Monday, October 25, 2021

Psychiatry Through the Lens of Institutional Corruption

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When you write a book, you usually do so in response to a prompt of some type, and in the process of researching and writing the book, you will come to see your subject in a new way. Psychiatry Under the Influence, a book I co-wrote with Lisa Cosgrove, provided that learning experience, and this is what I now know, with a much greater certainty than before: Our citizenry must develop a clear and cogent response to a medical specialty that, over the past 35 years, has displayed an “institutional corruption” that has done great injury to our society. In fact, I think this is one of the great political challenges of our times.

How Quantitative Mental Health Turns Oppression Into “Depression”

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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 Use of Neuroleptic Drugs As Chemical Restraints

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On July 17, I wrote a post on the use of neuroleptic drugs as chemical restraints in nursing homes.  The article generated some comments, one of which touched on some very fundamental issues which, in my view, warrant further discussion. The comment read as follows: "All drugs can be dangerous toxic chemicals when not used appropriately. While many valid points are made in this article, it’s very one-sided and could be considered biased in that it’s written by a psychologist. I’ve seen many patients and families benefit from their use."

REFOCUS Psychosis Recovery Intervention Ready for Trials

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A new pro-recovery manualized intervention – called the REFOCUS intervention – has been developed and will now be evaluated in a multisite randomized control trials. The strengths-based intervention, which focuses on promoting relationships, is outlined in the latest issue of the British Journal of Psychiatry.

RxISK Stories: If You’re Going to Look After Patients, Man Up

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Pharmalot has just posted a piece - 'Controversial FDA official, Tom Laughren, retires.' This is a must read for anyone with anything to do with mental health - both the post and the comments afterwards where some have posted that they still believe the Black Box warnings on antidepressants arose because of pressure from the Church of Scientology rather than in response to the data.The post will likely seem boring to many. But the comments won't - they seethe with anger.

Sickness Absence From Work: More Anxiety Than Otherwise

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Norwegian, Australian and U.K. researchers find, in a study of 13,436 community members, linked with official records of sickness absence from work (SA), that...

Tapering Neuroleptics: Two Year Results

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A colleague and I have been tracking individuals who elect to reduce their dose of neuroleptic drug. The two year results are presented here.

Binge Eating and Genetics

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Roberto Ferdman recently wrote an article for the Washington Post titled “Why you shouldn’t blame yourself for binge eating.” Long story short, Mr. Ferdman concluded:

“... the next time you find yourself in a rut, and eating too much, know that the unbecoming scene isn’t merely a question of will power – it’s rather, in all likelihood, a matter of your genetic makeup.”

In other words, it’s not you being “lazy” or “weak-willed” or a “bad decision maker” that is causing you to binge-eat. Your binge eating is a consequence of your genes – “a matter of your genetic makeup.” This claim is one of a growing, widespread belief that the definitive way of understanding psychological disorders is by identifying biological correlates and pathologies. However, the evidence strongly suggests that this belief is wrong and dangerous.

The United Met States of Psychiatry

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Psychiatry’s desperate drive to legitimize itself as a profitable medical authority has resulted in a mass delusion so pervasive and destructive that it's put us on a path towards societal collapse. This is not an overstatement, in my opinion, as the statistics are mind-boggling— one in five Americans are on psychiatric drugs. One in five. By my calculations, this means that 62,913,200 people ingest mind-altering, body-altering, spirit-altering pills they believe to be “medications” on a daily basis.

On Religious and Psychiatric Atheism: The Success of Epicurus, the Failure of Thomas Szasz

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When the American psychiatrist Thomas Szasz killed himself a year and a half ago at the age of 92, I thought there would be a global outpouring in psychiatric circles of sympathy or scorn. Instead, his death was largely met with silence, a silence as deafening as the one that attended the second half of his long, prolific, and polemical career. Szasz’ name didn’t show up at all in the APA program last year, and this presentation of mine is apparently the only one to mention him this year. This silent treatment has, ironically enough, and surely against his will, forced him to fulfill the ancient Epicurean ambition to live and die unnoticed.

Responsibility – Legal and Spiritual

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Law and spirituality both deal with the issue of responsibility. The law sets out norms and standards promulgated by authorities in accordance with the procedures established by the state, typically set out in a constitution or governing statute, or according to custom. These norms and standards might or might not reflect accurately a consensus about values and principles that are shared by the people governed by them, and might or might not have been adopted in procedures that are satisfyingly participatory and democratic.

As Opioid Crisis Rages, Some Trade “Tough Love” for Empathy

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From Kaiser Health News: "Two torturous days later, Jeff Duncan came home. While he returned to rehab, the Duncans decided their approach wasn’t working....

A Response to the Hyper-focus on Brain-based Research and “Disease”

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The past several years have born exciting developments for those critical of the current psychiatric paradigm. We have witnessed outright criticism of the DSM by prominent psychiatrists (i.e., Thomas Insel, Allen Frances) while others have admitted that no “biological markers” exist for any DSM-defined disorder. Amazingly, however, the suggested response to these problems is to continue pursuing the search for the biological underpinnings of so-called “mental illness” through an almost evangelical hyper-focus on brain research.

