes harm and should not be tolerated. Could the development of anti-psychiatric bullying policies in mental health institutions make psychiatric abuse visible and create a zero tolerance culture?