Understanding Psychosis and Schizophrenia? What About Black People?

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In many respects it is difficult to fault the report Understanding Psychosis and Schizophrenia, recently published by the British Psychological Society (BPS) and the Division of Clinical Psychology (DCP)[i]; indeed, as recent posts on Mad in America have observed, there is much to admire in it. Whilst not overtly attacking biomedical interpretations of psychosis, it rightly draws attention to the limitations and problems of this model, and points instead to the importance of contexts of adversity, oppression and abuse in understanding psychosis. But the report makes only scant, fleeting references to the role of cultural differences and the complex relationships that are apparent between such differences and individual experiences of psychosis.

Do You Still Need Your Psychiatric Diagnosis?

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Do you still need your psychiatric diagnosis? The answer for practical purposes is probably ‘Yes.’ In the current system, diagnosis is essential for accessing services and benefits and, particularly in the USA, for covering your treatment costs. But do you need to believe in your diagnosis? Do you have to accept this particular attempt to explain your difficulties, and to take it on as part of your identity by becoming one of the ‘mentally ill’? since psychiatric diagnoses have been admitted to be non-valid even by the people who drew them up, professionals should not be offering people the ‘choice’ of describing their difficulties in diagnostic terms in the first place. That would still leave people with the right to adopt whatever explanation suits them as private individuals.

The Curious Case of over 50 Consecutive ECTs in Melbourne

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Over the past few weeks I have been witness to, and increasingly involved in trying to stop one of the most extreme examples of psychiatric brutality I have encountered in my 40 years in this field. And I have encountered quite a few. I suggest you sit down before watching and reading. This is not your usual, run-of-the-mill psychiatric abuse story.

Why Neuroscience Cannot Explain Madness

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The decision by the National Institute of Mental Health to part company with the APA’s 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 Insel’s 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.

Psychiatrists May be Ready to Learn About Treating With Micronutrients

It was May 19, 2003, in San Francisco; the first-ever (we think) symposium on micronutrient treatment to be on the schedule for the annual meeting of the American Psychiatric Association. There was moderate interest. This year, the two of us (both psychologists) presented many, many studies on the use of micronutrients to treat anxiety, stress, depressive symptoms, ADHD, aggression, mood, and addictions. The amount of data differed dramatically from 12 years ago, but the biggest difference was the response from psychiatrists!

More Thinking about Alternatives to Psychiatric Diagnosis

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In my last post, I argued that the single most damaging effect of psychiatric diagnosis is loss of meaning. By ruthlessly divesting experiences of their personal, social and cultural significance, diagnosis turns ‘people with problems’ into ‘patients with illnesses.’ Horrifying stories of trauma, abuse, discrimination and deprivation are sealed off behind a pseudo-medical label as the individual is launched on what is often a lifelong journey of disability, exclusion and despair.

Prescribing Rights for Psychologists

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In an era of prescribing rights for psychologists will psychology become a more marketable, less tarnished version of psychiatry, a target for pharma marketing and a new distribution channel for psychotropic drugs?

Hearing Voices Network Launches Debate on DSM-5 and Psychiatric Diagnoses

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The recent furore surrounding publication of the new DSM has provided a much-needed opportunity to discuss and debate crucial issues about how we make sense of, and respond to, experiences of madness and distress. Many psychiatrists, psychologists and other mental health professionals have expressed their dismay about the dominance and inadequacy of a biomedical model of mental illness. Whilst we share these concerns, welcome these debates and support colleagues that are willing to take a stand, The Hearing Voices Network believes that people with lived experience of diagnosis must be at the heart of any discussions about alternatives to the current system.

The Shameful Story that Runs and Runs: A Review of The Bitterest Pills

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If the blimp that is psychiatric treatment were a passenger aircraft, the authorities would have grounded it many years ago, but still it continues to inflict harm on countless thousands of people. I read Joanna Moncrieff's latest book with a growing sense of anger and shame. The roots of drug treatment in psychiatry are thoroughly rotten. They sustain the decaying trunk of psychiatric theory and practice through misrepresentations and untruths; it is snake oil peddled by quackery.

Symptom or Experience: Does Language Matter?

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Of all the beliefs that I have had about my experiences, the belief that I was ‘schizophrenic’ was the most damaging. In adopting the story that others told about me, and abandoning my own sense-making process, I held on to a belief that both hid my traumatic life experiences and rendered them irrelevant. Does it matter if we sometimes slip into the language of illness when we all agree that these experiences are meaningful, personal and have value? Yes. It does.

The Truth About Antidepressant Research: An Invitation to Dialogue

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The Finnish Psychological Association held a meeting in Helsinki on 1 Sept 2014 titled “Mental Health and Medicalization.” I spoke at the meeting and four days later I sent a letter to another speaker, psychiatrist Erkki Isometsä. Professor Isometsä replied: “I will respond to it in detail within a few days..." As "Open Dialogue" is essential in science, I have published my letter to Isometsä here as well as on my own website, although I didn’t succeed in starting a dialogue.

“Psychiatric Prejudice” – A New Way of Silencing Criticism

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‘Psychiatric prejudice’ 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.