A Discussion of Justina Pelletier and Boston Children’s Hospital

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Justina Pelletier, who lived with her parents in Connecticut, had been diagnosed with mitochondrial disease, a rare and debilitating illness, and had been receiving treatment for this from Mark Korson, MD, Chief of Metabolism Services at Tufts Medical Center in Boston. In February of last year, Justina's parents took her to Boston Children's Hospital with flu-like symptoms. Dr. Korson had recommended an admission to Boston Children's so that Justina could be seen by Alex Flores, MD, a gastrointestinal specialist who had recently transferred from Tufts to BCH. But instead, Justina's care was taken over by the psychiatry department.

Lee Coleman – The Insanity Defence, Storytelling on the Witness Stand

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An interview with Doctor Lee Coleman, in which we focus on psychiatry in the courtroom and why the psychiatric expert witness role may be failing both the individual on trial and society at large.

In Time for RXmas: Motivational Pharmacotherapy

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Drug profitability requires three parties to work together – drug companies to make the drugs, psychiatrists to prescribe them and consumers to take them. Too often, though, patients have failed to play nicely and do their bit. They have banged on about tiresome things like adverse reactions and alternative treatments, they have expressed foolish opposition to the very concept of pharmacotherapy and questioned its efficacy. They have become medication non-compliant and undermined the profits of the pharmaceutical industry and the authority of psychiatry. They have been bad and landed themselves on a lot of people’s naughty lists and made the World Health Organization very sad and worried.

Why Screening Everyone for Depression is a Terrible Idea

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Too many people have come to view themselves as defective and powerless to change their life situations, when this may not be the case. Conversely, individual treatment with drugs or psychotherapy may cause individuals to reframe their problems in terms of neurochemistry or thinking styles – internalizing a belief that they are the problem, when their problems exist in a wider sociopolitical milieu.

Born to Sense: High Sensitivity+Trauma = Psychiatric Diagnosis?

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It's important that the potential for connection between high sensitivity, trauma and psychiatric diagnosis be explored.   Even if it could be proven that I were born more sensitive,  I have no idea how the way in which I interact with my everyday world may or may not be interrelated to the shape of my reactions to trauma overall (the same reactions that have, for me, led to psychiatric diagnosis).

Madness and the Family: What Helps, and What Makes Things Worse?

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Families are often very important for people encountering severe mental and emotional difficulties. But how can family members really know what is helpful, and what is likely to make things worse for the person having problems? Similarly, for those who want to help families, how can they know what will really be helpful for those families, and what will make things worse?

A Challenge to Dr. Lieberman

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On a national Canadian radio show on Sunday (April 26), former APA president Jeffrey Lieberman called me a "menace to society" for my writings on the long-term effects of psychiatric medications (and other writings.) He said there was abundant evidence that psychiatric medications improved long-term outcomes for various psychiatric disorders. And so now we would like to issue a challenge: Dr. Lieberman, please point out these studies for us.

Trauma, First-Episode Schizophrenia, and Brain-Derived Neurotrophic Factor

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A team of Egyptian researchers found, in a sample of 74 outpatients, a relationship between trauma and first-episode schizophrenia, with a "mediating" role of...

Generative Narratives and the Counterculture Psychiatrists

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For outsiders like me who are really critical of mainstream psychiatry, the first thing to understand is that "community psychiatry" is a counterculture within the larger culture of biomedical psychiatry. When I say "counterculture" I don't mean these people had flowers in their hair or face piercings.

A New Mental Health System? Interview with Jim van Os

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Dr. Jim van Os presents something unlike any other psychiatrist I have come across: a clear vision, and a pathway, for dismantling the existing mental health system and replacing it with something new that actually works. And he is doing it with all the status and prestige not only of a psychiatry insider, but as one of the world's leading scientists. Along with changes in the definitions of health and psychosis, van Os describes pilot programs now underway in The Netherlands to establish small, human-scale services — inspired by Open Dialogue — that engage the social network of people in distress. And, inspired by the best of the US "peer" movement, by involving people who have themselves recovered from madness in a treatment role.

Transcranial Magnetic Stimulation

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TMS is a psychiatric treatment that uses a rapidly alternating magnetic field to induce electric currents in the brain. These currents stimulate neurons, causing them to "fire." When used repetitively, TMS is said to alter the excitability of the brain area that has been stimulated. In the psychiatric field, TMS is being used increasingly as a treatment for depression, particularly with so-called treatment-resistant clients. I Googled the string "TMS + depression" and got 1.35 million hits. So the idea is attracting attention.
Mickey Nardo (photo by Abby Nardo)

Farewell Mickey Nardo, 1 (not very) Boring Old Man

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Mickey studied how the intimacy between leading academic psychiatrists and the pharmaceutical companies had impacted our profession. His blog was a treasure trove of analysis and information. Mickey did some heavy lifting, and for that we are all indebted.

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