Foreign Correspondents

In the 1950s, when the drugs we now call ‘antipsychotics’ first came along, psychiatrists recognised that they were toxic substances that happened to have the ability to suppress thoughts and emotions without simply putting people to sleep in the way the old sedatives did. The mental restriction the drugs produced was noted to be part of a general state of physical and mental inhibition that at extremes resembled Parkinson’s disease. Early psychiatrists didn’t doubt that this state of neurological suppression was potentially damaging to the brain.

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.

There are terms in psychiatry that are designed to portray violent and distressing events as benign, and normal human rights, feelings and behaviours as threatening – things I think we need to name for what they are. The term ‘antidepressant’, for instance, shapes the way we think of these drugs. It renders the fact that they can worsen depression and cause suicidal thinking and behavior counter-intuitive, and makes people skeptical of claims they don’t work and make distressed people feel worse.

We are profoundly social beings living not as isolated individuals but as integral members of interdependent social systems—our 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 “mental illness” are best seen not so much as something intrinsically “wrong” or “diseased” within the particular individual who is most exhibiting that distress, but rather as systemic problems that are merely being channeled through this individual.

In a bold and unprecedented move for any professional body, the UK Division of Clinical Psychology, a sub-division of the British Psychological Society, issued a Position Statement today calling for the end of the unevidenced biomedical model implied by psychiatric diagnosis. In brief, the argument is that the so-called ‘functional’ diagnoses – schizophrenia, bipolar disorder, personality disorder, ADHD and so on - are not scientifically valid categories and are often damaging in practice.

In 1972, prisoners at Holmesburg Prison in Philadelphia were paid $3 to have their eyes held open with clamps and hooks while Johnson & Johnson's baby shampoo was dropped into them. In 2011, mothers of newborns were arrested when their babies tested positive for exposure to cannabis, a false result caused by the use of Johnson & Johnson’s Head-to-Toe Foaming Baby Wash. Young men have undergone mastectomies to remove breasts grown as a result of Johnson & Johnson antipsychotics, which were used as a result of Johnson & Johnson's criminal promotion of its drugs for off-label purposes. And now, Johnson & Johnson has announced the removal of carcinogenic chemicals from their No More Tears baby shampoo.

For almost two decades I was a victim of what I now am aware was psychiatric torture. I believe because I am a woman, it was easier to become a psychiatric victim and to be denied my right to be human. I got my first bolt of electricity just three days after childbirth on the thirtieth of January 1976. I continued to be electrocuted for the month of February until the middle of March, twelve more times while simultaneously being drugged into oblivion.

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.

The idea of spending more time as a bureaucrat in the US Embassy in Iceland did not appeal to me. I longed for the freedom that academics have. While pursuing that dream I stumbled into the world of international media, “chemical imbalance”, book publishing and a greedy professor of psychiatry which was a prelude to my second annus horribilis.

Delegates attending the International Congress of the Royal College of Psychiatrists at London’s Barbican Centre in June this year will almost certainly not hear about the results of the seven-year outcome of the Dutch First Episode (FE) study widely discussed on Mad in America in recent months.

Stephen Fry’s exploration of manic depression (in the current BBC series on mental health, ‘In the Mind‘) has drawn both praise (because of his attempts to destigmatize mental illness) and criticism (because he appears to have a very narrow biomedical understanding of mental illness).  I have sent an open letter to the actor which challenges some of his assumptions about mental illness, and offers a very different understanding to that promoted in his recent television programme.

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.

In 2007 I returned to school to pursue a bachelor’s degree in psychology. I remember being confused by the over-emphasis on biological treatments for suffering which seemed to me much more spiritual and relational in nature. A few years earlier, my misgivings had been stirred as I sat on a California beach listening to a friend tell me about what it was like to be on Prozac. She told me that she couldn’t really cry anymore, or connect to her deeper feelings. She couldn’t orgasm. I recall my throat closing up, my thoughts running panicky and confused. I was so disturbed by the power of this drug to rob her of her tears and climaxes, experiences I associated with the more private, sacred parts of being human.