Me, My Brain, and Baked Beans

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I’ve spent much of my professional life studying psychological aspects of mental health problems. Inevitably, this has also meant discussing the role of biology. That’s my academic day-job. But it’s not just academic for me. I’m probably not untypical of most people reading this; I can see clear examples of how my experiences may have affected my own mental health, but I can also see reasons to suspect biological, heritable, traits. As in all aspects of human behaviour, both nature and nurture are involved and they have been intimately entwined in a complex interactive dance throughout my childhood and adult life.

Pinball Wizards and the Doomed Project of Psychiatric Diagnosis

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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.

Madness and the Family (Part Two): Towards a Unified Theory of Family Dynamics and...

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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.

Psychiatric Teams Have a Responsibility to Think About the Psychosis/Sexual Abuse Link

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In England, childhood sexual abuse (CSA) has become big news. The increasing understanding of the level of childhood sexual abuse and how this produces mental anguish has of course reached the psychosis arena, and encouraged academic study. Whilst the majority of psychiatrists continue to privilege a biological explanation of psychosis, more and more workers recognise abuse as at least a trigger if not a cause of psychosis. It's important to develop thinking points for teams struggling with, or more generally avoiding, the CSA/psychosis link.

From Psychiatry and Psychotherapy’s Grand Delusion Toward Constructions of a Post-Therapeutic State

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by Eugene Epstein, Manfred Wiesner, and Lothar Duda Over the past 50 years, the psychiatric and psychotherapeutic discourses of the western first world have infiltrated...

Book Review: The Importance of Suffering

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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 what’s really important to us, and our approach to it tells us what we’re really made of.

If You Are the Big, Big Tree; We Are the Small Axe

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In 2006 I undertook a neuropsychology placement during my Clinical Psychology Doctoral training course. It was in a community brain injury service. I had the fortunate experience of undertaking not only neuropsychological assessments, but also therapeutic interventions and service projects. My eyes were opened in a very positive way. Things suddenly made sense; psychology, interactions, life, all became much clearer. I now understood that we are all unique, not only because of our experiences and views on life, but because of our neurocircuitry. I began to see how our unique cognitive profiles make us who we are.

The Hidden Gorilla

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Three weeks ago What would Batman do Now covered the issue of suicide in the military – an issue that had Batman missing in action, and...

A Positive Understanding of How Our Minds Work

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Often it is a relief to get an understanding of how we have developed a psychological problem, and it is especially good if we can feel that there is a reason for the problem that it is understandable. When I suffered from a phobia, it was a relief to understand that I probably had linked fear to an insect when I was a child. And it was even more satisfying when I understood that there was nothing wrong with my brain — that the problem was in what I had experienced. It was in my “software.”

Causing a Stir: Launching “Understanding Psychosis and Schizophrenia” in New York City

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Those of you who read the New York Times may have seen its coverage of the British Psychological Society’s recent report, ‘Understanding Psychosis and Schizophrenia: Why people sometimes hear voices, believe things that others find strange, or appear out of touch with reality, and what can help.’ The report has been widely welcomed and many have seen it as a marker of how our understanding of these experiences is changing. The report has not been without its critics. We (Editor Anne Cooke and co-author Peter Kinderman) are coming to New York this month to launch the report in America.

What is Mental Illness Today? Five Hard Questions

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Subscribers to Mad in America might be interested in a Keynote Lecture given by Professor Nikolas Rose in Nottingham on May 15th 2013. In this lecture Professor Rose very thoughtfully challenges a number of the assumptions which underpin conventional and contemporary psychiatric practice. He asks five hard questions:
  • Is there (really) an epidemic of mental illness?
  • Does the path to understanding mental disorder lie through the brain?
  • What is the role of diagnosis and of diagnostic manuals?
  • Should we seek early identification of those at risk of future mental pathology?
  • What is the place of patients, users, survivors, & consumers of mental health systems?

New Research into Antipsychotic Discontinuation And Reduction: the RADAR programme

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For a long time I have felt that there just isn’t a good enough and long enough study on the pros and cons of long-term antipsychotic treatment versus reduction and discontinuation in people who have psychotic disorders, including those who are classified as having schizophrenia. Moreover, there are increasing reasons to be worried about the effects of long-term treatment with antipsychotics. I put this case to the UK’s National Institute of Health Research recently, and proposed that they fund a trial to assess the long-term outcomes of a gradual programme of antipsychotic reduction compared with standard ‘maintenance treatment.’ The NIHR agreed that this was an important issue, and that a new trial was urgently needed. The RADAR (Research into Antipsychotic Discontinuation And Reduction) study officially started in January 2016.

Children, Youth and Mental Health in British Columbia: A Presentation to the Legislature

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"From years of personal and professional experience, I must tell you my biggest fear is that we’re massively misunderstanding the emotional and mental suffering of children and teens. We’ve taken their feelings, thoughts and suffering and transformed them into symptoms, diagnoses, reductive theories and then prescribing them an array of psychiatric drugs with dire short- and long-term consequences. We’re drugging their emotions, their thinking and their quest for meaning into disabling silence."