Foreign Correspondents

On Monday night, Irish television screened a documentary covering the events leading to the self inflicted death of Shane Clancy & the other young man he killed. In the documentary, psychiatrist Professor Patricia Casey is quoted as saying that she does not believe the SSRI Shane was taking played any role in the killings and that in her opinion they were caused by an undiagnosed psychiatric illness. Professor Casey did not meet Shane when he was alive. She has never spoken to his family, does not have access to his medical records or family history and has not spoken to his doctor.

It isn’t easy coming to a point in your career where you begin to question widely held beliefs about the nature of mental illness, and how it should be treated. Indeed it becomes starkly obvious that, no matter what you think and believe, even know in your heart to be true, the world runs along different lines. Sometimes I can be full of hope for change, but frequently it angers and frustrates; often I am rendered melancholic by the mountain that lies ahead. Let me explain.

In the 40 years since I was wrongly - and catastrophically - "diagnosed" and "treated," I've seen one after another announcement of supposed "progress" in the "science" of understanding and treating "mental illness" come and go — first trumpeted, then with nary a mention, failing to hold their ground and falling away to the mists of time along with the people and the lives they'd ruined. People will continue to suffer and die if the public do not wake up and have the courage to act as a caring community, and stop regarding human problems as "diseases" to be "cured," rather than as challenges that we share.

One of the main arguments for continuing drug treatment for depression, psychosis and bipolar disorder is that you will get worse from stopping the drugs, especially if they are stopped abruptly. These are findings from mainstream psychiatry. However, if we combine this information with the methodology of the randomized controlled trial, we may see that these drug trials do not show efficacy of drugs, and may not be usable to show safety. The positive side to this is that the trials may actually demonstrate the healing power of our own minds.

The New Zealand government has just published research showing the numbers of children aged 2-14 years being diagnosed with mental disorders has doubled in the last five years with the key driver being an increase in anxiety disorders.

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.

I think I have underestimated just how hard it can be for people to approach mental health problems from a psychological and social perspective. The longer I work with people who are experiencing severe psychological distress, the more they teach me about the difficulties involved in breaking away from an “illness” mindset. Medications, by and large, are still the mainstay of helping people with psychological troubles despite an increasingly widespread acceptance that psychological problems are not medical problems. Mental illness is an “illness” only in the same way that love-sickness is an illness.

In 1995 I had a very frightening experience that I have never discussed publicly before. At that time the main symptoms I was experiencing...

This is a study of psychiatry. It is a study of an area officially a branch of medicine and overwhelmingly seen as legitimate, benign, progressive, and effective. But what if society had it wrong? What if this were not legitimate medicine? Dare we imagine a world where helping is not professionalized, where caring is not commodified. Where, in the spirit of community, we go about the business of life together?

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.

There used to be a wonderful cartoon series called 101 Uses for a Dead Cat, which led me 25 years ago to give a talk at a British Association for Psychopharmacology meeting entitled 101 Uses for a Dead Psychiatrist. That was back in the days when Psychopharmacology meetings were places of debate and the British Journal of Psychiatry was guaranteed to have something of real interest in every issue.

In Medicine there’s a saying “if you hear hoofbeats, don’t look for zebras.” It’s a reference to the wisdom of looking for the most likely explanations when making a diagnosis rather than looking for those that are rare and unusual. Hoofbeats are of course more likely to be the common horse than the rare zebra. My encounters with New Zealand’s pharmacovigilance system over the past four years have been akin to a safari, where I have witnessed scientists involved in pharmacovigilance and medicines regulators wildly hunting zebras while a rather large and obvious horse was standing on their toes.

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.

In recent weeks I have taken part in some very powerful meetings at my work place, the Family Care Foundation. By "powerful" I mean that they have been both moving and demanding, Many people who did not know about us before seeing Daniel Mackler´s movie, Healing Homes, have contacted the Family Care Foundation looking for a place where it is possible to get off pharmaceuticals, and to be supported. Even more importantly, they are longing for a place where they are met as a human being, amongst other human beings.

The BMJ 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.

One of the suggestions in the comments from my last post has really got my imagination going. Chaya Grossberg suggested that we can all edit Wikipedia entries. I went in and got surprised at how easy this was. Then I checked the hit rates on Wikipedia to see how big an impact this could have, and I was totally amazed.

It’s funny how things turn out. I would never have anticipated becoming interested in the way in which psychological treatment is provided to people. A benign comment by a manager at the beginning of my clinical psychology career, however, piqued my interest and things have never been the same since.

If not every week, then very often, we receive requests from people not living in Sweden asking if it would be possible to come to the Family Care Foundation and take part in our shared work. I often day-dream that I have a list of different places in different countries where it was obvious that the main task for the organization and everyone involved was to meet those we call clients and their families in a relational and dialogical way, where it was NOT important at all to define people in terms of diagnosis and where it was NO big deal to support people to get off medication. Where the big deal was about something else: to try to create a safe place and to make sense of experiences and to try to share the very hard things with each other.

Study 329 seems to fit the classic picture: It has Big Pharma ghostwriting articles, hiding data, corrupting the scientific process and leaving a trail of death, disability and grieving relatives in its wake. But is it at fault alone? Both Big Pharma and Big Risk (the insurance industry) were once our allies in keeping our hopes alive – in keeping our children alive and well. They are now a threat. And of the two – Big Risk is the bigger threat.

The area of politics that counts most for most of us is healthcare. Big Healthcare is now the biggest business in the United States and in the Western World. We desperately need a new compact between we the people and those who govern our healthcare – or at least a new compact between the doctors who make money for pharma by putting pills in our mouths and the pharmas of this world. Instead, we are told that to question the judgments of the scientific literature is to engage in an irrational War on Science itself.

When a pharmaceutical company discovers a potential new drug, they undertake a mammoth project. The aim is to amass sufficient evidence that national organizations such as the FDA will approve sale of the drug, and the type of disorders for which it can be openly prescribed – the so-called “on-label” uses. In order to encourage companies to undertake this risk, governments place a pot of gold at the end of the rainbow.

Since the invention of the printing press, community-controlled publications have enabled the voices of those with little power in society to be heard. Gandhi said that without a journal, a community could not be united. Asylum magazine is a printed magazine, in existence since 1986, which provides a place where alternative voices in mental health can be heard.

Stephen Hawking believes there are an infinite number of universes and that alien life exists. Nobel Prize winning physicist Neils Bohr’s interpretation of quantum mechanics shows a cat can be alive and dead simultaneously until we fix it in one state through our observation of it. These are ideas that most people would struggle to see as credible science and yet recent literature reviews reveal that physicists are far more trusted than psychiatrists.

What distinguishes the pharmaceutical industry from the producers of other potentially harmful products, is the fact that, governments have passed legislation allowing detention of potential customers and forced administration of its product to consumers who do not wish to purchase it. Imagine if goverments passed laws allowing other industries to detain potential customers and force them to use their products.

I am proud and happy to announce that our webpage DrivingUsCrazy was launched today. It will help us to get the word out about the international film festival taking place in Gothenburg, 16-18 October, 2015, and also to highlight the issue of madness every day until then — and hopefully for many days afterwards.