My last blog raised issues about the involvement of Shire Pharmaceuticals in lobbying for the inclusion of mandatory screening of children for ADHD in...

It would be a shame if Andrew Scull’s Madness in Civilization did no more than draw well deserved applause for his authorship and historical expertise, and a prominent place in the bibliography of madness. My own copy of Madness in Civilization arrived last week, and it is great; comprehensive, brilliantly written, lots of colourful and many disturbing illustrations. Madness’ continuing story, “From the Bible to Freud, from the Madhouse to Modern Medicine” is told as never before, but there seems to be something missing...

Just this week, a report written by a task force advising on new dietary guidelines commissioned by the US departments of Health and Human Service and Agriculture recognized the importance of nutrition in mental health outcomes for the first time. Is the public ready to accept the importance of nutrition for mental health?

Why do stories matter? Why is it that what a psychiatrist says to a patient about their experiences can have such a powerful effect - for good or for ill? This is something that has puzzled me for many years. It still does.

Facing a sexual abuse lawsuit, the archdiocese of St Paul and Minneapolis made a big deal of putting an independent panel in place to investigate. They put the Reverend Reginald Whitt in charge of appointing the panel and receiving its reports on behalf of the archdiocese. Rev. Whitt told priests and deacons that the task force may review specific files to determine whether the policies of the archdiocese concerning clergy sexual misconduct were properly followed. But, he wrote, “Access to these files will be within my control, and limited only to what is necessary for the task force.” This sounds terribly like the approach Sir Andrew Witty is attempting to put in place for GSK, AbbVie and the rest of the branded pharmaceutical industry vis-a-vis abuses, including child abuse committed in their name. They are asserting their right to spin their version of what it is you put in your body even though this clashes fundamentally with your right to know what you are putting in your body.

The 90s were labeled - rather optimistically - as the ‘decade of recovery.’ More recently, recovery has been placed slap bang central in mental health policy. Is supporting recovery pretty much good common sense? Or is the term being misused to pressure those suffering to behave in certain ways?

In 2009, my friend Leonie’s 22-year-old son Shane killed himself and another young man after taking Citalopram for 17 days. Eighteen days after Shane’s death, Psychiatrist Dr Michael Corry publicly stated his view that he could not have done what he did had he not been on Citalopram. Initially Leonie admits to thinking he was mad. How could medicine prescribed by a doctor have anything to do with what had happened to her son?

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.

Large numbers of studies are being conducted with many claiming internet use causes structural changes in the brain similar to those found in the brains of drug addicts. No snorting, smoking or injecting required. You just have to look at this drug for long enough and your brain is damaged. Is it possible your laptop and mobile phone are the crack cocaine of gadgets?

On Monday a new study was published with the finding that there is a three- to four-fold increase in the rates of Autistic Spectrum Disorder and Developmental Delay in children, especially boys, born to mothers who have been on antidepressants through pregnancy. There are further studies with comparable findings in the offing. Not only this but it looks as though the SSRIs may redefine what it means to be a teratogen. Other teratogens produce their effects in the first trimester of pregnancy when organs are first being formed. But it looks like antidepressants used in the third trimester can lead to autistic spectrum disorder and developmental delay.

A growing appreciation of the importance of involving people in their own health care has seen the development of initiatives such as “patient-centred care.” Patient-centred care has been defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.” While this definition seems reasonable enough, it appears to be very difficult to translate into practice; particularly in the area of mental health.

The idea that our more distressing emotions can best be understood as symptoms of physical illnesses is a pervasive, seductive but harmful myth. It means that our present approach to helping vulnerable people in acute emotional distress is severely hampered by old-fashioned, inhumane and fundamentally unscientific ideas about the nature and origins of mental health problems. We need wholesale and radical change in how we understand mental health problems and in how we design and commission mental health services.